Preventing low birthweight / Committee to Study the Prevention of Low Birthweight, Division of Health Promotion and Disease Prevention, Institute of Medicine.

Format:

Book

Author/Creator:

Institute of Medicine (U.S.). Committee to Study the Prevention of Low Birthweight.

Language:

English

Subjects (All):

Birth weight, Low--United States.

Birth weight, Low.

Premature infants--United States.

Premature infants.

Physical Description:

1 online resource (296 p.)

Edition:

1st ed.

Place of Publication:

Washington, D.C. : National Academy Press, 1985.

Language Note:

English

Summary:

Despite recent declines in infant mortality, the rates of low birthweight deliveries in the United States continue to be high. Part I of this volume defines the significance of the problems, presents current data on risk factors and etiology, and reviews recent state and national trends in the incidence of low birthweight among various groups. Part II describes the preventive approaches found most desirable and considers their costs. Research needs are discussed throughout the volume.

Contents:

Preventing Low Birthweight

Copyright

PREFACE

ACKNOWLEDGMENTS

Contents

SUMMARY AND RECOMMENDATIONS

ETIOLOGY AND RISK FACTORS

TRENDS IN LOW BIRTHWEIGHT

AN OVERVIEW OF PREVENTIVE APPROACHES

PLANNING FOR PREGNANCY

ENSURING ACCESS TO PRENATAL CARE

A System of Accountability

IMPROVING THE CONTENT OF PRENATAL CARE

Programs Complementary to Prenatal Care

Encouraging Change in Prenatal Care

Research Needs

A PUBLIC INFORMATION PROGRAM

COST ISSUES

PART I DEFINITIONS, RISK FACTORS, AND TREND

Chapter 1 The Significance of Low Birthweight

CURRENT CONCEPTS OF FETAL GROWTH

BIRTHWEIGHT AND INFANT MORTALITY

Postneonatal Mortality

Effect of Gestational Age and Other Risk Factors

Current Decline in Neonatal Mortality

LOW BIRTHWEIGHT AND MORBIDITY

Neurodevelopmental Handicaps

The Risk of Congenital Anomalies

Respiratory Tract Conditions

Complications of Neonatal Care

Nonspecific Morbidity

Injury

Use of Health Services

Family Function

Financial Stress

Overall Contribution of Low Birthweight To Morbidity

Decreasing Mortality: the Effect on Morbidity

SUMMARY

REFERENCES AND NOTES

Chapter 2 Etiology and Risk Factors

ETIOLOGY

Prematurity

Intrauterine Growth Retardation (IUGR)

RISK FACTORS: AN OVERVIEW

DEMOGRAPHIC RISKS

Race

Age

Socioeconomic Status

MEDICAL AND OBSTETRIC RISKS

Hypertension/Preeclampsia

Diabetes

Obstetric History

Multiple Pregnancy

Infections

NUTRITION

BEHAVIORAL AND ENVIRONMENTAL RISKS

Smoking

Alcohol

IATROGENIC RISKS

EVOLVING CONCEPTS OF RISK

Stress

Uterine Irritability

Cervical Changes

Inadequate Plasma Volume Expansion

Progesterone Deficiency

RISK ASSESSMENT

Screening for Obstetric Risk

Strengths and Limitations

Improving Risk Assessment

CONCLUSIONS.

References

Chapter 3 Trends in Low Birthweight

OVERALL TRENDS IN LOW BIRTHWEIGHT RATES

THE COMPOSITION OF LOW-WEIGHT BIRTHS

SOCIODEMOGRAPHIC CHARACTERISTICS

PREGNANCY HISTORY

PRENATAL CARE

ANALYSIS OF 1981 SINGLE LIVE BIRTHS IN THE UNITED STATES

CONCLUSIONS

References and Notes

PART II REDUCING THE INCIDENCE OF LOW BIRTHWEIGHT

Chapter 4 An Overview of Promising Interventions

PROMISING STRATEGIES

NATIONAL DIRECTION FOR AN NATIONAL PROBLEM

Chapter 5 Planning for Pregnancy

PREPREGNANCY RISK IDENTIFICATION AND REDUCTION

ENLARGING THE CONTENT OF HEALTH EDUCATION

THE ROLE OF FAMILY PLANNING IN REDUCING LOW BIRTHWEIGHT

Unmet Need for Family Planning

Chapter 6 The Effectiveness of Prenatal Care

ISSUES IN STUDYING THE EFFECTS OF PRENATAL CARE

Research Design

Defining Prenatal Care

Validity of Data

Control Variables

Selection Bias

REVIEW OF STUDIES OF PRENATAL CARE EFFECTS

Results of Studies Using Large Data Bases

Results of Program Evaluations

Chapter 7 Ensuring Access to Prenatal Care

WHO RECEIVES INADEQUATE PRENATAL CARE?

Time Trends

WHY DO SOME WOMEN OBTAIN INADEQUATE PRENATAL CARE?

FINANCIAL CONSTRAINTS

MATERNITY CARE PROVIDERS

Obstetrician-Gynecologists

Nurse-Midwives and Obstetrical Nurse Practitioners

INSUFFICIENT PRENATAL CARE SERVICES

WOMEN'S EXPERIENCES, ATTITUDES, AND BELIEFS

TRANSPORTATION AND CHILD CARE

INCREASING THE CAPACITY FOR OUTREACH

Outreach Personnel

Outreach Through Program Links

A SYSTEM OF ACCOUNTABILITY AND RESPONSIBILITY

Chapter 8 Improving the Content of Prenatal Care

CARE FOR ALL PREGNANT WOMEN

Care For Women at Risk of Preterm Delivery.

Care for Women at Risk of Intrauterine Growth Retardation

PROGRAMS COMPLEMENTARY TO PRENATAL CARE

Smoking Reduction Programs

Prenatal Nutrition Intervention: WIC

Stress and Fatigue Alleviation

ENCOURAGING CHANGE IN PRENATAL SERVICES

RESEARCH NEEDS

Describing the Current Content

Research on Individual Care Components

Clinical Topics

Behavioral and Environmental Topics

Research on Combinations of Interventions

Chapter 9 A Public Information Program

CONDITIONS FOR SUCCESS

Social Support

Consistency of Effort

Use of Multiple Mass Media

Audience Definition and Message Development

Quality of Materials

A PUBLIC INFORMATION PROGRAM ON LOW BIRTHWEIGHT PREVENTION

Program Objectives and Audience

Messages

Information Channels

Leadership and Organizational Structure

References

Chapter 10 Prenatal Care and Low Birthweight: Effects on Health Care Expenditures

OVERVIEW OF THE ANALYSIS

Target Population

Unit Cost of Prenatal Care

Total Cost of Prenatal Care

Costs of Care of Low-Weight Births

Estimated Cost Savings

Additional Assumptions and Comments

DESCRIPTION OF COSTS

Prenatal and Delivery Costs

Initial Hospitalization Costs

Rehospitalization Costs

Long-Term Morbidity Costs

RESULTS OF THE COST COMPARISON

New Prenatal Care Expenditures

Savings in the Cost of Caring for Low Birthweight Children

Overall Cost Savings

APPENDIXES

Appendix A Risk Factors Associated with Low Birthweight

Additional Reading On Risks Associated with Low Birthweight

Appendix B Data On Selected Low Birthweight Trends

Appendix C A Summary of Three Prematurity Prevention Programs.

Appendix D Notes On National Data Available To Study Low Birthweight Trends and To Monitor Related Programs

Data Sources

Data Needs

INDEX.

Notes:

Bibliographic Level Mode of Issuance: Monograph

Includes bibliographical references and index.

ISBN:

9786610222278

9780309306201

0309306205

9781280222276

1280222271

9780309542074

0309542073

9780585168593

0585168598

OCLC:

44965306