Preterm Birth

The increasing prevalence of preterm birth in the United States is a complex public health problem that requires multifaceted solutions. Preterm birth is a cluster of problems with a set of overlapping factors of influence. Its causes may include individual-level behavioral and psychosocial factors, sociodemographic and neighborhood characteristics, environmental exposure, medical conditions, infertility treatments, and biological factors. Many of these factors co-occur, particularly in those who are socioeconomically disadvantaged or who are members of racial and ethnic minority groups. While advances in perinatal and neonatal care have improved survival for preterm infants, those infants who do survive have a greater risk than infants born at term for developmental disabilities, health problems, and poor growth. The birth of a preterm infant can also bring considerable emotional and economic costs to families and have implications for public-sector services, such as health insurance, educational, and other social support systems. Preterm Birth assesses the problem with respect to both its causes and outcomes. This book addresses the need for research involving clinical, basic, behavioral, and social science disciplines. By defining and addressing the health and economic consequences of premature birth, this book will be of particular interest to health care professionals, public health officials, policy makers, professional associations and clinical, basic, behavioral, and social science researchers. Table of Contents Front Matter Summary 1 Introduction SECTION I Measurement : 2 Measurement of Fetal and Infant Maturity Section I Recommendations SECTION II Causes of Preterm Birth: 3 Behavioral and Psychosocial Contributors to Preterm Birth 4 Sociodemographic and Community Factors Contributing to Preterm Birth 5 Medical and Pregnancy Conditions Associated with Preterm Birth 6 Biological Pathways Leading to Preterm Birth 7 Role of Gene-Environment Interactions in Preterm Birth 8 Role of Environmental Toxicants in Preterm Birth Section II Recommendations SECTION III Diagnosis and Treatment of Preterm Labor: 9 Diagnosis and Treatment of Conditions Leading to Spontaneous Preterm Birth Section III Recommendations SECTION IV Consequences of Preterm Birth: 10 Mortality and Acute Complications in Preterm Infants 11 Neurodevelopmental, Health, and Family Outcomes for Infants Born Preterm 12 Societal Costs of Preterm Birth Section IV Recommendations SECTION V Research and Policy: 13 Barriers to Clinical Research on Preterm Birth and Outcomes of Preterm Infants 14 Public Policies Affected by Preterm Birth Section V Recommendations 15 A Research Agenda to Investigate Preterm Birth References Appendix A Data Sources and Methods Appendix B Prematurity at Birth: Determinents, Consequences, and Geographic Variation Appendix C A Review of Ethical Issues involved in Premature Birth Appendix D A Systematic Review of Costs Associated with Preterm Birth Appendix E Selected Programs Funding Preterm Birth Research Appendix F Committee and Staff Biographies Index