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Preterm Birth: Causes, Consequences, and Prevention (2007)
Board on Health Sciences Policy (HSP)

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308
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Preterm Birth: Causes, Consequences, and Prevention

Section III
Diagnosis and Treatment of Preterm Labor

RECOMMENDATIONS


Recommendation III-1: Improve methods for the identification and treatment of women at increased risk of preterm labor. Researchers should investigate ways to improve methods to identify and treat women with an increased risk of preterm labor.


Specifically:


  • The content and structure of prenatal care should include an assessment of the risk of preterm labor.

  • Improved methods for the identification of women at increased risk of preterm labor both before pregnancy and in the first and second trimesters are needed.

  • Combinations of known markers of preterm labor (e.g., a prior preterm birth, ethnicity, a short cervix, and biochemical and biophysical markers) and potential new markers (e.g., genetic markers) should be studied to allow the creation of an individualized composite assessment of risk.

  • More accurate methods are needed to

    • diagnose preterm labor,

    • assess fetal health to identify women and fetuses that are and that are not candidates for the arrest of labor, and

    • arrest labor.

 Page
308
Front Matter (R1-R18)
Summary (1-30)
1 Introduction (31-52)
SECTION I Measurement : 2 Measurement of Fetal and Infant Maturity (53-83)
Section I Recommendations (84-86)
SECTION II Causes of Preterm Birth: 3 Behavioral and Psychosocial Contributors to Preterm Birth (87-123)
4 Sociodemographic and Community Factors Contributing to Preterm Birth (124-147)
5 Medical and Pregnancy Conditions Associated with Preterm Birth (148-168)
6 Biological Pathways Leading to Preterm Birth (169-206)
7 Role of Gene-Environment Interactions in Preterm Birth (207-228)
8 Role of Environmental Toxicants in Preterm Birth (229-254)
Section II Recommendations (255-258)
SECTION III Diagnosis and Treatment of Preterm Labor: 9 Diagnosis and Treatment of Conditions Leading to Spontaneous Preterm Birth (259-307)
Section III Recommendations (308-310)
SECTION IV Consequences of Preterm Birth: 10 Mortality and Acute Complications in Preterm Infants (311-345)
11 Neurodevelopmental, Health, and Family Outcomes for Infants Born Preterm (346-397)
12 Societal Costs of Preterm Birth (398-429)
Section IV Recommendations (430-432)
SECTION V Research and Policy: 13 Barriers to Clinical Research on Preterm Birth and Outcomes of Preterm Infants (433-454)
14 Public Policies Affected by Preterm Birth (455-472)
Section V Recommendations (473-476)
15 A Research Agenda to Investigate Preterm Birth (477-492)
References (493-590)
Appendix A Data Sources and Methods (591-603)
Appendix B Prematurity at Birth: Determinents, Consequences, and Geographic Variation (604-643)
Appendix C A Review of Ethical Issues involved in Premature Birth (644-687)
Appendix D A Systematic Review of Costs Associated with Preterm Birth (688-724)
Appendix E Selected Programs Funding Preterm Birth Research (725-731)
Appendix F Committee and Staff Biographies (732-740)
Index (741-772)

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OCR for page 308
Preterm Birth: Causes, Consequences, and Prevention Section III Diagnosis and Treatment of Preterm Labor RECOMMENDATIONS Recommendation III-1: Improve methods for the identification and treatment of women at increased risk of preterm labor. Researchers should investigate ways to improve methods to identify and treat women with an increased risk of preterm labor. Specifically: The content and structure of prenatal care should include an assessment of the risk of preterm labor. Improved methods for the identification of women at increased risk of preterm labor both before pregnancy and in the first and second trimesters are needed. Combinations of known markers of preterm labor (e.g., a prior preterm birth, ethnicity, a short cervix, and biochemical and biophysical markers) and potential new markers (e.g., genetic markers) should be studied to allow the creation of an individualized composite assessment of risk. More accurate methods are needed to diagnose preterm labor, assess fetal health to identify women and fetuses that are and that are not candidates for the arrest of labor, and arrest labor.

OCR for page 309
Preterm Birth: Causes, Consequences, and Prevention The success of perinatal care during preterm birth should be based primarily on perinatal morbidity and mortality rates as well as the rate of preterm birth, the numbers of infants born with low birth weights, or neonatal morbidity and mortality.

OCR for page 310
Preterm Birth: Causes, Consequences, and Prevention This page intentionally left blank.

Representative terms from entire chapter:

children born