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Preterm Birth: Causes, Consequences, and Prevention
survival with high-risk intensive care services after they are born (17–19). Beyond the elevated health care costs of newborn premature infants, however, those born preterm have an appreciable risk of long-term neurological impairment and developmental delay (20–22). The ongoing medical and support service needs of these infants and their families add to the overall health care system cost burden over time and emphasize the continuing health and developmental problems that some preterm infants face. Finally, the high preterm birth rates in the United States have been identified as a major contributor to this nation’s relatively poor ranking in infant mortality among other developed countries (23). Although low birth weight has often received greater attention than preterm birth as the leading factor underlying poor pregnancy outcomes in the United States, it has been recognized that to successfully address these problems, the “key goal is prevention of preterm birth” (23).
Policy makers and the public need to be kept informed of the rapid developments in research and their implications for clinical practice and public programs and policies. Because of the continuing problem that premature birth poses in the United States and other countries, as well as the rapid and ongoing developments in research in this area, there has been a recognized need for periodic forums, reports, and public investigative committees that would increase knowledge and awareness of evolving strategies for the prevention of preterm birth. In 1985, the Institute of Medicine released the report of its Committee to Study the Prevention of Low Birth Weight (24). That report addressed the epidemiology of low birth weight and assessed preventive approaches for cost and effectiveness. That same year, Émile Papiernik, an international French innovator and leader in prematurity research, organized a conference in Evian, France, entitled Prevention of Preterm Birth: New Goals and New Practices in Prenatal Care. That conference focused on reducing the risk of preterm labor and delivery and offered participants an opportunity to disclose their latest research findings (25). A follow-up to the 1985 Evian conference was held in the United States in 1988. That conference, Advances in the Prevention of Low Birth Weight, was hosted by H. Berendes, S. Kessel, and S. Yaffe and focused on the results of clinical trials and community-based interventions aimed at reducing low birth weight (25). Yet another follow-up to those conferences, The International Conference on Preterm Birth: Etiology, Mechanisms and Prevention, was held in 1997 (26). That conference was also developed to provide an overview of studies in preterm birth research, a review of risk factors and potential etiologic pathways, and an assessment of the then current intervention and prevention strategies.
Other reports, conferences, and national efforts, including the current Prematurity Campaign of the National March of Dimes, have been developed over the last 2 decades to address the widely perceived problem of