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OCR for page 84
Preterm Birth: Causes, Consequences, and Prevention Section I Measurement RECOMMENDATIONS Recommendation I-1: Promote the collection of improved perinatal data. The National Center for Health Statistics of the Centers for Disease Control and Prevention should promote and use a national mechanism to collect, record, and report perinatal data. The following key elements should be included: The quality of gestational age measurements in vital records should be evaluated. Vital records should indicate the accuracy of the gestational age determined by ultrasound early in pregnancy (less than 20 weeks of gestation). Birth weight for gestational age should be considered one measure of the adequacy of fetal growth. Perinatal mortality and morbidity should be reported by gestational age, birth weight, and birth weight for gestational age. A categorization or coding scheme that reflects the heterogeneous etiologies of preterm birth should be developed and implemented. Vital records should also state whether fertility treatments (including in vitro fertilization and ovulation promotion) were used. The committee recognizes that the nature of these data is private and sensitive.
OCR for page 85
Preterm Birth: Causes, Consequences, and Prevention Recommendation I-2: Encourage the use of ultrasound early in pregnancy to establish gestational age. Because it is recognized that more precise measures of gestational age are needed to move the field forward, professional societies should encourage the use of ultrasound early in pregnancy (less than 20 weeks of gestation) to establish gestational age and should establish standards of practice and recommendations for the training of personnel to improve the reliability and the quality of ultrasound data. Recommendation I-3: Develop indicators of maturational age. Funding agencies should support and investigators should develop reliable and precise perinatal (prenatal and postnatal) standards as indicators of maturational age.
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