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OCR for page R1
Preventing l:~ow Birthweight
~ Summary ~
Committee to Study the
Prevention of Low Birthweight
Division of Health Promotion
and Disease Prevention
INSTITUTE OF MEDICINE
NATIONAL ACADEMY PRESS
Washington, D.C. 1985
OCR for page R2
NATIONAL ACADEMY PRESS 2101 Constitution Avenue, NW Washington, DC 20418
NOTICE: The project that is the subject of this report was approved by the Governing Board of
the National Research Council, whose members are drawn from the councils of the National
Academy of Sciences, the National Academy of Engineering, and the Institute of Medicine.
The members of the committee responsible for the report were chosen for their special
competences and with regard for appropriate balance.
This report has been reviewed by a group other than the authors according to the proce-
dures approved by a Report Review Committee consisting of members of the National
Academy of Sciences, the National Academy of Engineering, and the Institute of Medicine.
The Institute of Medicine was chartered in 1970 by the National Academy of Sciences to
enlist distinguished members of the appropriate professions in the examination of policy
matters pertaining to the health of the public. In this, the Institute acts under both the
Academy's 1863 congressional charter responsibility to be an adviser to the federal govern-
ment and its own initiative in identifying issues of medical care research, and education.
Library of Congress Catalog Card Number 85-60083
International Standard Book Number 0-309-03535-X
Text prepared by Eve K. Nichols
Cover photo by Susie Fitzhugh for Children's Hospital National Medical Center, Washington,
D.C.
The full report on which this summary is based is available for sale from the National
Academy Press at the above address. (Preventing Low Birthweight, 284 pages)
Copyright ~ 1985 by the National Academy of Sciences
No part of this book may be reproduced by any mechanical, photographic, or electronic
process or in the form of a phonographic recording, nor may it be stored in a retrieval system,
transmitted, or otherwise copied for public or private use, without written permission from
the publisher, except for the purposes of official use by the United States Government.
First Printing, January 1985
Second Printing, May 1985
Third Printing, January 1986
Fourth Printing, August 198 7
Fifth Printing, November 19 87
Sixth Printing, September 1988
Seventh Printing, November 1989
Printed in the United States of America
OCR for page R3
Committee to Study the
Prevention of Low Birthweight
RICHARD E. BEHRMAN, Chairman, Committee to Study the Prevention of
Low Birthweight, Institute of Medicine, and Dean, School of Medicine,
Case Western Reserve University, Cleveland, Ohio
JEFFREY E. HARRIS, Associate Professor, Department of Economics,
Massachusetts Institute of Technology, Cambridge, Massachusetts, and
Clinical Associate, Massachusetts General Hospital, Boston, Massachusetts
CALVIN I. HOBEL, Professor of Obstetrics, Gynecology and Pediatrics, School
of Medicine, University of California at Los Angeles, and Director,
Maternal-Fetal Medicine, Cedars Sinai Medical Center, Los Angeles,
California
JEROME O. KLEIN, Professor of Pediatrics, Boston University School of
Medicine, and Director, Division of Pediatric Infectious Diseases, Boston
City Hospital, Boston, Massachusetts
LUELLA KLEIN, President, American College of Obstetricians and
Gynecologists, and Professor of Gynecology and Obstetrics, Emory
University School of Medicine, Atlanta, Georgia
MARIE C. MCCORMICK, Assistant Professor of Pediatrics, University of
Pennsylvania School of Medicine, Philadelphia, Pennsylvania
JAMES METCALFE, Professor of Medicine, Oregon Health Sciences University,
Portland, Oregon
C. ARDEN MILLER, Professor and Chairman, Department of Maternal and
Child Health, School of Public Health, University of North Carolina at
Chapel Hill, Chapel Hill, North Carolina
JOHN T. QUEENAN, Professor and Chairman, Department of Obstetrics and
Gynecology, Georgetown University Hospital, Washington, D.C.
JULIUS B. RICHMOND, Director, Division of Health Policy Research and
Education, and John D. MacArthur Professor of Health Policy and
Management, Harvard University, Boston, Massachusetts
JUDITH P. ROOKS, President, American College of Nurse-Midwives, Portland,
Oregon
SAM SHAPIRO, Professor of Health Policy and Management, and Past
Director, Health Services Research and Development Center, School of
Hygiene and Public Health, Johns Hopkins University, Baltimore,
Maryland
Study Staff
SARAH S. BROWN, Study Director, Committee to Study the Prevention of
Low Birthweight
ENRIQUETA C. BOND, Director, Division of Health Promotion and Disease
Prevention
. . .
OCR for page R4
STEPHANIE C. BRUGLER, Research Assistant, Division of Health Promotion
and Disease Prevention
EVE K. NICHOLS, Editor, Division of Health Promotion and Disease
Prevention
WALLACE K. WATERFALL, Editor, Institute of Medicine
LINDA DEPUGH, Administrative Secretary, Division of Health Promotion and
Disease Prevention
NAOMI HUDSON, Administrative Secretary, Division of Health Sciences
Policy
Consultant
LORRAINE KLERMAN, Professor of Public Health and Head, Division of
Health Services Administration, Department of Epidemiology and Public
Health, School of Medicine, Yale University, New Haven, Connecticut
The authors of the many commissioned and contributed papers used by
the committee in developing this statement are listed in the full report, of
which this is only a summary.
1V
OCR for page R5
Contents
Introduction
The Low Birthweight Problem
Causes of Low Birthweight
Planning for Pre~nanev
The Impact of Prenatal Care
Ensuring Access to Prenatal Care
Improving the Content of Prenatal Care
A Public Information Program
References
v
15
18
21
27
35
36
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