National Academies Press: OpenBook

Preterm Birth: Causes, Consequences, and Prevention (2007)

Chapter: Section I Recommendations

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Suggested Citation:"Section I Recommendations ." Institute of Medicine. 2007. Preterm Birth: Causes, Consequences, and Prevention. Washington, DC: The National Academies Press. doi: 10.17226/11622.
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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.

Suggested Citation:"Section I Recommendations ." Institute of Medicine. 2007. Preterm Birth: Causes, Consequences, and Prevention. Washington, DC: The National Academies Press. doi: 10.17226/11622.
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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.

Suggested Citation:"Section I Recommendations ." Institute of Medicine. 2007. Preterm Birth: Causes, Consequences, and Prevention. Washington, DC: The National Academies Press. doi: 10.17226/11622.
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Suggested Citation:"Section I Recommendations ." Institute of Medicine. 2007. Preterm Birth: Causes, Consequences, and Prevention. Washington, DC: The National Academies Press. doi: 10.17226/11622.
×
Page 84
Suggested Citation:"Section I Recommendations ." Institute of Medicine. 2007. Preterm Birth: Causes, Consequences, and Prevention. Washington, DC: The National Academies Press. doi: 10.17226/11622.
×
Page 85
Suggested Citation:"Section I Recommendations ." Institute of Medicine. 2007. Preterm Birth: Causes, Consequences, and Prevention. Washington, DC: The National Academies Press. doi: 10.17226/11622.
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Page 86
Next: SECTION II Causes of Preterm Birth: 3 Behavioral and Psychosocial Contributors to Preterm Birth »
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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.

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