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The Role of Environmental Hazards in Premature Birth Workshop Summary (2003) / Chapter Skim
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Summary
Pages 1-5

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From page 1...
... Sometimes, the Roundtable convenes workshops to explore issues in greater depth and facilitate discussion. This is a summary of a workshop convened by the Roundtable on October 2-3, 2001, to look at the issues surrounding the role of the environment in premature birth.
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From page 2...
... The discussion of preterm birth is confused by a lack of firm agreement about, and understanding of, what constitutes "preterm." The length of the natural term of pregnancy exhibits tremendous variability, and the gestational period for an infant with low birth weight can be within a normal range. Further, the assignment of due dates for delivery is an inaccurate clinical practice.
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From page 3...
... This research suggests possible etiologic pathways to preterm birth, offers insights into methodological challenges, and identifies potential confounding factors. At present, strong predictors of preterm birth are limited to multiple gestation, prior preterm birth, and African-American ethnicity; weaker but modifiable influences include infection, tobacco use, low prepregnancy weight, and lower socioeconomic status.
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From page 4...
... The gene-environment approach is likely to improve knowledge of the pathogenesis of preterm birth and to help develop a generic analytical approach to understanding the genetic contribution in populations with marked differences in social status and experience. Conventional interventions to reduce spontaneous preterm birth include prenatal care, across-the-board nutritional supplementation, and social support or home visiting.
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From page 5...
... SUMMARY s Some workshop participants questioned whether the disappointing trend toward an increase in preterm birth rate reflects a failure to prevent preterm delivery, or whether it results from relying on the increased use of early ultrasound for estimating gestational age, early delivery for extreme fetal growth retardation and severe preeclampsia, multiple gestation, inclusion of newborns near the borderline of viability on registries, or changes in sociodemographic or behavioral determinants of preterm birth. These questions can be answered, many participants concluded, by conducting carefully designed interdisciplinary studies that account for the environmental influences and biological mechanisms that cause a pregnancy to end prematurely, placing the fetus, and sometimes the mother, at increased risk.
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Key Terms

  • fetal growth
  • uterine activity
  • prenatal care
  • birth weight
  • reduced mortality

  • multiple gestation
  • preterm labor
  • low birth
  • growth restriction
  • medical expenditures

  • normal pregnancy
  • preterm births
  • reproductive biologists
  • predictive value
  • exhibits tremendous

  • neonatal morbidity
  • reduced rates
  • conventional interventions
  • birth include
  • acute event

  • various populations
  • help develop
  • caloric supplementation
  • estimates indicate
  • potential increase

  • carefully programmed
  • little success
  • uterine quiescence
  • normal range
  • nutrition counseling


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