07503nam 2200625Ia 450 991081222500332120240417000135.00-309-30620-51-280-22227-197866102222780-309-54207-30-585-16859-8(CKB)111004366656344(OCoLC)44965306(CaPaEBR)ebrary10063004(SSID)ssj0000226810(PQKBManifestationID)11199675(PQKBTitleCode)TC0000226810(PQKBWorkID)10258494(PQKB)10391984(MiAaPQ)EBC3377044(Au-PeEL)EBL3377044(CaPaEBR)ebr10063004(CaONFJC)MIL22227(OCoLC)923267858(EXLCZ)9911100436665634419850523d1985 ua 0engurcn|||||||||txtccrPreventing low birthweight /Committee to Study the Prevention of Low Birthweight, Division of Health Promotion and Disease Prevention, Institute of Medicine1st ed.Washington, D.C. National Academy Press19851 online resource (296 p.) Bibliographic Level Mode of Issuance: Monograph0-309-03530-9 Includes bibliographical references and index.Preventing Low Birthweight -- Copyright -- PREFACE -- ACKNOWLEDGMENTS -- Contents -- SUMMARY AND RECOMMENDATIONS -- ETIOLOGY AND RISK FACTORS -- TRENDS IN LOW BIRTHWEIGHT -- AN OVERVIEW OF PREVENTIVE APPROACHES -- PLANNING FOR PREGNANCY -- ENSURING ACCESS TO PRENATAL CARE -- A System of Accountability -- IMPROVING THE CONTENT OF PRENATAL CARE -- Programs Complementary to Prenatal Care -- Encouraging Change in Prenatal Care -- Research Needs -- A PUBLIC INFORMATION PROGRAM -- COST ISSUES -- PART I DEFINITIONS, RISK FACTORS, AND TREND -- Chapter 1 The Significance of Low Birthweight -- CURRENT CONCEPTS OF FETAL GROWTH -- BIRTHWEIGHT AND INFANT MORTALITY -- Postneonatal Mortality -- Effect of Gestational Age and Other Risk Factors -- Current Decline in Neonatal Mortality -- LOW BIRTHWEIGHT AND MORBIDITY -- Neurodevelopmental Handicaps -- The Risk of Congenital Anomalies -- Respiratory Tract Conditions -- Complications of Neonatal Care -- Nonspecific Morbidity -- Injury -- Use of Health Services -- Family Function -- Financial Stress -- Overall Contribution of Low Birthweight To Morbidity -- Decreasing Mortality: the Effect on Morbidity -- SUMMARY -- REFERENCES AND NOTES -- Chapter 2 Etiology and Risk Factors -- ETIOLOGY -- Prematurity -- Intrauterine Growth Retardation (IUGR) -- RISK FACTORS: AN OVERVIEW -- DEMOGRAPHIC RISKS -- Race -- Age -- Socioeconomic Status -- MEDICAL AND OBSTETRIC RISKS -- Hypertension/Preeclampsia -- Diabetes -- Obstetric History -- Multiple Pregnancy -- Infections -- NUTRITION -- BEHAVIORAL AND ENVIRONMENTAL RISKS -- Smoking -- Alcohol -- IATROGENIC RISKS -- EVOLVING CONCEPTS OF RISK -- Stress -- Uterine Irritability -- Cervical Changes -- Inadequate Plasma Volume Expansion -- Progesterone Deficiency -- RISK ASSESSMENT -- Screening for Obstetric Risk -- Strengths and Limitations -- Improving Risk Assessment -- CONCLUSIONS.References -- Chapter 3 Trends in Low Birthweight -- OVERALL TRENDS IN LOW BIRTHWEIGHT RATES -- THE COMPOSITION OF LOW-WEIGHT BIRTHS -- SOCIODEMOGRAPHIC CHARACTERISTICS -- PREGNANCY HISTORY -- PRENATAL CARE -- ANALYSIS OF 1981 SINGLE LIVE BIRTHS IN THE UNITED STATES -- CONCLUSIONS -- References and Notes -- PART II REDUCING THE INCIDENCE OF LOW BIRTHWEIGHT -- Chapter 4 An Overview of Promising Interventions -- PROMISING STRATEGIES -- NATIONAL DIRECTION FOR AN NATIONAL PROBLEM -- References and Notes -- Chapter 5 Planning for Pregnancy -- PREPREGNANCY RISK IDENTIFICATION AND REDUCTION -- ENLARGING THE CONTENT OF HEALTH EDUCATION -- THE ROLE OF FAMILY PLANNING IN REDUCING LOW BIRTHWEIGHT -- Unmet Need for Family Planning -- SUMMARY -- References and Notes -- Chapter 6 The Effectiveness of Prenatal Care -- ISSUES IN STUDYING THE EFFECTS OF PRENATAL CARE -- Research Design -- Defining Prenatal Care -- Validity of Data -- Control Variables -- Selection Bias -- REVIEW OF STUDIES OF PRENATAL CARE EFFECTS -- Results of Studies Using Large Data Bases -- Results of Program Evaluations -- CONCLUSIONS -- References and Notes -- Chapter 7 Ensuring Access to Prenatal Care -- WHO RECEIVES INADEQUATE PRENATAL CARE? -- Time Trends -- WHY DO SOME WOMEN OBTAIN INADEQUATE PRENATAL CARE? -- FINANCIAL CONSTRAINTS -- MATERNITY CARE PROVIDERS -- Obstetrician-Gynecologists -- Nurse-Midwives and Obstetrical Nurse Practitioners -- INSUFFICIENT PRENATAL CARE SERVICES -- WOMEN'S EXPERIENCES, ATTITUDES, AND BELIEFS -- TRANSPORTATION AND CHILD CARE -- INCREASING THE CAPACITY FOR OUTREACH -- Outreach Personnel -- Outreach Through Program Links -- A SYSTEM OF ACCOUNTABILITY AND RESPONSIBILITY -- References and Notes -- Chapter 8 Improving the Content of Prenatal Care -- CARE FOR ALL PREGNANT WOMEN -- Care For Women at Risk of Preterm Delivery.Care for Women at Risk of Intrauterine Growth Retardation -- PROGRAMS COMPLEMENTARY TO PRENATAL CARE -- Smoking Reduction Programs -- Prenatal Nutrition Intervention: WIC -- Stress and Fatigue Alleviation -- ENCOURAGING CHANGE IN PRENATAL SERVICES -- RESEARCH NEEDS -- Describing the Current Content -- Research on Individual Care Components -- Clinical Topics -- Behavioral and Environmental Topics -- Research on Combinations of Interventions -- SUMMARY -- References and Notes -- Chapter 9 A Public Information Program -- CONDITIONS FOR SUCCESS -- Social Support -- Consistency of Effort -- Use of Multiple Mass Media -- Audience Definition and Message Development -- Quality of Materials -- A PUBLIC INFORMATION PROGRAM ON LOW BIRTHWEIGHT PREVENTION -- Program Objectives and Audience -- Messages -- Information Channels -- Leadership and Organizational Structure -- References -- Chapter 10 Prenatal Care and Low Birthweight: Effects on Health Care Expenditures -- OVERVIEW OF THE ANALYSIS -- Target Population -- Unit Cost of Prenatal Care -- Total Cost of Prenatal Care -- Costs of Care of Low-Weight Births -- Estimated Cost Savings -- Additional Assumptions and Comments -- DESCRIPTION OF COSTS -- Prenatal and Delivery Costs -- Initial Hospitalization Costs -- Rehospitalization Costs -- Long-Term Morbidity Costs -- RESULTS OF THE COST COMPARISON -- New Prenatal Care Expenditures -- Savings in the Cost of Caring for Low Birthweight Children -- Overall Cost Savings -- SUMMARY -- References and Notes -- APPENDIXES -- Appendix A Risk Factors Associated with Low Birthweight -- References and Notes -- Additional Reading On Risks Associated with Low Birthweight -- Appendix B Data On Selected Low Birthweight Trends -- Appendix C A Summary of Three Prematurity Prevention Programs.Appendix D Notes On National Data Available To Study Low Birthweight Trends and To Monitor Related Programs -- Data Sources -- Data Needs -- References -- INDEX.Birth weight, LowUnited StatesPremature infantsUnited StatesBirth weight, LowPremature infants618.92/011MiAaPQMiAaPQMiAaPQBOOK9910812225003321Preventing low birthweight4050224UNINA