LEADER 07503nam 2200625Ia 450 001 9910812225003321 005 20240417000135.0 010 $a0-309-30620-5 010 $a1-280-22227-1 010 $a9786610222278 010 $a0-309-54207-3 010 $a0-585-16859-8 035 $a(CKB)111004366656344 035 $a(OCoLC)44965306 035 $a(CaPaEBR)ebrary10063004 035 $a(SSID)ssj0000226810 035 $a(PQKBManifestationID)11199675 035 $a(PQKBTitleCode)TC0000226810 035 $a(PQKBWorkID)10258494 035 $a(PQKB)10391984 035 $a(MiAaPQ)EBC3377044 035 $a(Au-PeEL)EBL3377044 035 $a(CaPaEBR)ebr10063004 035 $a(CaONFJC)MIL22227 035 $a(OCoLC)923267858 035 $a(EXLCZ)99111004366656344 100 $a19850523d1985 ua 0 101 0 $aeng 135 $aurcn||||||||| 181 $ctxt 182 $cc 183 $acr 200 10$aPreventing low birthweight /$fCommittee to Study the Prevention of Low Birthweight, Division of Health Promotion and Disease Prevention, Institute of Medicine 205 $a1st ed. 210 $aWashington, D.C. $cNational Academy Press$d1985 215 $a1 online resource (296 p.) 300 $aBibliographic Level Mode of Issuance: Monograph 311 $a0-309-03530-9 320 $aIncludes bibliographical references and index. 327 $aPreventing 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. 327 $aReferences -- 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. 327 $aCare 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. 327 $aAppendix D Notes On National Data Available To Study Low Birthweight Trends and To Monitor Related Programs -- Data Sources -- Data Needs -- References -- INDEX. 606 $aBirth weight, Low$zUnited States 606 $aPremature infants$zUnited States 615 0$aBirth weight, Low 615 0$aPremature infants 676 $a618.92/011 801 0$bMiAaPQ 801 1$bMiAaPQ 801 2$bMiAaPQ 906 $aBOOK 912 $a9910812225003321 996 $aPreventing low birthweight$94050224 997 $aUNINA