LEADER 08237nam 2200733Ia 450 001 9910963608803321 005 20251017110100.0 010 $a9786610222278 010 $a9780309306201 010 $a0309306205 010 $a9781280222276 010 $a1280222271 010 $a9780309542074 010 $a0309542073 010 $a9780585168593 010 $a0585168598 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(Perlego)4734392 035 $a(DNLM)1639579 035 $a(BIP)1280125 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 $aBibliographic Level Mode of Issuance: Monograph 311 08$a9780309035309 311 08$a0309035309 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. 330 $aDespite recent declines in infant mortality, the rates of low birthweight deliveries in the United States continue to be high. Part I of this volume defines the significance of the problems, presents current data on risk factors and etiology, and reviews recent state and national trends in the incidence of low birthweight among various groups. Part II describes the preventive approaches found most desirable and considers their costs. Research needs are discussed throughout the volume. 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 $a9910963608803321 996 $aPreventing low birthweight$94356089 997 $aUNINA