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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 w...
Despite 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.
The delivery of high quality and equitable care for both mothers and newborns is complex and requires efforts across many sectors. The United States spends more on childbirth than any other country in the world, yet outcomes are worse than other high-resource countries, and even worse for Black and Native American women. There are a variety of factors that influence childbirth, including social determinants such as income, educational levels, access to care, financing, transportation, structural racism and geographic variability in birth settings. It is important to reevaluate the United States' approach to maternal and newborn care through the lens of these factors across multiple disciplines. Birth Settings in America: Outcomes, Quality, Access, and Choice reviews and evaluates maternal and newborn care in the United States, the epidemiology of social and clinical risks in pregnancy and childbirth, birth settings research, and access to and choice of birth settings.
The Government recognises that many lifestyle-driven health problems are at alarming levels: obesity; high rates of sexually transmitted infections; a relatively large population of drug users; rising levels of harm from alcohol; 80,000 deaths a year from smoking; poor mental health; health inequalities between rich and poor. This white paper outlines the Government's proposals to protect the population from serious health threats; help people live longer, healthier and more fulfilling lives; and improve the health of the poorest. It aims to empower individuals to make healthy choices and give communities and local government the freedom, responsibility and funding to innovate and develop wa...
This volume analyses the distinct care needs of late preterm infants and their parents by reflecting on the best available evidence to inform practice and latest innovations in care. It addresses the spectrum of issues experienced by late preterm infants and their parents and ways to ensure healthy transitions from hospital to community. We define late preterm infants as those born between 340/7 to 366/7 weeks’ gestational age. The book uses creative writing prompts and a narrative style to gain insight and be self-reflection in and on practice to move the reader to embrace best practices. Issues such as mother’s physical and emotional health, father’s burden in postpartum period, the ...
The United States is among the wealthiest nations in the world, but it is far from the healthiest. Although life expectancy and survival rates in the United States have improved dramatically over the past century, Americans live shorter lives and experience more injuries and illnesses than people in other high-income countries. The U.S. health disadvantage cannot be attributed solely to the adverse health status of racial or ethnic minorities or poor people: even highly advantaged Americans are in worse health than their counterparts in other, "peer" countries. In light of the new and growing evidence about the U.S. health disadvantage, the National Institutes of Health asked the National Re...
While there are many studies and books regarding preterm birth, both the obstetric and in the neonatal/pediatric literature, what is missing is the integration of data from obstetrics through neonatal course and into pediatrics as the neonate transverses childhood. A continued dialogue between specialties is essential in the battle against preterm birth in an attempt to relieve the effects or after-effects of preterm birth. For all of our medical advances to date, preterm birth is still all too common, and its ramifications are significant for hospitals, families and society in general.
The emphasis of the manual is on rapid assessment and decision making. The clinical action steps are based on clinical assessment with limited reliance on laboratory or other tests and most are possible in a variety of clinical settings.