Prevention of preterm birth: a renewed national priority

作者：Karla Damus · 发表于：Current Opinion in Obstetrics & Gynecology · 年份：2008 · DOI：10.1097/gco.0b013e3283186964 · 被引用次数：71 · 研究领域：Preterm Birth and Chorioamnionitis、Infant Development and Preterm Care、Assisted Reproductive Technology and Twin Pregnancy

PURPOSE OF REVIEW: To summarize some recent major epidemiological changes, evidence-based interventions, shifting paradigms, and national initiatives targeting the prevention of preterm birth in the United States. RECENT FINDINGS: Noteworthy epidemiological changes in preterm births include a shift from 40 to 39 weeks as the most common length of gestation for singleton births in the United States; significant jumps in late preterm births, which is the major contributor to increasing preterm rates: more multiple births with rates highest for non-Hispanic whites; dramatic increases in births to women of advanced maternal age; and substantial increases in cesarean births. Key paradigm shifts have also occurred such as considering most spontaneous preterm birth as a common complex disorder highlighting the importance of interactions of biological predispositions and environment; support for the fetal origins hypothesis requiring a life course perspective, including preconception health promotion to improve perinatal health and enhance equity; and a renewed focus on preventing recurrence. The March of Dimes National Prematurity Campaign, the National Institute of Child Health and Human Development leadership on late preterm birth, the 2006 Institute of Medicine's report on preterm birth, and passage of the Prematurity Research Expansion and Education for Mothers who Deliver Infants Early Bill with the resultant 2008 Surgeon General's Conference underscore the national resolve to ...