Prenatal Care and Preterm Births

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Prenatal Care and Preterm Births

In the last 20 years the hopes of survival for neonates have seen significant increase, almost all of the causes of perinatal mortality and morbidity have decreased. There is only one threat unmoved, still standing above the rest- Preterm birth. Prematurity or preterm birth is defined as the birth of any child between 20-37 weeks of gestation. Delivery prior to 20 weeks of gestation is considered a Natural abortion.1 The survival rate of low birth weight infants has significantly increased from 15-80% in the last 20 years. However, the incidence of prematurity has not seen any change, neither decrease nor increase. Currently the average incidence is 10-11%.1

There are noticeable sex and race differences in incidence and survival rates. In African-Americans the incidence of preterm births is 18.9% compared to 8.8% of Caucasian births. Also, there are differences in survival rates, with male infants having a mortality rate twice that of females, twin infants having a mortality rate 4 times greater than that of singletons, and African-Americans generally having higher survival rates. After 29 weeks of gestation differences are no longer significant. 1 Some factors that have been proposed in order to explain race differences are lower socio-economic status (SES), availability and quality of prenatal care and residence in urban neighborhoods. 2 Traditionally, SES is the focus of arguments that try to explain the differences. However, in a study carried out, SES was not found as a major factor, rather, Bacterial Vaginosis was the center of attention. 3 It was found that among black pregnant women, there was a higher incidence of Bacterial Vaginosis, an infection which will be dis...

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8. A, pg 502

9. McGregor J.A., French J.I.: Bacterial Vaginosis in pregnancy (PubMed; 2000)

10. A, pg. 503

11. B, pg. 270

12. Katz V.L., Farmer R.M.: Controversies in tocolytics therapy (PubMed; 1999)

13. A, pg. 507

14. A, pgs. 508-509

15. B, pgs. 273-274

16. B, pg. 271

17. A, pg. 513

18. Higby K., Suiter C.R.: A risk-benefit assessment of therapies for premature labour (PubMed; 1999)

19. Crowther C.A., Moore V.: Magnesium for preventing preterm birth after threatened preterm labour (PubMed; 2000)

20. Sanchez-Ramos L., Kaunitz A.M., Gaudier F.L., Delke I.: Efficacy of maintenance therapy after acute Tocolysis: a meta-analysis (PubMed; 1999)

21. A, pg. 510

22. A, pg. 509

23. C, pgs.659-660

24. Rogowski J.: Cost-effectiveness of care for very low birth weight infants (PubMed, 1998)

25. A, pg. 509

Figure 1: B, pg. 267

Figure 2: A, pg. 507

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