The Alabama preterm birth prevention project
Article Abstract:
Birth occurring before 37 completed weeks of pregnancy is considered a preterm (premature) delivery and is associated with an increased risk of infant illness and death. The effectiveness of tocolytic agents, drugs that control preterm labor, is inconsistent. It is thought that tocolytic agents fail because they are often administered late, after labor is too far advanced. To determine whether preterm birth can be prevented if the signs are discovered and treated early, 1,000 high-risk indigent black women enrolled in a preterm birth prevention program in Alabama; this was one of five sites conducting similar studies. The subjects were randomly assigned to either the treatment or control groups. Control subjects continued to receive their usual prenatal care, while subjects in the treatment group were educated on the signs and symptoms of early labor. The women in the treatment group were also seen every week beginning in the twenty-second week of pregnancy for a physical exam, to determine preterm delivery risk status. Preterm labor was diagnosed and treated more often in the treatment group than in the control group. However, there were no significant differences between groups in the birth weights of infants, the gestational age (duration of pregnancy) at birth, or the rate of spontaneous preterm delivery. The fetal and infant mortality rates and the incidence of respiratory distress syndrome, a common breathing complication in premature infants, were slightly greater in the treatment group, however, the differences were not statistically significant. In the treatment group there were more cases of intracranial hemorrhage, a complication of preterm delivery causing bleeding in the infant's brain, and treatment-group infants required more time on mechanical ventilators for breathing assistance. In some areas the treatment group fared worse than the control subjects, but overall, there was little difference in infant health between the groups. The Alabama Preterm Birth Prevention Project, which was designed to reduce preterm delivery, failed to do so in a population of indigent black mothers. (Consumer Summary produced by Reliance Medical Information, Inc.)
Publication Name: Obstetrics and Gynecology
Subject: Health
ISSN: 0029-7844
Year: 1990
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Black-white differences in newborn anthropometric measurements
Article Abstract:
Several studies have reported that black babies weigh less than white babies at birth, and twice as many black as white infants are born before term. Also, mortality is twice as high among black infants as it is among white infants. It has been suggested that the higher mortality among black babies may be related to lower birth weight. However, the exact relationship between race, birth weight and mortality remains unknown. To address this issue, a total of 1,205 pregnant women (830 black and 375 white) from low-income families and having term pregnancies were studied. The women of both races were of similar age, height and body weight, and had similar rates of alcohol and drug use. More white women (73 percent) than black women (37 percent) smoked cigarettes, while more black women (41 percent) than white women (26 percent) had previously given birth to a low-birth-weight infant. For term deliveries (at 40 weeks), the average birth weight of the black infants was 0.3 pounds less than the average birth weight of the white infants. When all deliveries (preterm and term combined) were taken into account, black infants were born an average of four days earlier and weighed an average of 6.4 ounces less than white infants. The black infants were shorter in length, and had smaller head, chest and abdominal circumferences, but had larger arm circumferences. Triceps and thigh skinfold thicknesses were similar for white and black infants. The results of this study indicate that factors associated with race account for the differences in birth weight and smaller body measurements. (Consumer Summary produced by Reliance Medical Information, Inc.)
Publication Name: Obstetrics and Gynecology
Subject: Health
ISSN: 0029-7844
Year: 1991
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The length of the cervix and the risk of spontaneous premature delivery
Article Abstract:
Shorter cervical length in pregnancy appears to be associated with increased likelihood of premature birth. Researchers used transvaginal ultrasound imaging to measure the length of the cervix in 2,915 women at 22 to 24 weeks gestation and remeasured the cervix in 2,531 women at 27 to 29 weeks gestation. Overall, 4.3% of the women measured during the earlier time period gave birth before 35 weeks gestation. The risk of giving birth prematurely went up as the length of the cervix declined. The odds of premature birth doubled from 2% to 4% in women experiencing a decrease in cervical length between the earlier and later cervical measurements. Twenty-three percent of women with cervixes shorter than 20 millimeters at 22 to 24 weeks and 31% of women with cervixes shorter than 20 millimeters at 27 to 29 weeks gave birth prematurely.
Publication Name: The New England Journal of Medicine
Subject: Health
ISSN: 0028-4793
Year: 1996
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