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As women of childbearing age have become heavier, the trade-off between maternal and child health created by variation in gestational weight gain has become more difficult to reconcile. Weight Gain During Pregnancy responds to the need for a reexamination of the 1990 Institute of Medicine guidelines for weight gain during pregnancy. It builds on the conceptual framework that underscored the 1990 weight gain guidelines and addresses the need to update them through a comprehensive review of the literature and independent analyses of existing databases. The book explores relationships between weight gain during pregnancy and a variety of factors (e.g., the mother's weight and height before pregnancy) and places this in the context of the health of the infant and the mother, presenting specific, updated target ranges for weight gain during pregnancy and guidelines for proper measurement. New features of this book include a specific range of recommended gain for obese women. Weight Gain During Pregnancy is intended to assist practitioners who care for women of childbearing age, policy makers, educators, researchers, and the pregnant women themselves to understand the role of gestational weight gain and to provide them with the tools needed to promote optimal pregnancy outcomes.
The evaluation of reproductive, maternal, newborn, and child health (RMNCH) by the Disease Control Priorities, Third Edition (DCP3) focuses on maternal conditions, childhood illness, and malnutrition. Specifically, the chapters address acute illness and undernutrition in children, principally under age 5. It also covers maternal mortality, morbidity, stillbirth, and influences to pregnancy and pre-pregnancy. Volume 3 focuses on developments since the publication of DCP2 and will also include the transition to older childhood, in particular, the overlap and commonality with the child development volume. The DCP3 evaluation of these conditions produced three key findings: 1. There is significant difficulty in measuring the burden of key conditions such as unintended pregnancy, unsafe abortion, nonsexually transmitted infections, infertility, and violence against women. 2. Investments in the continuum of care can have significant returns for improved and equitable access, health, poverty, and health systems. 3. There is a large difference in how RMNCH conditions affect different income groups; investments in RMNCH can lessen the disparity in terms of both health and financial risk.
There is no longer any doubt that the inherited genetic constitution of the individual has a large influence on the entire life cycle, from human fetal development and pre- and postnatal growth to subsequent health status. However, growing evidence suggests that this predisposition is not rigid, but that early genetic imprinting, caused by exposure to a diverse spectrum of nutrients, macromolecules, microbial agents and other cellular or soluble components present in the external environment, is also of importance. According to this concept of the developmental origins of adult diseases, intrauterine and early life events play an important role in the etiology of human diseases: there seems to exist a critical 'window of opportunity' in the human infant before and during pregnancy, and up to 24 months of age. Altered exposure to different environmental agents during this critical period may determine the nature of responses in the perinatal period, and the expression of specific disease states in later life. The papers presented in this publication thus focus on the impact of perinatal growth, nutrition, environmental microflora, and host immune responses on the outcome of health and disease in later life.
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.
Abstract: This publication reports the results of three meetings held to plan the 1988 National Material and Infant Health Survey (NMIHS). The purposes of the meetings were: to layout methodological and policy issues which will affect the 1988 NMIHS; to examine the relationship of the 1988 NMIHS to other National Center for Health Statistics surveys; and to review contracting mechanisms ann funding sources annd alternatives.
By all indicators, the reproductive health of Americans has been deteriorating since 1980. Our nation is troubled by rates of teen pregnancies and newborn deaths that are worse than almost all others in the Western world. Science and Babies is a straightforward presentation of the major reproductive issues we face that suggests answers for the public. The book discusses how the clash of opinions on sex and family planning prevents us from making a national commitment to reproductive health; why people in the United States have fewer contraceptive choices than those in many other countries; what we need to do to improve social and medical services for teens and people living in poverty; how couples should "shop" for a fertility service and make consumer-wise decisions; and what we can expect in the futureâ€"featuring interesting accounts of potential scientific advances.
This report describes the study design and summary data from the first year of data collection for the Urban Child Institute Conditions Affecting Neurocognitive Development and Learning in Early Childhood Study: participant demographics, prenatal and birth measures; child and family health and nutrition; mothers' mental and behavioral health; and cognitive performance, psychosocial measures, and biological samples for mothers and children.
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 who do survive have a greater risk than infants born at term for developmental disabilities, health problems, and poor growth. The birth of a preterm infant can also bring considerable emotional and economic costs to families and have implications for public-sector services, such as health insurance, educational, and other social support systems. Preterm Birth assesses the problem with respect to both its causes and outcomes. This book addresses the need for research involving clinical, basic, behavioral, and social science disciplines. By defining and addressing the health and economic consequences of premature birth, this book will be of particular interest to health care professionals, public health officials, policy makers, professional associations and clinical, basic, behavioral, and social science researchers.
Abstract: The nutritional status of the pregnant women is being recognized as one of the most important factors in the development of a baby, both pre and postnatally. Malnutrition can cause sterility, spontaneous aborption, stillbirth, premature birth, deformities and mental retardation. Statistics from many sources, such as European clinics during WWII and current figures from hospital observations all over the country, have been collected and compiled to provide information on prenatal and early childhood development in relation to nutrition in three ways--physiologically, neurologically, and behaviorally. Low birth weight is the measurement most closely associated with the incidence of neonatal disorders, and is shown to be closely related also to maternal nutrition. Reproductive casualties, particularly in regard to handicapped children, can be greatly decreased by better education and nourishment of expectant mothers.
BOOKER PRIZE WINNER • NATIONAL BESTSELLER • A novel that follows a middle-aged man as he contends with a past he never much thought about—until his closest childhood friends return with a vengeance: one of them from the grave, another maddeningly present. A novel so compelling that it begs to be read in a single setting, The Sense of an Ending has the psychological and emotional depth and sophistication of Henry James at his best, and is a stunning achievement in Julian Barnes's oeuvre. Tony Webster thought he left his past behind as he built a life for himself, and his career has provided him with a secure retirement and an amicable relationship with his ex-wife and daughter, who now has a family of her own. But when he is presented with a mysterious legacy, he is forced to revise his estimation of his own nature and place in the world.