The Role of Environmental Hazards in Premature Birth: Workshop Summary

by Mattison, Donald R.

• ISBN13: 9780309090650
• ISBN10: 0309090652
• Edition: 1st
• Format: Paperback
• Copyright: 2003-01-01
• Publisher: NATL ACADEMY OF SCIENCE

Summary

Each year in the United States approximately 440,000 babies are born premature. These infants are at greater risk of death, and are more likely to suffer lifelong medical complications than full-term infants. Clinicians and researchers have made vast improvements in treating preterm birth; however, little success has been attained in understanding and preventing preterm birth. Understanding the complexity of interactions underlying preterm birth will be needed if further gains in outcomes are expected. The Institute of Medicine's Roundtable on Environmental Health Sciences, Research, and Medicine sponsored a workshop to understand the biological mechanism of normal labor and delivery, and how environmental influences, as broadly defined, can interact with the processes of normal pregnancy to result in preterm birth. This report is a summary of the main themes presented by the speakers and participants.

Table of Contents

SUMMARY	1	(5)
Preterm Birth,	1	(5)
CHARGE TO PARTICIPANTS AND WORKSHOP SCOPE	6	(3)
PROBLEM STATEMENT	9	(4)
1 PRETERM BIRTH AND ITS CONSEQUENCES	13	(14)
Preterm Birth,	13	(1)
What Is Preterm Birth?,	14	(1)
Incidence,	15	(2)
Long-Term Outcomes of Premature Infants,	17	(3)
Measuring Predictors of Preterm Birth,	20	(1)
Interventions in Preterm Birth,	21	(5)
Purpose and Timing of this Workshop,	26	(1)
2 LABOR AND DELIVERY	27	(15)
Understanding the Switch from Pregnancy to Labor and Delivery,	28	(14)
3 PRETERM BIRTH-BRIEF SUMMARY OF BIOLOGICAL PATHWAYS	42	(4)
Biological Causes and Mechanisms of Preterm Labor,	42	(4)
4 PRETERM BIRTH-GENE-ENVIRONMENT INTERACTIONS	46	(16)
Environmental Factors Associated with Preterm Birth,	47	(4)
Convergence of Cellular Pathways,	51	(1)
Gene-Environment Interactions and Preterm Birth,	52	(2)
Immune-Deficient Knockout Mice as a Model to Elucidate Environmental Toxicants,	54	(2)
Federal Government Toxicology Programs,	56	(6)
5 PRETERM BIRTH-SOCIAL IMPLICATIONS	62	(6)
Stress,	63	(3)
Social Support,	66	(1)
Social Position,	66	(1)
Coping Strategies,	67	(1)
6 FUTURE DIRECTIONS	68	(9)
Overview,	68	(1)
Research Opportunities,	69	(8)
ABSTRACTS	77	(30)
Evaluating Chemical Agents for Potential Hazards to Reproduction,	77	(1)
Models That Study the Actions of Uterine Lymphocytes During Pregnancy,	78	(3)
Regulation and Assessment of Uterine Contractility and Cervical Ripening During Pregnancy,	81	(2)
Function of Steroids in Parturition and Preterm Labor,	83	(1)
Clinical and Public Health Interventions-Why Nothing Has Worked,	84	(2)
Adverse Child Outcomes Associated with Preterm Birth,	86	(1)
A Framework for Social and Cultural Determinants of Prematurity,	87	(2)
Current Approaches to Reproductive and Developmental Toxicity Testing and Risk Assessment,	89	(1)
Assessment and Relevance of Environmental Chemical Effects on Uterine Muscle,	90	(2)
Exposures to Environmental Agents and Preterm Delivery,	92	(1)
Fetal Size and Preterm Birth,	93	(2)
Species Differentiation and Animal Models of Parturition,	95	(3)
Toxic Social Environment: A Factor in Preterm Birth?,	98	(1)
Causes and Mechanisms of Premature Labor,	99	(2)
Molecular Mechanisms and Cellular Signaling Pathways Associated with Parturition,	101	(1)
Behavior, Nutrition, Infection, and Stress: Epidemiologic Clues to the Study of the Environment and Preterm Birth,	102	(2)
Gene-Environment Interactions and Preterm Delivery,	104	(1)
Role of Nitric Oxide in Uterine Activity and Premature Parturition,	105	(2)
REFERENCES	107	(6)
APPENDIXES
A WORKSHOP AGENDA	113	(7)
B SPEAKERS AND PANELISTS	120	(3)
C WORKSHOP PARTICIPANTS	123