title: Prematurity: an overview and public health implications.
abstract: The high rate of premature births in the United States remains a public health concern. These infants experience substantial morbidity and mortality in the newborn period, which translate into significant medical costs. In early childhood, survivors are characterized by a variety of health problems, including motor delay and/or cerebral palsy, lower IQs, behavior problems, and respiratory illness, especially asthma. Many experience difficulty with school work, lower health-related quality of life, and family stress. Emerging information in adolescence and young adulthood paints a more optimistic picture, with persistence of many problems but with better adaptation and more positive expectations by the young adults. Few opportunities for prevention have been identified; therefore, public health approaches to prematurity include assurance of delivery in a facility capable of managing neonatal complications, quality improvement to minimize interinstitutional variations, early developmental support for such infants, and attention to related family health issues.
authors.affiliation: Department of Society, Human Development and Health, School of Public Health, Harvard University, Boston, Massachusetts 02115, USA. mmccormi@hsph.harvard.edu
authors.forename: Marie C
authors.initials: MC
authors.lastname: McCormick
authors.forename: Jonathan S
authors.initials: JS
authors.lastname: Litt
authors.forename: Vincent C
authors.initials: VC
authors.lastname: Smith
authors.forename: John A F
authors.initials: JA
authors.lastname: Zupancic
mesh_terms: D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D017048:Health Care Costs; D006801:Humans; D007231:Infant, Newborn; D007234:Infant, Premature; D009017:Morbidity; D047928:Premature Birth / Q000453:epidemiology*; D011634:Public Health; D011640:Public Policy; D014481:United States / Q000453:epidemiology; D055815:Young Adult