THE PROBLEM OF LOW-BIRTH-WEIGHT
THE PROBLEM OF LOW-BIRTH-WEIGHT
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DOI：
10.2307/1602505
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发表时间：
1995-03-01
影响因子：
--
通讯作者：
PANETH, NS
中科院分区：
文献类型：
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作者：
PANETH, NS
低出生体重是美国的一个主要公共卫生问题，在很大程度上导致婴儿死亡率和儿童残疾。在美国，低出生体重的主要决定因素是早产，这是一种病因学很大程度上未知的现象。早产在美国比许多其他工业化国家更为常见，也是造成美国婴儿死亡率相对较高的主要原因。在美国，亚洲人口的早产率最低，而西班牙裔和美洲原住民的早产率略高于白人。然而，非裔美国人的早产率比任何其他主要种族群体都要高得多。贫困与低出生体重密切相关，但导致早产的确切社会和环境条件尚未阐明。尽管人们普遍将非法药物使用与低出生体重联系起来，但在 20 世纪 80 年代可卡因流行之前的几十年里，高低出生体重率一直是美国的特征。在过去 25 年里，美国的低出生体重率和早产率都没有改善。经过仔细评估，大多数预防早产或低出生体重的努力都没有被证明有效。生物医学研究的一个主要目标应该是更好地了解这一重要公共卫生问题的原因。
Low birth weight is a major public health problem in the United States, contributing substantially both to infant mortality and to childhood handicap. The principal determinant of low birth weight in the United States is preterm delivery, a phenomenon of largely unknown etiology. Preterm delivery is more common in the United States than in many other industrialized nations, and is the factor most responsible for the relatively high infant mortality rate in the United States.Within the United States, Asian populations experience the lowest preterm delivery rates, while Hispanic and Native American populations experience slightly higher preterm delivery rates than the white population. African Americans, however, have much higher rates of preterm delivery than any of the other major ethnic groups. Poverty is strongly and consistently associated with low birth weight, but the precise social and environmental conditions that produce preterm delivery have not been elucidated. Although it is popular to link illicit drug use to low birth weight, a high low birth weight rate was characteristic of the United States for decades before the cocaine epidemic of the 1980s.Neither the low birth weight rate nor the preterm delivery rate has improved in the United States in the past quarter century. Most efforts to prevent prematurity or low birth weight, when carefully evaluated, have not proven effective. A major goal of biomedical research ought to be better understanding of the causes of this important public health problem.