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Journal Issue: Low Birth Weight Volume 5 Number 1 Spring 1995

Statement of Purpose
Richard E. Behrman

Statement of Purpose

In this issue of The Future of Children, we focus on the seemingly intractable problem of preventing death and disability in infants as a result of being born too soon at low birth weight. This topic is important because (1) low birth weight results in a significant loss of life—with the years of unfulfilled potential that early death represents for each child and for society; (2) many surviving infants sustain residual injuries that often tragically involve the central nervous system; (3) the children and their families often endure pain and suffering; and (4) there are substantial financial costs involved. Over the past three decades it had been hoped that a number of health and welfare programs, whose primary objectives were to provide needed medical services to pregnant women (such as prenatal care) or to ameliorate harmful effects of poverty on children (such as WIC), would also, coincidentally, prevent the onset of most preterm labor and delivery. This has not occurred. Therefore, based on current knowledge, further interventions are needed. These should include providing women of reproductive age with additional health services before pregnancy. Because cigarette smoking during pregnancy significantly increases the likelihood of having a moderately low birth weight baby, there also should be intensive programs to discontinue smoking during pregnancy. Programs directed at discouraging children and adolescents from starting to smoke would also have a beneficial effect on reducing the low birth weight rate.

In addition to these measures, a significantly greater research priority should be given to investigating the mechanisms controlling the onset of labor. Further, two-fold black to white (and Asian) racial differences persist in the prevalence of preterm labor, low birth weight, and infant mortality, and these outcomes are not adequately explained by socioeconomic or lifestyle variables. Consequently, particular attention should be given to possible biological factors that might contribute to the increased vulnerability of black women to having the premature onset of labor. It is our hope that by redirecting attention to this subject, further progress can be made in reducing preterm delivery of low birth weight infants early in the 21st Century.

The articles presented here summarize knowledge and experience in selected areas that we believe are relevant to improving public policies in the United States that have an impact on infant mortality and morbidity. We hope the information and analyses these articles contain will further understanding of the important issues and thus contribute to reasonable changes in policies which will benefit children.

We invite your comments and suggestions regarding this issue of The Future of Children. Our intention is to encourage informed debate about preventing the preterm birth of low birth weight infants. To this end we invite correspondence to the Editor. We would also appreciate your comments about the approach we have taken in presenting the focus topic and welcome your suggestions for future topics.