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Show Reproductive Medicine to limit the number of fertilized ova implanted should be followed by all infertility clinics in Utah. > Use of fertility drugs should be closely monitored by infertility specialists to reduce the risk of multiple gestation pregnancies. • Promotion of effective contraception can be helpful in reducing poor pregnancy outcomes due to short interpregnancy intervals and unintended pregnancies. For example, postpartum women can be given oral contraceptive pills or another form of contraceptive method prior to discharge home from the hospital or birthing center. • Women should be encouraged to seek preconceptional health care to assist them in preparing for healthy pregnancies. Additional Analysis Further analysis is necessary in order to identify preventable risk factors for low birth weight. For example, what is it about a certain geographic area that results in higher low birth weight rates? Is it because more women in that area do not receive prenatal care? Or are there other reasons? Obviously more data analysis is needed to determine specifically why certain populations within Utah are at higher risk for low birth weight. Better strategies to support women at risk for preterm labor and thus low birth weight are needed. These include interventions developed by European countries with significantly lower low birth weight rates, such as universal prenatal care, extended maternity leave, and home visitation programs to promote healthier pregnancies and babies. The Utah Department of Health is initiating a new surveillance project, developed by the Centers for Disease Control and Prevention (CDC), called Pregnancy Risk Assessment Monitoring System (PRAMS). The Utah Department of Health will conduct the Utah PRAMS Project with technical assistance from CDC. PRAMS is a mail-out survey to a sample of Utah women several months after delivery to ask them about their experiences and behaviors before, during and after pregnancy. The Utah sample will be stratified by birth weight and race, which will enable the Department to report findings in each group after several years of data collection. Data collection will begin mid-1999 with the first results available early 2001. Examples of information collected through PRAMS include pregnancy intendedness, barriers to prenatal care, information given by providers, stresses and available support, income levels, and breastfeeding. References American Society for Reproductive Medicine. (1998). Revised minimum standards for in vitro fertilization, gamete intrafallopian transfer, and related procedures. Fertility and Sterility, 70 (4, suppl 2). Internet address: http://cdc.gov/nccdphp/drh Bureau of Surveillance and Analysis. (1998). Community health status: Selected measures of health status by small area in Utah. Salt Lake City, UT: Utah Department of Health. Bureau of Vital Records. (1998). Utah's vital statistics: birth and deaths 1997. Salt Lake City, UT: Utah Department of Health. Bureau of Vital Records. (1999a). Birth certificate database, 1989-1997 [electronic database]. Salt Lake City, UT: Utah Department of Health. Bureau of Vital Records. (1999b). Birth certificate database, 1994-1996 [electronic database].. Utah Department of Health and Utah State Geographic Information. 1990 census data, Automated Geographic Reference Center, Information Technology Service, State of Utah. Bureau of Vital Records. (1999c). Death certificate database, 1989-1997 [electronic database]. Salt Lake City, UT: Utah Department of Health. Goldenberg, R.L, & Rouse, D.J. (1998). Prevention of premature birth. New England Journal of Medicine, 339 (5), 313-320. Hack, M., Klein, N., & Taylor, H. (1995). Long term developmental outcomes of low birth weight infants. The future of children: low birth weight. 5(1): 187. Institute of Medicine. (1992). Nutrition during pregnancy and lactation. Washington DC. 45 |