The rate of preterm birth is 5-9% of all births in Europe, and 12-13% in the United States of America (USA); the rates in both continents are increasing, partly due to the higher number of multiple births associated with assisted conceptions.1 About 30-35% of preterm births are the result of maternal or fetal disease, but 40-45% of premature births result from spontaneous preterm birth (SPL) and 25-30% from preterm rupture of the membranes (PROM). For families struggling to cope with having a baby in special care, this will be one of the most difficult, emotional and stressful times of their lives,2 whatever the longer term outcome. The sequelae of preterm birth also pose significant challenges. Children born preterm are at increased risk of major disabilities, such as cerebral palsy, with the risk increasing with decreasing gestation at birth.3 Many preterm children without disability develop serious behavioural and educational difficulties.4 The prevention of preterm birth and reduction of associated disability are therefore important health priorities, and are a major focus of my work. The principle that health care should be “evidence-based” lies at the heart of today’s National Health Service (NHS) but this has not always been the case. Lessons about the importance of evaluation of treatments can readily be demonstrated within maternity and perinatal care. Perhaps the most famous example is that of thalidomide, which became recommended treatment for pregnant women to relieve morning sickness in the late 1950s.5 By the beginning of the 1960s obstetricians had begun to notice increased numbers of children with severely malformed arms and legs.
| Identifer | oai:union.ndltd.org:bl.uk/oai:ethos.bl.uk:525742 |
| Date | January 2009 |
| Creators | Kenyon, Sara |
| Contributors | Dixon-Woods, Mary |
| Publisher | University of Leicester |
| Source Sets | Ethos UK |
| Detected Language | English |
| Type | Electronic Thesis or Dissertation |
| Source | http://hdl.handle.net/2381/8588 |
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