ABSTRACT
This book has been written in an attempt to refocus the debate on the prevention of low birthweight and preterm birth that has tended to stall on the disap pointing results of the evaluation of carefully designed preventive programmes (see Chapter 6). It has been driven by the conviction that fundamental improve ments in mortality and morbidity in infancy, childhood and adulthood depend, in large part, on ensuring that fewer babies are born too early and/or too small and as many babies as possible achieve a birthweight within the optimal range. Populations that have high rates of low birthweight ( < 2500g) and preterm birth ( < 37 weeks’ gestation) and a low proportion of infants born within the optimal birthweight range will have less healthy infants, children and adults. The book has been informed by an understanding that, although birthweight is the culmination of a biological process in individual women, social, environmental, cultural and psychological factors combine to directly or indirectly modify the biology. Despite imperfect knowledge of the precise mechanisms by which the social translates into the biological, there can be no doubt that birthweight results from a complex interplay of these influences acting between generations and over the woman’s life course as well as within the pregnancy itself.
