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Assessment and Evaluation of the High Risk Neonate: The NICU Network Neurobehavioral Scale
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Published on: August 25, 2014

Behavioral influences on preterm birth: a review.

David A Savitz1, Pamela Murnane

  • 1Disease Prevention and Public Health Institute, Mount Sinai School of Medicine, New York, NY 10029-6574, USA. david.savitz@mssm.edu

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|April 14, 2010
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Summary

While tobacco smoking is linked to preterm birth, other behaviors like alcohol or drug use show weaker associations. Future research needs new methods to identify causal links for prevention.

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Area of Science:

  • Reproductive Epidemiology
  • Behavioral Science
  • Public Health

Background:

  • Numerous studies have investigated behavioral factors influencing preterm birth.
  • However, only tobacco smoking has a consistent, albeit weak, association with preterm birth.
  • Most other behavioral influences remain unestablished causes.

Purpose of the Study:

  • To comprehensively summarize epidemiologic evidence on behaviors and preterm birth.
  • To identify promising research directions and areas requiring new methodologies.
  • To move beyond correlational studies towards identifying causal relationships for prevention.

Main Methods:

  • Systematic review and synthesis of epidemiologic studies.
  • Analysis of evidence on tobacco, alcohol, and illicit drug use.
  • Evaluation of physical activity, sexual activity, and occupational exposures.

Main Results:

  • Tobacco use shows a consistent, weak association with preterm birth, stronger with heavier smoking and earlier gestations.
  • Environmental tobacco smoke, heavy alcohol/cocaine use, and strenuous work suggest potential adverse effects.
  • Low alcohol, caffeine, sexual activity, and employment show no consistent association; leisure activity results are mixed.

Conclusions:

  • Progress in understanding preterm birth requires examining behavioral antecedents and biologic pathways.
  • Novel research technologies and strategies are essential for identifying causal links.
  • New approaches are needed to develop effective preventive measures for preterm birth.