Online Program

Environmental contributors to preterm birth- implications for practice and policy

Tuesday, November 5, 2013

Karin Russ, MS, RN, Feritility & Reproductive Health Working Group, Collaborative on Health and Environment, Freeland, WA
Preterm birth is an intractable public health problem, affecting more than 500,000 infants per year in the United States. Long term sequelae of preterm birth include intellectual disabilities, cerebral palsy, vision and hearing loss, and respiratory and digestive problems. The annual societal economic burden associated with preterm birth in the U.S. was estimated at $26.2 billion in 2005. The etiology of preterm birth is complex, but is believed to involve a combination of maternal health, genetic and environmental factors. Traditional models of environmental influences examine the effects of nutrition, substance abuse, psychosocial stress and social support on the duration of gestation. A mounting body of research links environmental contaminants to preterm birth.

This presentation will examine the growing body of evidence associating environmental toxicants with preterm birth. For example, epidemiological studies link perflourinated chemicals, brominated flame retardants, plastic additives called phthalates, pesticides, and components of air pollution to shortened gestation. Animal models provide insight into the biological mechanisms that may be responsible for this effect. An inflammatory response in the female reproductive tract appears to be a major factor.

Interventions that minimize exposures to toxicants during pregnancy are a valuable public health strategy in reducing preterm births. Potential sources of environmental exposures will be reviewed, along with clinical screening tools and resources for patient education on risk reduction. Because many exposures are not avoidable on an individual basis, changes in health policy maybe warranted. Policy implications based on the current body of reproductive environmental health research will be discussed.

Learning Areas:

Clinical medicine applied in public health
Environmental health sciences
Implementation of health education strategies, interventions and programs
Public health or related nursing
Public health or related public policy
Systems thinking models (conceptual and theoretical models), applications related to public health

Learning Objectives:
Identify environmental contaminants associated with preterm birth List potential sources of environmental toxicant exposure Utilize prenatal environmental health screening tools readily available on the internet Discuss innovative strategies for ameliorating exposures to environmental hazards Describe the implications of reproductive environmental health research findings on state and federal policy

Keyword(s): Pregnancy Outcomes, Environmental Health

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: Karin Russ is the National Coordinator of the Fertility and Reproductive Health Working Group for the Collaborative on Health and the Environment. Ms. Russ is faculty for the Community/Public Health Department, University of Maryland School of Nursing. Ms. Russ chairs the Maryland Nurses Association’s Environmental Health Committee, and serves on many advisory boards. Ms. Russ earned a Masters degree in Nursing Management, and post-masters specialty certificates in Environmental Health Nursing and Teaching in Nursing.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.