Preterm birth is a pervasive and persistent maternal and child health concern in developed countries. In the United States in particular, the rate of preterm birth has been rising, reaching 12.5% in 2005. This is significantly higher than other developed countries–the rate of preterm birth in European countries is only 5–7%. Preterm birth compromises the health of infants, putting him or her at high risk of early death. In 2005, infants born preterm accounted for 68.6% of all deaths of infants under one year of age.
Despite these concerning statistics, methods for prevention of preterm birth are not well understood. The most common strategies include prescribing bed rest and/or activity restriction for antepartum mothers at risk for preterm delivery. Though this strategy is widely used, however, the risks and benefits of this practice are still under research.
Dr. Judith Maloni, professor in the Frances Payne Bolton School of Nursing at CWRU, has been working with women on bed rest for over twenty years. She has recently published a critical review of the existing researcher examining the risks and benefits of bed rest for the health of both pregnant women and their infants. This review suggests that there is not sufficient scientific evidence that bed rest improves child outcomes. Furthermore, the article documents significant evidence of negative outcomes of bed rest for the mother, including bone density loss, muscle atrophy and depression. These data suggest that bed rest needs to be reexamined as a strategy for preventing preterm birth. Furthermore, Dr. Maloni advocates for the use of alternative strategies to prevent preterm birth, such as home-based care, for which there is scientific evidence to support efficacy.