Public Health Importance

This study is among the first large-scale evaluation of preterm delivery that simultaneously addresses genital tract infection, nutrition, tobacco, and drug use with biological assessments as well as detailed self-report. While these exposures have been strongly suspected of influencing preterm delivery, this study will provide much firmer evidence for screening practice for bacterial vaginosis, encouragement for smoking cessation, and potentially for vitamin supplementation.

The PIN Study is also examining psychosocial domains, physical activity, and sexual behaviors to advance the understanding of these exposures to the risk for preterm delivery.

The study is now focusing on pathways that may lead to preterm birth, particularly placental vascular compromise, infection and inflammation, and genetic modifiers of risk. At the same time, we have expanded an interest in social and economic factors that act at the community level.

With the addition of the postpartum component of the study, the role of weight gain and retention during and after pregnancy will be examined. This is an important topic given the increasing level of obesity in the American population. The role of diet, physical activity, and stress will be evaluated with regard to postpartum weight retention.