Preterm birth and poor pregnancy outcomes have been recognized as public health issues for decades and public health has provided leadership for improving pregnancy outcomes. Preterm birth is the most prevalent among the three major conditions considered to be poor pregnancy outcomes: preterm birth, low birth weight and congenital anomalies. Despite intensive and expensive prevention efforts, the prevalence of preterm birth in the United States has increased since the 1980's. Secondary and tertiary prevention efforts have made significant improvements in the intact survival of prematurely born infants, but the numbers of these infants have continued to increase. Annual costs of prematurity in the United States are conservatively estimated at $26 billion. Access to and improved utilization of prenatal care has been the focus of prevention efforts of the decades during which the prevalence of prematurity has continued to increase. Far too many women lack adequate health care prior to pregnancy and enter pregnancy with existing risks for poor outcomes. A change in the focus on care during the reproductive years to preconception and interconception care is needed so that women are in better physical and mental health as they begin pregnancy.Master of Public Healt
