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Consensus Study Report


The increasing prevalence of preterm birth in the United States is a complex public health problem that requires multifaceted solutions. Preterm birth is a cluster of problems with a set of overlapping factors of influence. Its causes may include individual-level behavioral and psychosocial factors, sociodemographic and neighborhood characteristics, environmental exposure, medical conditions, infertility treatments, and biological factors. Many of these factors co-occur, particularly in those who are socioeconomically disadvantaged or who are members of racial and ethnic minority groups.

While advances in perinatal and neonatal care have improved survival for preterm infants, those infants who do survive have a greater risk than infants born at term for developmental disabilities, health problems, and poor growth. The birth of a preterm infant can also bring considerable emotional and economic costs to families and have implications for public-sector services, such as health insurance, educational, and other social support systems.

Preterm Birth assesses the problem with respect to both its causes and outcomes. This book addresses the need for research involving clinical, basic, behavioral, and social science disciplines. By defining and addressing the health and economic consequences of premature birth, this book will be of particular interest to health care professionals, public health officials, policy makers, professional associations and clinical, basic, behavioral, and social science researchers.


Suggested Citation

Institute of Medicine. 2007. Preterm Birth: Causes, Consequences, and Prevention. Washington, DC: The National Academies Press.

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Publication Info

790 pages |  6 x 9 |  Hardcover
ISBN: 978-0-309-10159-2
Chapters skim
Front Matter i-xviii
Summary 1-30
1 Introduction 31-52
SECTION I Measurement : 2 Measurement of Fetal and Infant Maturity 53-83
Section I Recommendations 84-86
SECTION II Causes of Preterm Birth: 3 Behavioral and Psychosocial Contributors to Preterm Birth 87-123
4 Sociodemographic and Community Factors Contributing to Preterm Birth 124-147
5 Medical and Pregnancy Conditions Associated with Preterm Birth 148-168
6 Biological Pathways Leading to Preterm Birth 169-206
7 Role of Gene-Environment Interactions in Preterm Birth 207-228
8 Role of Environmental Toxicants in Preterm Birth 229-254
Section II Recommendations 255-258
SECTION III Diagnosis and Treatment of Preterm Labor: 9 Diagnosis and Treatment of Conditions Leading to Spontaneous Preterm Birth 259-307
Section III Recommendations 308-310
SECTION IV Consequences of Preterm Birth: 10 Mortality and Acute Complications in Preterm Infants 311-345
11 Neurodevelopmental, Health, and Family Outcomes for Infants Born Preterm 346-397
12 Societal Costs of Preterm Birth 398-429
Section IV Recommendations 430-432
SECTION V Research and Policy: 13 Barriers to Clinical Research on Preterm Birth and Outcomes of Preterm Infants 433-454
14 Public Policies Affected by Preterm Birth 455-472
Section V Recommendations 473-476
15 A Research Agenda to Investigate Preterm Birth 477-492
References 493-590
Appendix A Data Sources and Methods 591-603
Appendix B Prematurity at Birth: Determinents, Consequences, and Geographic Variation 604-643
Appendix C A Review of Ethical Issues involved in Premature Birth 644-687
Appendix D A Systematic Review of Costs Associated with Preterm Birth 688-724
Appendix E Selected Programs Funding Preterm Birth Research 725-731
Appendix F Committee and Staff Biographies 732-740
Index 741-772

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