Washington, DC -- The American College of Obstetricians and Gynecologists (ACOG), the nation's leading group of obstetrician-gynecologists dedicated to women's health, applauds the Institute of Medicine (IOM) for addressing the important health, economic, and societal consequences of preterm birth in the US in its report, "Preterm Birth: Causes, Consequences, and Prevention." ACOG is pleased to be a cosponsor of this report because the impact of preterm birth is a major public health problem both in the US and worldwide.

Preterm birth is, and has been, a key concern of the nation's obstetrician-gynecologists, who deliver the majority of babies in this country. ACOG commends the IOM for tackling this extremely complicated issue and for developing such a comprehensive analysis. In particular, ACOG strongly supports the IOM recommendation for an increase in federal funding for research into the causes and prevention of preterm birth.

According to the IOM report, premature birth is the leading cause of newborn deaths. In 2004, 12.5% of all live births in the US were preterm (born before 37 weeks of gestation). Over the past decade, the overall preterm rate has risen steadily in the US and has increased 30% since 1981. The preterm birth rate is highest among African-American women (17.8%) and lowest among Asian and Pacific Islander women (10.5%).

While the exact causes of preterm labor are not known, they may include behavioral, environmental, biological and psychosocial factors, medical conditions and genetics. There are striking racial-ethnic and socioeconomic differences in preterm birth rates that are largely unexplained. The IOM report calls for a research agenda to investigate the problem of preterm birth including the establishment of multidisciplinary research centers.

Preterm infants have a greater risk of death and have significant health and developmental problems compared with full term infants. These health problems are both short term and long term, and include respiratory, gastrointestinal, hearing, vision, neurological, behavioral, central nervous system, emotional, and cognitive problems, among others. Whereas infants born at less than 32 weeks gestation have the highest risk of death and health problems, infants born between 32 and 36 weeks gestation are the largest group of infants born preterm and also are at increased risk for adverse health and developmental outcomes.

While little is known about how to prevent preterm birth, there have been advancements in treating preterm infants and improving their survival rate. To date, there are no reliable diagnostic tests for preterm labor. Treatments have been focused on inhibiting contractions to delay delivery until antenatal steroids can be administered to help develop the fetus' lungs. Recent studies have found that preterm birth can be reduced when progesterone is given to women who had a previous preterm birth.

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