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Several reports on the problem of preterm birth, low birth weight, and other infant outcomes have been published by the Institute of Medicine, in addition to the workshop summary on The Role of Environmental Hazards in Premature Birth. Preventing Low Birthweight (IOM, 1985) defined the significance of the problem of low birth weight, reviewed data on risk factors and etiology, and examined state and national trends in the incidence of low birth weight among various groups. This report also described approaches to prevent low birth weight and their economic costs and identified research needs. Prenatal Care: Reaching Mothers, Reaching Infants (IOM, 1988) examined 30 prenatal care programs, analyzed surveys of mothers who did not seek prenatal care, and made recommendations for improving the nation’s maternity system and increasing the use of prenatal care programs. Two recent reports: Reducing Birth Defects: Meeting the Challenges in the Developing World (IOM, 2003) and Improving Birth Outcomes: Meeting the Challenges in the Developing World (IOM, 2003) address issues specific to developing countries.

Two IOM reports are specifically related to the committee’s charge to address research barriers; Medical Professional Liability and the Delivery of Obstetrical Care (IOM, 1989) and Strengthening Research in Academic OB/GYN Departments (IOM, 1992). The first report addressed medical liability and its effect on access to and delivery of obstetrical care; and civil justice and insurance systems, medical liability issues, and their combined effect on health care for mothers and children. The second report examined the ability of departments of obstetrics and gynecology to conduct research within academic departments in order to improve women’s health and the outcomes of pregnancy.

Research and other activities addressing preterm birth are also being conducted and supported by a variety of federal agencies and private foundations (see Chapter 13 for review). A major effort has been undertaken by the March of Dimes to address the problem of preterm birth. In January 2003, the Foundation launched its Prematurity Campaign to raise awareness of the problem of prematurity and reduce the rate of premature births. Components of the campaign include funding research, providing support to families affected by prematurity, working for access to insurance and health care coverage, helping providers learn ways to help reduce the risk for preterm delivery, and educating women about how to reduce their risk and recognize symptoms of preterm labor. The March of Dimes recently published a research agenda for preterm birth (Green et al., 2005). Major recommendations outlined six primary research topics including epidemiologic studies, genes and gene-environment interactions, racial-ethnic dis-

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