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artificial environmental factors, geographic locations, physical surroundings, social factors, cultural and family influences and differences, behavioral influences and outcomes, biological and chemical factors, and genetics. The study will analyze the interactions of these factors and how they might affect children’s health. Many of these factors have been discussed in this report as potential causes of preterm birth. Such a cohort study will be of great value in helping to provide an understanding of the causes and consequences of preterm birth. Therefore, if the study is conducted, data should be collected in a manner consistent with the committee’s recommendations.

This final chapter organizes the recommendations and findings presented in previous sections into a research agenda. The agenda is presented to help focus and direct research efforts. The recommendations are grouped and prioritized and therefore presented in a different sequence than they appear in the full report; however, their numeric designation remains the same.

Priority areas are grouped as follows:


  1. Establish Multidisciplinary Research Centers

  2. Priority Areas for Research

    • Better define the problem of preterm birth with improved data Recommendations included in this category pertain to the need for improved collection of surveillance and descriptive data in order to better define the nature and scope of the problem of preterm birth.

      1. Improve national data

      2. Study the economic outcomes for infants born preterm

    • Conduct clinical and health services research investigations Recommendations in this category pertain to the need to examine and improve the clinical treatment of women who deliver preterm and infants born preterm and the health care systems that care for them.

      1. Improve the methods of identifying and treating women at risk for preterm labor

      2. Study the acute and the long-term outcomes for infants born preterm

      3. Study infertility treatments and institute guidelines to reduce the number of multiple gestations

      4. Improve the quality of care for women at risk for preterm labor and infants born preterm

      5. Investigate the impact of the health care delivery system on



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