non-Hispanic white and Hispanic infants. In 2002, there were 57.3 deaths per 1,000 live births for black infants born at less than 37 weeks of gestation. In contrast, the mortality rates were 33.2 deaths per 1,000 live births for white infants and 30.7 deaths per 1,000 live births for Hispanic infants.

Many believe that differences in family socioeconomic conditions explain the differences in the risk for preterm birth by race, particularly between African American and white, non-Hispanic women. However, evidence suggests that the differences in the rates of preterm birth between African American women and white women, as well as the differences in the birth weights and the rates of infant mortality, remain after attempting to adjustment for the family’s socioeconomic condition (Collins and Hawkes, 1997; McGrady et al., 1992; Schoendorf et al., 1992; Shiono et al., 1997). Investigators have noted that even after attempting to adjust for socioeconomic condition, substantial differences in income and other related variables remain (Schoendorf et al., 1992). (see Chapter 4 for a full discussion of the sociodemographic factors associated with preterm birth).

The purpose of this report is to assess the state of the science on the causes of preterm birth, address the health and economic costs of preterm birth for children born before term and their families, and establish a framework for action in addressing the range of priority issues, including a research and policy agenda for the future. The report is divided into five sections (Table 1-2). Section I reviews and discusses the definitions and terms used to describe the population of preterm infants (Chapter 2). Section II reviews the major categories of research investigating the causes of preterm birth: behavioral and psychosocial factors, sociodemographic and community factors, medical and pregnancy conditions, biological pathways, gene-environment interactions, and environmental toxicants (Chapters 3 to 8). Section III assesses the current understanding of the diagnosis and treat-