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ment of spontaneous preterm labor (Chapter 9). Section IV explores the consequences of preterm birth including health, developmental, social, psychological, educational, and economic outcomes (Chapters 10 to 12). The final section explores research and policy considerations and concludes with the committee’s proposed research agenda for the investigation of preterm birth (Chapters 13 to 15). Recommendations are provided at the end of each section. Table 1-3 describes the points of the committee’s charge and the corresponding chapters in which they are addressed.

TABLE 1-3 Committee Charge Points and Report Location Where Addressed

Committee Charge


Review and assess the various factors contributing to the growing incidence of premature birth

3 to 8

Assess the economic costs and other societal burdens associated with premature births

10, 12

Address research gaps/needs and priorities for defining the mechanisms by which biological and environmental factors influence premature birth


Explore possible changes in public health policy and other policies that may benefit from more research


Identify major obstacles to conducting clinical research, which may include

  • the declining number of residents interested in entering the field of obstetrics and gynecology and the resulting effect on the pipeline of clinical researchers

  • the impact of rising medical malpractice premiums on the ability of academic programs to provide protected time for physicians to pursue research

  • the ethical and legal issues involved with conducting research with pregnant women


Provide strategies for removing barriers, including those targeting resident career choices, departments of obstetrics and gynecology, agencies and organizations that fund research, and professional organizations


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