Prematurity is the leading killer of America's newborns. Those who survive often have lifelong health problems, including cerebral palsy, mental retardation, chronic lung disease, blindness and hearing loss.

Prematurity has been escalating steadily and alarmingly over the past two decades. In 2006, nearly 543,000 infants were born prematurely. In 2005, the United States as a society paid at least $26.2 billion in economic costs associated with preterm birth (medical and educational expenses, loss in productivity).

Preterm delivery can happen to any pregnant woman. In about four out of every 10 cases, the causes are unknown.

The March of Dimes has taken on this devastating problem—to find out what causes it and how it can be stopped.

About the Prematurity Campaign
The March of Dimes Prematurity Campaign was launched on January 30, 2003. The Campaign has two goals: (1) to raise public awareness of the problems of prematurity and (2) to decrease the rate of preterm birth in the U.S. The campaign:

• Funds research to find the causes of premature birth
• Encourages investment of public and private research dollars to identify causes and to identify and test promising interventions
• Educates women about risk-reduction strategies and the signs and symptoms of premature labor
• Provides information and emotional support to families affected by prematurity
• Advocates to expand access to health care coverage to improve maternity care and infant health outcomes
• Helps health care providers to improve risk detection and address risk factors
• Generates concern and action around the problem

Important Milestones in the Campaign

• Creation of the Prematurity Research Initiative in 2004, which funds promising, innovative research into the causes of prematurity. Nearly $11 million has been awarded to 30 grantees over the past four years, and the program has already produced promising discoveries.
• Publication of the Institute of Medicine report Preterm Birth: Causes, Consequences, and Prevention (2005). Funded in part by the March of Dimes, this report thoroughly documented the impact of premature birth on families, the health care system and business; it also provided the first cost estimates.
• The March of Dimes initiated the PREEMIE Act (“Prematurity Research Expansion and Education for Mothers Who Deliver Infants Early”) in 2005. This act became law in 2006. It authorizes increased federal support for research and education on prematurity. Work continues on appropriation of funding to implement the act's provisions.
• The PREEMIE Act also called for the first Surgeon General’s Conference on the Prevention of Preterm Birth, which was held in June 2008. The conference brought together experts from the public and private sectors. March of Dimes staff and volunteers were key participants in each of the six work groups that developed goals for an action plan. The goals were presented to the Surgeon General at the conclusion of the conference. Achieving the goals of this plan will require both private and public resources for broad-based research, capacity building, data systems, creation of interventions, quality initiatives and a comprehensive communications strategy.
• In March 2008, a strategic review of the Campaign was completed. It resulted in a March of Dimes board resolution that extended the Campaign to 2020 and established prematurity prevention as a global campaign. Publication of the first global report on preterm birth by the March of Dimes and the World Health Organization is planned to take place in October 2009 in New Delhi, India.

To learn more about what the campaign has achieved, read Progress and Impact.

National Research Agenda on Prematurity
The March of Dimes Scientific Advisory Committee on Prematurity has identified six priority areas for a national research agenda on prematurity. Preterm birth is a complex disorder, like heart disease or diabetes, with no single cause. Consequently, it requires a multifaceted approach. The six priority areas are:

1. New epidemiologic studies focused on the risk of extremely preterm births to identify the factors that predispose women to very early labor and delivery.
2. Genes and their interaction with the environment that, together, lead to preterm birth.
3. Racial and ethnic differences. While prematurity affects all socioeconomic groups, there are significant racial and ethnic disparities. For example, in 2006, non-Hispanic African-Americans had the highest rate of premature births at 18.5 percent, well above the national rate of 12.8 percent. We know very little about why these differences occur.
4. The roles of infection and immune response to those infections.
5. The effects of stress on the mother and fetus.
6. Clinical trials to assess the impact of potential treatments, to identify the women who could most benefit, and to determine the best time to provide treatment during pregnancy.

The March of Dimes is actively funding research grants in these six areas and urging the federal government to fund similar projects.

Why the March of Dimes
For over 65 years, the March of Dimes has saved millions of babies and children from death and disabilities through our life-saving research, innovative programs, and dedicated volunteers. The March of Dimes was founded in 1938 by President Franklin Delano Roosevelt to defeat polio, a dreaded disease that claimed the lives and limbs of America's children in record numbers. Within 17 years, the Salk vaccine was developed and polio was defeated.

The March of Dimes then turned its attention to an even greater challenge—fighting birth defects and other infant health problems. With a track record of success in bringing people together to solve complex health challenges, the March of Dimes is uniquely qualified to take on the problem of prematurity.

July 2009