Siobhan M. Dolan, MD¹, Nancy Green, MD¹, Joann Petrini, PhD, MPH², Janis Biermann, MS², and Karla Damus, RN, PhD². (1) March of Dimes, 1275 Mamaroneck Avenue, White Plains, NY 10605, 914.997.4788, siobhanmdolan@yahoo.com, (2) Perinatal Data Center, March of Dimes Birth Defects Foundation, 1275 Mamaroneck Ave, White Plains, NY 10605

In 2002, the upward trend in preterm birth (PTB) continued, reaching 12.1%, the highest rate ever reported. There are important disparities in preterm birth by race/ethnicity, maternal age, maternal education, plurality, and region. For these respective categories, the highest PTB rates for 2001were: 17.6% for non-Hispanic black infants, 22.2% for women <15 years of age, 15.6% for women >40 years, 13.6% for less than high school education, and 92.7% for triplets and higher multiples. PTB also remained the leading cause of neonatal mortality and of black infant mortality. PTB has an important impact on and shares many risk factors with birth defects and developmental disabilities. Despite decades of research, accurate prediction strategies and effective interventions have remained illusive. While many risk factors and four pathways have been identified (inflammation, maternal/fetal stress, uterine distension, and thrombophilia), prevention of PTB will require a paradigm shift to approach the condition as a common complex disorder. Reevaluation of clinical practice, a focus on disparities, and a comprehensive research strategy utilizing genomic approaches will be required to begin to reverse the intractable trends. Identification of genetic contributions to preterm birth as well as environmental influences and gene-environment interactions will allow the tools and promise of the genomic era to open research and therapeutic opportunities in preterm birth. Such hope and progress is long overdue. The 5 year National March of Dimes Prematurity Campaign is addressing many of these key components. Targeted research, clinical, epidemiological, educational and programmatic strategies integrated into the campaign will be presented.

Learning Objectives:

• Understand the epidemiology of preterm birth
• Consider genomic approaches to preterm birth as a common complex disorder

Keywords: MCH Epidemiology, Genetics

Presenting author's disclosure statement:
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.