Background
Preterm birth is when a baby is born before 37 weeks and accounts for 15% of infant deaths in the US. One-third of the 100 cities with the greatest number of live births had a preterm birth rate of 11.5% or higher in 2023. Additionally, preterm birth rates impact specific populations disproportionately, with rates being higher in babies born to mothers of Black, Alaskan Native/American Indian, and Pacific Islander as well as those living in rural areas and the Southeast US.
Preterm birth rate and grade by state, 2023
Preterm babies may have more health problems or need to stay in the hospital longer than babies born on time. Some of these babies face long-term health issues, like problems that affect the brain, lungs, hearing, or vision. The annual cost of preterm births in the US is over $25 billion, encompassing not only direct care costs, but also those associated with lost labor market productivity and special education services. These costs put incredible financial strain on families.
With preterm births rising 8% nationally from 2013 to 2023 and impacting over 373,000 babies in 2023, we cannot be complacent. We must continue efforts to better understand the causes and how we can prevent preterm birth to give our moms and babies the best possible start.
In 2006, Congress passed the original PREEMIE Act (P.L. 109-450), expanding research and developing a public-private agenda aimed at reducing preterm birth and its negative consequences.
In 2018, Congress reauthorized a 5-year extension, called the PREEMIE Reauthorization Act (S. 3029/H.R. 6085), renewing our nation’s commitment to address preterm birth through federal research, promoting known interventions, and promoting community initiatives.
The PREEMIE Reauthorization Act of 2023 (S. 1573/H.R. 3226) aimed to reauthorize the programs authorized by the PREEMIE Act again and it was introduced on May 12, 2023. Although the PREEMIE Reauthorization Act unanimously passed the House and moved out of the Senate HELP committee, reauthorization did not occur by the end of the 118th Congress in 2024 after it was removed from the end-of-year package. As a result, the PREEMIE Act’s programs are at risk or were terminated without new reauthorization legislation.
Supporting reauthorization in the current 119th Congress will ensure that the lifesaving programs authorized by the PREEMIE Act are safeguarded from staff and funding elimination. The PREEMIE Reauthorization Act of 2025 (S. 1562/H.R. 1197) was introduced by Sen. Bennet (D-CO), Sen. Boozman (R-AR) in the Senate on May 1, 2025, and by Rep. Kelly (D-IL), Rep. Miller-Meeks (R-IA), Rep. Fletcher (D-TX), Rep. Carter (R-GA), Rep. Brown (D-OH), and Rep. Kiggans (R-VA) on February 11, 2025, in the House.
This imperative legislation is a top priority for March of Dimes and numerous organizations involved in maternal and infant health.
Key bill provisions
Key provisions of the PREEMIE Reauthorization Act included:
- Renewal of the Centers for Disease Control and Prevention’s research and programs on preterm birth, including improved tracking of national data.
- Reauthorization of the Health Resources and Services Administration’s activities aimed at promoting healthy pregnancies and preventing preterm birth.
- Provision for a new study on the costs, impact of social factors, gaps in public health programs that lead to prematurity, and calls for Department of Health and Human Services (HHS) to make recommendations to prevent preterm birth.
- Establishment of an entity in the HHS to coordinate all federal activities and programs related to preterm birth, infant mortality, and other adverse birth outcomes
