I 
108TH CONGRESS 
1ST SESSION H. R. 3350
To reduce preterm labor and delivery and the risk of pregnancy-related 
deaths and complications due to pregnancy, and to reduce infant mor-
tality caused by prematurity. 
IN THE HOUSE OF REPRESENTATIVES 
OCTOBER 20, 2003
Mr. UPTON (for himself, Ms. ESHOO, Mr. RAMSTAD, Mr. BACHUS, Mr. 
BROWN of Ohio, Mr. TOWNS, and Mr. JACKSON of Illinois) introduced 
the following bill; which was referred to the Committee on Energy and 
Commerce 
A BILL 
To reduce preterm labor and delivery and the risk of preg-
nancy-related deaths and complications due to pregnancy, 
and to reduce infant mortality caused by prematurity.
Be it enacted by the Senate and House of Representa-
tives of the United States of America in Congress assembled,
SECTION 1. SHORT TITLE. 
This Act may be cited as the ‘‘Prematurity Research 
Expansion and Education for Mothers who deliver Infants 
Early Act’’ or the ‘‘PREEMIE Act’’.
born to white mothers (10.6 percent). Prematurity 
or low birthweight is the leading cause of death for 
African-American infants. 
(7) The cause of approximately half of all pre-
mature births is unknown. 
(8) Women who smoke during pregnancy are 
twice as likely as nonsmokers to give birth to a low 
birthweight baby. Babies born to smokers weigh, on 
average, 200 grams less than nonsmokers’ babies. 
(9) To reduce the rates of preterm labor and 
delivery more research is needed on the underlying 
causes of preterm delivery, the development of treat-
ments for prevention of preterm birth, and treat-
ments improving outcomes for infants born preterm. 
(b) PURPOSES.—It is the purpose of this Act to—
(1) reduce rates of preterm labor and delivery; 
(2) work toward an evidence-based standard of 
care for pregnant women at risk of preterm labor or 
other serious complications, and for infants born 
preterm and at a low birthweight; and 
(3) reduce infant mortality and disabilities 
caused by prematurity.
SEC. 3. RESEARCH RELATING TO PRETERM LABOR AND DE-
LIVERY AND THE CARE, TREATMENT, AND 
OUTCOMES OF PRETERM AND LOW BIRTH-
WEIGHT INFANTS. 
(a) GENERAL EXPANSION
OF NIH RESEARCH.—
Part B of title IV of the Public Health Service Act (42 
U.S.C. 284 et seq.) is amended by adding at the end the 
following: 
‘‘SEC. 409J. EXPANSION AND COORDINATION OF RESEARCH 
RELATING TO PRETERM LABOR AND DELIV-
ERY AND INFANT MORTALITY. 
‘‘(a) IN GENERAL.—The Director of NIH shall ex-
pand, intensify, and coordinate the activities of the Na-
tional Institutes of Health with respect to research on the 
causes of preterm labor and delivery, infant mortality, and 
improving the care and treatment of preterm and low 
birthweight infants. 
‘‘(b) AUTHORIZATION OF RESEARCH NETWORKS.—
There shall be established within the National Institutes 
of Health a Maternal-Fetal Medicine Units Network and 
a Neonatal Research Units Network. In complying with 
this subsection, the Director of NIH shall utilize existing 
networks. 
‘‘(c) AUTHORIZATION OF APPROPRIATIONS.—There 
are authorized to be appropriated to carry out this section,
such sums as may be necessary for each of fiscal years 
2004 through 2008.’’. 
(b) GENERAL EXPANSION OF CDC RESEARCH.—
Section 301 of the Public Health Service Act (42 U.S.C. 
241 et seq.) is amended by adding at the end the fol-
lowing: 
‘‘(e) The Director of the Centers for Disease Control 
and Prevention shall expand, intensify, and coordinate the 
activities of the Centers for Disease Control and Preven-
tion with respect to preterm labor and delivery and infant 
mortality.’’. 
(c) STUDY
ON ASSISTED REPRODUCTION TECH-
NOLOGIES.—Section 1004(c) of the Children’s Health Act 
of 2000 (Public Law 106–310) is amended—
(1) in paragraph (2), by striking ‘‘and’’ at the 
end; 
(2) in paragraph (3), by striking the period and 
inserting ‘‘; and’’; and 
(3) by adding at the end the following: 
‘‘(4) consider the impact of assisted reproduc-
tion technologies on the mother’s and children’s 
health and development.’’.
(d) STUDY
ON
RELATIONSHIP
BETWEEN
PRE-
MATURITY AND BIRTH DEFECTS.—
(1) IN GENERAL.—The Director of the Centers 
for Disease Control and Prevention shall conduct a 
study on the relationship between prematurity, birth 
defects, and developmental disabilities. 
(2) REPORT.—Not later than 2 year after the 
date of enactment of this Act, the Director of the 
Centers for Disease Control and Prevention shall 
submit to the appropriate committees of Congress a 
report concerning the results of the study conducted 
under paragraph (1). 
(e) REVIEW
OF PREGNANCY RISK ASSESSMENT 
MONITORING SURVEY.—The Director of the Centers for 
Disease Control and Prevention shall conduct a review of 
the Pregnancy Risk Assessment Monitoring Survey to en-
sure that the Survey includes information relative to med-
ical care and intervention received, in order to track preg-
nancy outcomes and reduce instances of preterm birth. 
(f) STUDY ON THE HEALTH AND ECONOMIC CON-
SEQUENCES OF PRETERM BIRTH.—
(1) IN GENERAL.—The Director of the National 
Institutes of Health in conjunction with the Director 
of the Centers for Disease Control and Prevention 
shall enter into a contract with the Institute of Med-
icine of the National Academy of Sciences for the 
conduct of a study to define and address the health
and economic consequences of preterm birth. In con-
ducting the study, the Institute of Medicine shall—
(A) review and assess the epidemiology of 
premature birth and low birthweight, and the 
associated maternal and child health effects in 
the United States, with attention paid to cat-
egories of gestational age, plurality, maternal 
age, and racial or ethnic disparities; 
(B) review and describe the spectrum of 
short and long-term disability and health-re-
lated quality of life associated with premature 
births and the impact on maternal health, 
health care and quality of life, family employ-
ment, caregiver issues, and other social and fi-
nancial burdens; 
(C) assess the direct and indirect costs as-
sociated with premature birth, including mor-
bidity, disability, and mortality; 
(D) 
identify 
gaps 
and 
provide 
rec-
ommendations for feasible systems of moni-
toring and assessing associated economic and 
quality of life burdens associated with pre-
maturity; 
(E) explore the implications of the burden 
of premature births for national health policy;
(F) identify community outreach models 
that are effective in decreasing prematurity 
rates in communities; 
(G) consider options for addressing, as ap-
propriate, the allocation of public funds to bio-
medical and behavioral research, the costs and 
benefits of preventive interventions, public 
health, and access to health care; and 
(H) provide recommendations on best 
practices and interventions to prevent pre-
mature birth, as well as the most promising 
areas of research to further prevention efforts. 
(2) REPORT.—Not later than 1 year after the 
date on which the contract is entered into under 
paragraph (1), the Institute of Medicine shall submit 
to the Director of the National Institutes of Health, 
the Director of the Centers for Disease Control and 
Prevention, and the appropriate committees of Con-
gress a report concerning the results of the study 
conducted under such paragraph. 
(g) EVALUATION OF NATIONAL CORE PERFORMANCE 
MEASURES.—
(1) IN
GENERAL.—The Administrator of the 
Health Resources and Services Administration shall 
conduct an assessment of the current national core