I 
109TH CONGRESS 
1ST SESSION H. R. 2861 
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 
JUNE 9, 2005 
Mr. UPTON (for himself and Ms. ESHOO) 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’’. 
SEC. 2. FINDINGS AND PURPOSE. 
(a) FINDINGS.—Congress makes the following find-
ings:
(1) Premature birth is a serious and growing 
problem. The rate of preterm birth increased 27 per-
cent between 1982 and 2002 (from 9.4 percent to 
11.9 percent). In 2002, more than 480,000 babies 
were born prematurely in the United States. 
(2) Preterm birth accounts for 24 percent of 
deaths in the first month of life. 
(3) Premature infants are 14 times more likely 
to die in the first year of life. 
(4) Premature babies who survive may suffer 
lifelong consequences, including cerebral palsy, men-
tal retardation, chronic lung disease, and vision and 
hearing loss. 
(5) Preterm and low birthweight birth is a sig-
nificant financial burden in health care. The esti-
mated charges for hospital stays for infants with any 
diagnosis 
of 
prematurity/low 
birthweight 
were 
$15,000,000,000 in 2002. The average lifetime med-
ical costs of a premature baby are conservatively es-
timated at $500,000. 
(6) The proportion of preterm infants born to 
African-American mothers (17.3 percent) was sig-
nificantly higher compared to the rate of infants 
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 
2006 through 2010.’’. 
(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
performance measures and national core outcome 
measures utilized under the Maternal and Child 
Health Block Grant under title V of the Social Secu-
rity Act (42 U.S.C. 701 et seq.) for purposes of ex-
panding such measures to include some of the 
known risk factors of low birthweight and pre-
maturity, including the percentage of infants born to 
pregnant women who smoked during pregnancy. 
(2) REPORT.—Not later than 1 year after the 
date of enactment of this Act, the Administrator of 
the Health Resources and Services Administration 
shall submit to the appropriate committees of Con-
gress a report concerning the results of the evalua-
tion conducted under paragraph (1). 
SEC. 4. PUBLIC AND HEALTH CARE PROVIDER EDUCATION 
AND SUPPORT SERVICES. 
Part P of title III of the Public Health Service Act 
(42 U.S.C. 280g et seq.) is amended by adding at the end 
the following: 
‘‘SEC. 399O. PUBLIC AND HEALTH CARE PROVIDER EDU-
CATION AND SUPPORT SERVICES. 
‘‘(a) IN
GENERAL.—The Secretary, directly or 
through the awarding of grants to public or private non-
profit entities, shall conduct a demonstration project to 
improve the provision of information on prematurity to
health professionals and other health care providers and 
the public. 
‘‘(b) ACTIVITIES.—Activities to be carried out under 
the demonstration project under subsection (a) shall in-
clude the establishment of programs— 
‘‘(1) to provide information and education to 
health professionals, other health care providers, and 
the public concerning— 
‘‘(A) the signs of preterm labor, updated 
as new research results become available; 
‘‘(B) the screening for and the treating of 
infections; 
‘‘(C) counseling on optimal weight and 
good nutrition, including folic acid; 
‘‘(D) smoking cessation education and 
counseling; and 
‘‘(E) stress management; and 
‘‘(2) to improve the treatment and outcomes for 
babies born premature, including the use of evi-
dence-based standards of care by health care profes-
sionals for pregnant women at risk of preterm labor 
or other serious complications and for infants born 
preterm and at a low birthweight. 
‘‘(c) REQUIREMENT.—Any program or activity fund-
ed under this section shall be evidence-based.
‘‘(d) NICU FAMILY SUPPORT PROGRAMS.—The Sec-
retary shall conduct, through the awarding of grants to 
public and nonprofit private entities, projects to respond 
to the emotional and informational needs of families dur-
ing the stay of an infant in a neonatal intensive care unit, 
during the transition of the infant to the home, and in 
the event of a newborn death. Activities under such 
projects may include providing books and videos to fami-
lies that provide information about the neonatal intensive 
care unit experience, and providing direct services that 
provide emotional support within the neonatal intensive 
care unit setting. 
‘‘(e) 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 
2006 through 2010.’’. 
SEC. 5. INTERAGENCY COORDINATING COUNCIL ON PRE-
MATURITY AND LOW BIRTHWEIGHT. 
(a) PURPOSE.—It is the purpose of this section to 
stimulate multidisciplinary research, scientific exchange, 
and collaboration among the agencies of the Department 
of Health and Human Services and to assist the Depart-
ment in targeting efforts to achieve the greatest advances 
toward the goal of reducing prematurity and low birth-
weight.
(b) ESTABLISHMENT.—The Secretary of Health and 
Human Services shall establish an Interagency Coordi-
nating Council on Prematurity and Low Birthweight (re-
ferred to in this section as the Council) to carry out the 
purpose of this section. 
(c) COMPOSITION.—The Council shall be composed of 
members to be appointed by the Secretary, including rep-
resentatives of— 
(1) the agencies of the Department of Health 
and Human Services; and 
(2) voluntary health care organizations, includ-
ing grassroots advocacy organizations, providers of 
specialty obstetrical and pediatric care, and re-
searcher organizations. 
(d) ACTIVITIES.—The Council shall— 
(1) annually report to the Secretary of Health 
and Human Services on current Departmental ac-
tivities relating to prematurity and low birthweight; 
(2) plan and hold a conference on prematurity 
and low birthweight under the sponsorship of the 
Surgeon General; 
(3) establish a consensus research plan for the 
Department of Health and Human Services on pre-
maturity and low birthweight;
(4) report to the Secretary of Health and 
Human Services and the appropriate committees of 
Congress on recommendations derived from the con-
ference held under paragraph (2) and on the status 
of Departmental research activities concerning pre-
maturity and low birthweight; 
(5) carry out other activities determined appro-
priate by the Secretary of Health and Human Serv-
ices; and 
(6) oversee the coordination of the implementa-
tion of this Act. 
SEC. 6. AUTHORIZATION OF APPROPRIATIONS. 
There are authorized to be appropriated to carry out 
this Act, such sums as may be necessary for each of fiscal 
years 2006 through 2010. 
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