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Preterm births have continued to increase despite years of research into the causes, epidemiology, and management of preterm labor. In the United States, the rate of preterm births now exceeds 12 percent. There are many hypotheses to explain this increase. Assisted reproductive technology has contributed to a substantial increase in multiple gestations. As compared with singletons, multiples are at higher risk for early delivery and are disproportionately represented among infants born extremely preterm. Another contributing factor is the willingness of obstetricians to elect delivery of infants of women in whom medical, fetal, or obstetrical complications occur preterm. The majority of
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