The researchers used a data cohort of 23,631 babies born in Utah from 1998-2000, all covered by Intermountain Healthcare's health insurance. And it tracked those infants through age 5, using all the data on their medical costs, to figure out what the national medical cost would be — $15.9 billion of the $26 billion total. Then they figured out the costs of maternal delivery, early intervention services, special ed costs for children growing up disabled, lost productivity and other factors.

It's the first study to look so far beyond the initial cost of care. And it's an "absolute floor — the bare minimum costs," said Norman Waitzman, associate professor in the department of economics at the University of Utah, who served on the panel and headed the cost analysis.

Besides the Intermountain data, researchers drew on a study from the Atlanta area to come up with estimates on the lifetime cost of developmental disabilities, which occur more frequently among children who were born too soon. They considered only four developmental challenges: mental retardation, cerebral palsy, hearing loss and vision loss, looking at special education costs, lost productivity and medical costs beyond age 5. Costs of other disabilities were not calculated.

The study has drawn a lot of attention to reproduction assistance such as fertility treatments or in vitro fertilization because women are more likely to have multiple births with such methods. And multiple births confer increased risk of premature delivery. On the other hand, multiple births represent only 10 percent of preterm births, the report says. But if you are one of the women having twins, there's a 61.7 percent they are born early, while 97.2 percent of triplets and other "multiples" are born preterm.

Society needs to become a little more stressed about the issue, Iams said. "Isn't it wonderful what they can do with these little babies," the public says, according to Iams. "That translates into it's no big deal to have my baby born early and, of course, it is a big deal."

The report is available online at www.nap.edu.

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