Preterm birth can be reduced if critical actions are taken

I recently helped administer surveys in which researchers and funders were asked to enumerate their priorities for researching and developing interventions to prevent prematurity and stillbirth, and the results were not encouraging. We found that there is a lack of consensus among both parties as to which projects are most important; the only shared sentiment was that current research and funding is fragmented and uncoordinated.

The good news is that this lack of consensus provides an opportunity to forge a more cohesive research agenda by engaging funders and researchers to recognize the importance of understanding healthy pregnancies and the consequences of adverse pregnancy outcomes. In the latest issue of American Journal of Obstetrics and Gynecology, which is focused on prematurity in honor of World Prematurity Day on Nov. 17, my colleague Dr. Craig Rubens and I present a blueprint for critical actions that can be taken to reduce premature births worldwide.

As we note in the article, “Pregnancy remains one of the least explored aspects of human biology, creating a tremendous opportunity. Long-term funding commitments for research could advance discovery science and the development of interventions targeted at pregnancy and early life and impact maternal and newborn health around the world.”

The Born Too Soon report in May showed that incidence of prematurity is increasing worldwide. Unfortunately, even if all current interventions were universally applied, the preterm birth rate would drop by less than 20 percent. While great strides are being made in the care of preterm infants, there is a critical need for more research and development into how to prevent prematurity altogether.

One of the ways that GAPPS is helping to close that solution gap is through the Preventing Preterm Birth initiative, a Grand Challenge in Global Health. The initiative is funding innovative research projects to discover biological mechanisms that lead to preterm birth and develop novel prevention interventions. We recently announced five new projects that are being funded, examining a range of causes, from inflammation to malaria infections.

The economic incentive for investing in preventive research has never been greater. Consider that the costs associated with preterm birth exceed $26 billion a year in the U.S. alone, and that estimate is from 2005; the cost is surely even greater now. In a time where the global economy is struggling and healthcare costs continue to rise, preventing premature birth would not only save millions of lives but also billions of dollars.

Included here are some of the recommendations that Dr. Rubens and I proposed in the AJOG article, and which can go a long way toward making every birth a healthy birth:

  • Develop and adopt clear and consistent definitions and classification criteria 

  • Utilize descriptive sciences and economic modeling to establish true costs and burdens of disease and assess impact of costs of current or future interventions

  • Identify commonalities among funding organizations to develop a coordinated research and intervention agenda

  • Establish strategic alliance of funders, researchers, and other stakeholders in areas of pregnancy, childbirth, and early life

  • Recognize preterm birth and stillbirth as multifactorial, complex endpoints

  • Develop infrastructure to support research and intervention in high-burden, low-resource settings

  • Emphasize that healthy outcomes in pregnancy benefit everyone, directly and indirectly

Watch a video with one of the winners, Dr. Kevin Kain of the University Health Network and the University of Toronto will be investigating malaria infections of the placenta to reveal specific roles of the immune response that lead to preterm birth, low birth weight, and stillbirth. This project will focus on discovering biomarkers to identify at-risk pregnancies as well as new interventions to prevent adverse pregnancy outcomes: 

Click here to watch videos from the additional innovative research projects. 

 

This blog is part of a series on HNN that will lead to World Prematuriy Day, November 17, discussing preterm birth and highlighting the actions needed to prevent and reduce preterm birth, the leading cause of newborn deaths. Join us as we discover that everyone has a role to play. To get involved and learn more, please visit www.facebook.com/WorldPrematurityDay.
Additional blogs related to preterm birth:

 


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