Maternal, Newborn, and Adolescent Health

Sanjay Jain of Johns Hopkins University School of Medicine in the U.S. and colleagues in the U.S. and India will develop a cloud-based platform to record the location, caregiver relationships, and immunization records of infants in developing countries, and provide personalized reminders and incentives via mobile phone to improve the coverage of childhood immunizations. Low immunization coverage has been linked to inaccurate or incomplete records, and the difficulties of encouraging follow-up immunizations and identifying those who miss them.

Oldimeji Oladepo of the University of Ibadan in Nigeria will use mobile phone messaging reminders to encourage parents in Nigeria to complete the full series of routine vaccinations for their children at the recommended times. They will conduct a 10-month study of 1800 mothers with infants aged up to two months at selected health clinics and collect mobile phone numbers also from their families and friends. They will develop a database to store this information and an SMS platform to deliver vaccination reminders, and let them know where they can be obtained and why they are important.

Pratyusha Pareddy and Manoj Sanker of the Centre for Healthcare Entrepreneurship in collaboration with NemoCare Wellness in India will develop a small, battery-operated wearable device for newborns that continuously monitors vital signs in premature babies to alert health workers when a life-threating situation might occur, and provides vibration to stimulate breathing. Premature babies are susceptible to a variety of potentially fatal conditions such as apnea (suspension of breathing) and hypothermia.

David Olson from the University of Alberta in Canada will work to better understand how infections can cause preterm birth. Using animal models and later in studies of women in low-income countries, he and his team will investigate multiple mediators of inflammation in the uterus early in pregnancy, as well as test new diagnostics and therapeutics that can identify women at risk, modulate the inflammatory response, and prolong pregnancy. Funding partners: Global Alliance to Prevent Prematurity and Stillbirth (GAPPS) and Bill & Melinda Gates Foundation.

Kevin Kain of the University Health Network and the University of Toronto in Canada will investigate 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. Funding partners: Global Alliance to Prevent Prematurity and Stillbirth (GAPPS) and Bill & Melinda Gates Foundation.

David Aronoff of the University of Michigan in the U.S., with an interdisciplinary team of experts in microbiology, immunology, reproductive biology, and vaccine development, will examine how infections of the female reproductive tract interact with and evade the immune system, resulting in infections of the uterus that cause preterm birth and stillbirth. This work will research potential targets for prevention of invasive infections of the female genital tract, including plans to investigate strains of group B Streptococcus (GBS) from low-income countries for vaccine and drug development.

Sam Mesiano of Case Western Reserve University School of Medicine in the U.S. and his team will investigate the body's receptors for progestin-based therapies in pregnancy to identify ways to enhance anti-inflammatory processes in all pregnant women and prevent preterm birth. The long-term goal of this project is to develop an inexpensive oral therapy that will reduce the prevalence of preterm birth worldwide. Funding partners: Global Alliance to Prevent Prematurity and Stillbirth (GAPPS) and Bill & Melinda Gates Foundation.

Margaret Hostetter from Cincinnati Children's Hospital Medical Center in the U.S. and her co-investigators will examine how disruption of the normal bacteria and other micro-organisms (the microbiome) of the lower female genital tract may increase risk of preterm birth. These investigations will focus on vaginal Candida infections in pregnancy, inflammation, and regulation of the immune response. Research will be conducted using animal models and laboratory investigations connected to studies of women in low-resource countries.

Anisur Rahman of the Matlab Health Research Centre at the International Centre for Diarrhoeal Disease Research, Bangladesh (ICCDR,B) will lead a prospective cohort study of pregnant women, building on the ICDDR,B community-based surveillance site, to enroll more than 4,000 pregnant women over three years. His team will visit women monthly at their homes for early identification of pregnancy, followed by accurate gestational age dating by ultrasound and follow up throughout pregnancy and at delivery for collection of clinical data and specimens.

Jeffrey Stringer of the University of North Carolina Global Women's Health group in the U.S. will oversee a team of Zambian and U.S. researchers in a prospective cohort study of 2,000 pregnant women over a three-year period in Lusaka, Zambia. The study will assess gestational age by early ultrasound and collect data and specimens throughout pregnancy and at delivery with standardized systems to document complications of pregnancy and assessment of birth outcomes. Data and specimens will be used to evaluate the causes of preterm birth and investigate novel strategies for prevention.