Preterm Birth

Anywhere when a baby is born very small, less than 2.5 kg, birth attendants need warnings to timely make decisions as refer him to the hospital. Without the critical care, the newborn survival could be neglected, as well appropriate management of the respiratory distress syndrome. Most of the lives could be saved with prompt hazard identification, but current methods remains an unsolved challenge because of the disadvantages as low accessibility and the high cost of the obstetric ultrasound

Despite known benefits of Kangaroo Care (KC), uptake is low. KC has been shown to promote healthy growth related to reductions in hypothermia, sepsis, and death [1]. It is highly beneficial for 10 mil premature or Low Birth Weight Indian babies. Parents do not practice adequate KC in hospital or home; doing it incorrectly/for significantly short episodes. Unfortunately, KC promoters do not have tools to measure amount/quality of KC received aside from parents' reporting, which is unreliable.

The project aims to use a Development Impact Bond (DIB) to implement Kangaroo Mother Care (KMC), a cost-effective intervention known to save and improve the lives of low birth weight and pre-term infants in low resource settings, in up to 10 hospitals in Cameroon.

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.