Preterm Birth

David Eschenbach and his team from the University of Washington in the U.S. will determine the effect of disturbances in the vaginal microbiome on preterm birth. Their research will investigate how specific vaginal bacterial infections and changes in the female reproductive tract are associated with preterm birth.

Stephen Lye at Mount Sinai Hospital in Canada and his team will initiate a pilot study that will use a systems biology analysis of genomic, proteomic and plasma markers to identify novel pathways and biomarkers to preterm birth, as well as define the risk of preterm birth in pregnant women. Previous efforts to identify pathways or biomarkers associated with preterm birth have focused on single methodological approaches.

Rita de Cássia Silveira from Hospital de Clínicas de Porto Alegre in Brazil will develop and test a program for families with preterm infants to follow at home to improve the child's cognitive, motor and social development. Preterm infants (those born with less than 37 weeks of gestation) can suffer a variety of complications due to incomplete brain, lung and eye development, which can cause long-term problems.

Marcos Augusto Bastos Dias from Fiocruz in Brazil in collaboration with the Global Pregnancy Collaboration (CoLab) will test a new approach for managing women in Brazil with preeclampsia in order to reduce unnecessary preterm births. Preeclampsia is characterized by high blood pressure and impaired organ function during pregnancy and can cause severe complications or even death for mother and child. The only cure is delivery, but preterm births are also high risk.

Maria do Carmo Leal from Fiocruz in Brazil will undertake a pilot "Parto Adequado" (Adequate Birth) project to evaluate whether different health care models offered by medical institutions during pregnancy and childbirth can promote healthier births, particularly by reducing the rate of unnecessary medical procedures. These include caesarean section without clinical indication, which occur frequently in Brazil and can have negative consequences. They have selected 23 geographically dispersed hospitals for the pilot study, which will involve around 16,000 mothers.

Renato Soibelmann Procianoy from the Universidade Federal do Rio Grande do Sul in Brazil will analyze the association between bacterial populations in the vagina and gut of mothers in their third trimester and in the meconium of very preterm newborns, with risk of preterm delivery. It was previously assumed that microbes from the mother are first transferred to the fetus during delivery.

Tania Maria Ruffoni Ortiga from the Universidade Federal do Rio de Janeiro in Brazil will measure the levels of so-called ABC transporters throughout pregnancy, and during normal and preterm labor, and how they are influenced by infections such as malaria and influenza, to determine whether they might increase the risk of preterm labor. ABC transporters sit in the outer membranes of cells and actively transport drugs, toxins and immune signaling molecules out of them.

Silvia Regina Dias Medici Saldiva from the Instituto de Saúde in Brazil will determine whether and which physical, social and cultural aspects of urban environments can increase the incidence of preterm birth. Prematurity is a major cause of childhood mortality and disability, and levels are high in Brazil. Preterm birth is likely caused by combinations of factors that, particularly in urban locales, might include environmental factors such as the quality of housing, proximity to health facilities and pollution levels, which then interact with social and cultural factors.

Renato Luis da Silveira Ximenes of Universidade Federal de São Paulo in Brazil will conduct a randomized controlled trial to evaluate whether a daily low dose of aspirin taken from early in pregnancy can prevent preeclampsia and thereby reduce the rate of preterm birth. Preterm birth is a leading cause of neonatal morbidity and mortality, and preeclampsia is a major cause of maternal death.

Jose Simon Camelo Junior from the Universidade Federal de São Paulo in Brazil will test a method for producing a lyophilized human milk concentrate for feeding very low birth weight newborns that can be implemented in developing countries. Very small premature babies of less than 1,500 grams require large quantities of proteins, calories, minerals, micronutrients and electrolytes to survive and thrive. However, breast milk alone is not concentrated enough.