Preterm Birth

Jose Maria de Andrade Lopes of the Instituto Fernandes Figueira - Fiocruz in Brazil will conduct a randomized study to evaluate "Quarenta Semana," which is a program designed to remove risk factors associated with preterm births in Rio de Janeiro. The preterm birth rate in Brazil is amongst the highest globally. Some known risk factors for preterm birth include limited access to healthcare services, maternal social and health factors such as diabetes, and the quality of prenatal care.

Joao Guilherme Bezerra Alves from the Instituto de Medicina Integral Professor Fernando Figueira in Brazil will perform a randomized controlled trial to assess whether a daily oral supplement of magnesium citrate can prevent placental vascular disease, which can lead to preterm birth. Placental vascular disease restricts the flow of nutrients to the fetus and can cause growth restriction and maternal hypertensive disorders. Magnesium is known to promote placental vascular flow, and magnesium citrate is safe, inexpensive and easily absorbed in the body.

Carmen Gracinda Silvan Scochi from the Universidade de São Paulo in Brazil will encourage mothers of preterm infants in Brazil to exclusively breastfeed them for the first six months to better protect them against infections and optimize their growth and neurodevelopment. The incidence of preterm births in Brazil is increasing, and causes multiple short and long-term complications.

Bernardo Jefferson de Oliveira from the Universidade Federal de Minas Gerais in Brazil will develop an interactive exhibit including images, audio, games, and theatre to encourage natural childbirth and perform a pilot study to evaluate its effect on changing public perception of labor and birth. They aim to reduce unnecessary cesarean sections in Brazil where the incidence of preterm births, which can cause severe disabilities, has been increasing.

Antonio Fernandes Moron from the Universidade Federal de São Paulo in Brazil will investigate whether the presence of specific bacterial populations in the vagina can predict preterm birth, which could form part of an inexpensive test suitable for low resource settings. Preterm birth leads to major short- and long-term health problems for the child. The causes are largely unknown, making it hard to identify pregnant women at increased risk who need monitoring and might benefit from treatment.

Rodolfo de Carvalho Pacagnella from the Universidade Estadual de Campinas in Brazil will perform two randomized clinical trials across 15 obstetric clinics in Brazil to evaluate treatment with progesterone in the presence or absence of a cervical pessary for preventing spontaneous preterm birth. Both cervical pessary and progesterone are individually considered to be effective preventative treatments for preterm birth, which is one of the most common complications seen in pregnancy and can cause severe complications for the premature infant.

José Guilherme Cecatti from the Universidade Estadual de Campinas in Brazil will develop a predictive algorithm to identify early in pregnancy those at increased risk of preterm birth so that if possible they can be treated. There are likely to be many causes of preterm birth, and it is a major cause of both short and long term life-threatening complications for infants.

Chetan Patil of Temple University in the U.S. is adapting camera mobile phones for the simple and low cost measurement of bilirubin levels to identify jaundice in newborns by photographing the skin. Jaundice is a common disorder in newborns and can often be easily treated with sunlight. In developed countries, bilirubin measurements are standard-of-care, but in low resource settings, detection can be prohibitively expensive. If jaundice is not treated, it can lead to long-term disabilities.

Lineo Matsela from Sefako Makgatho University in South Africa together with collaborators at the University of Alabama at Birmingham will develop a progesterone-impregnated cervical pessary with strain gauge sensors to identify cervical shortening and dilation and help prevent preterm labor. Preterm birth is a major cause of infant mortality. One of the best predictors is shortening of the cervix, which is currently detected by ultrasound and can then be treated by either vaginal progesterone or a pessary. However, none of these methods are practical in resource-limited settings.

Louis Roux from LifeAssay Diagnostics (Pty) Ltd. in South Africa, in collaboration with PATH, will develop an easy-to-use, low-cost, strip test for pregnant women in developing countries to detect the onset of proteinuria, which indicates a highly increased risk of preeclampsia/eclampsia. Preeclampsia/eclampsia is a major cause of maternal death, particularly in developing countries. Onset is rapid, and so early diagnosis is crucial, particularly in remote communities where health care is not immediately available.