Knowledge Generation

Ricardo Tavares Pinheiro from the Universidade Católica de Pelotas in Brazil will identify factors that are associated with gestational depression, and determine whether they influence their response to treatment and ultimately the healthy development of the child. Gestational and postpartum anxiety and depression affect 15-25% of mothers and can alter the emotional, social and cognitive development of the child. They are likely caused by a complex combination of genetic, hormonal, psychological and social/environmental factors.

Sonia Isoyama Venancio from the Instituto de Saúde in Brazil will implement a program for monitoring the development of children less than five years of age during vaccination campaigns in the municipalities, to help identify risk factors, raise awareness, and support healthy development. They will design and pilot test a questionnaire that can be easily applied during a vaccination procedure to carefully query the health and behavior of the child, as well as their family environment and access to health services and education.

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.

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.

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.

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.

James Platts-Mills of the University of Virginia in the U.S. will quantify the effect of factors, including antibiotic use and hospitalization, in infants on the subsequent incidence and spread of drug-resistant pathogens in developing countries. This will help design more effective strategies for containing it. They will use samples and data taken from birth up to one year of age from a previous longitudinal study, the MAL-ED study, which was performed in eight developing countries. Monthly samples from fifty infants will be analyzed for the emergence of drug-resistant E. coli.

Kristin Wall of Emory University in the U.S. will develop a comprehensive approach to improve the uptake of intrauterine contraceptive devices shortly after birth, which is safe and effective but currently vastly underutilized for preventing unwanted pregnancies in Rwanda even though it is widely available. They will hold focus groups and in-depth interviews with couples, both separately and together, and health workers, to evaluate their knowledge and attitudes on the intrauterine devices, as well as evaluating current practices at two health clinics.