Combating a crisis: Global burden of preterm birth can be reduced if critical actions are taken

November 6, 2012

New surveys of researchers and funders reveal a lack of consensus regarding researching and developing interventions to prevent prematurity and stillbirth, according to an article published in the American Journal of Obstetrics and Gynecology ahead of World Prematurity Day on November 17.

Authored by Michael G. Gravett, MD, scientific director of the Global Alliance to Prevent Prematurity and Stillbirth (GAPPS), an initiative of Seattle Children's, and Craig E. Rubens, MD, PhD, executive director of GAPPS, the article outlines significant opportunities to enhance research into and develop solutions to prevent prematurity and stillbirth, which combined take the lives of 4 million babies every year.

"One of the main observations from the technical team was that current research funding is fragmented and uncoordinated, lacking central leadership," the authors write in A framework for strategic investments in research to reduce the global burden of preterm birth. "Funders do not understand where the field is going."

Gravett and Rubens surveyed researchers and funders and found that both parties are equally uncertain about research and development projects that need to be undertaken, and many funders are hard-pressed to support research on the complex problems of and childbirth given competing priorities. This lack of consensus provides an opportunity to engage with funders and researchers to recognize the importance of understanding healthy pregnancies and the consequences of adverse .

The article proposes that a strategic alliance of funders, researchers, nongovernmental organizations, the private sector, and others could organize a set of grand challenges centered on pregnancy and childbirth that could yield a substantial improvement in the development and delivery of new and much more effective interventions, even in low-resource settings.

The authors note: "Pregnancy remains one of the least explored aspects of human biology, creating a tremendous opportunity. Long-term funding commitments for research could advance discovery science and the development of interventions targeted at pregnancy and early life and impact maternal and newborn health around the world."

Preterm birth and stillbirth are among the greatest health burdens associated with pregnancy and childbirth. Fifteen million babies are born preterm each year, causing about 1 million deaths annually and lifelong problems for many survivors; 3 million stillbirths also occur annually. Worldwide, the number of women and children who die during pregnancy and childbirth exceeds the total number of births in the United States. Even if all current interventions were universally applied, the authors estimate that the preterm birthrate would drop by less than 20 percent.

Based on their interviews, the authors compiled a set of recommendations that could greatly improve the visibility of research on pregnancy, childbirth, and early life, and mobilize funders to increase investments leading to the discovery, development, and delivery of low-cost and high-impact interventions to prevent preterm birth and stillbirth.

Toward making every pregnancy a healthy pregnancy:

  • Emphasize that healthy outcomes in pregnancy benefit everyone, directly and indirectly
  • Raise awareness of personal and public burden of prematurity, stillbirth, and other pregnancy and early life problems
  • Establish strategic alliance of funders, researchers, and other stakeholders in areas of pregnancy, childbirth, and early life
  • Identify commonalities among funding organizations to develop a coordinated research and intervention agenda
  • Identify and promote research opportunities in areas of pregnancy, childbirth, and early life that can attract investigators
  • Engage new investigators from multiple disciplines
  • Utilize descriptive sciences and economic modeling to establish true costs and burdens of disease and assess impact of costs of current or future interventions
  • Establish collaborations and promote research within high-burden, low-resource countries
Key considerations in developing a framework for a global approach to reduce preterm birth and stillbirth:
  • Develop and adopt clear and consistent definitions and classification criteria
  • Longitudinally characterize determinants of healthy continuum pregnancy and pathologic perturbations
  • Recognize preterm birth and stillbirth as multifactorial, complex endpoints
  • Develop predictive biomarkers and interventions that are pathway-specific for varied causes of and stillbirth
  • Develop infrastructure to support population-specific research and intervention in high-burden, low-resource settings
  • Link discovery science to intervention development and implementation science

Explore further: New global report says US lags behind 130 other nations in preterm birth rate

Related Stories

New global report says US lags behind 130 other nations in preterm birth rate

May 2, 2012
Preterm babies are born at a higher rate in the United States than in 130 other countries of the world, including many poorer nations, according to the just-released report Born Too Soon: The Global Action Report on Preterm ...

Preterm birth rate shows three year improvement in most states

November 1, 2011
Preterm birth rates improved in almost every state between 2006 and 2009, and in several states the change was more than 10 percent, according to the March of Dimes 2011 Premature Birth Report Card.

US preterm birth rate under 12 percent, the lowest level in nearly a decade

November 17, 2011
The nation's preterm birth rate slipped under 12 percent for the first time in nearly a decade, the fourth consecutive year it declined, potentially sparing tens of thousands of babies the serious health consequences of an ...

Most pregnancy-related infections are caused by four treatable conditions

October 9, 2012
In low-and-middle income countries, pregnancy-related infections are a major cause of maternal death, can also be fatal to unborn and newborn babies, and are mostly caused by four types of conditions that are treatable and ...

Study shows progesterone fails to prevent preterm birth in high risk group

October 18, 2012
(Medical Xpress)—A formulation of the hormone progesterone, shown to be effective in women at risk for another preterm birth because they had a prior preterm birth, was not found to be effective in preventing preterm birth ...

Recommended for you

Population health impact of infants born small for gestational age in low- and middle-income countries

August 18, 2017
In low-and middle-income countries, it is common for babies to be born of low birth weight, due to either inadequate growth in utero (fetal growth restriction) and/or preterm birth, (birth before 37 weeks gestation). Maternal ...

Hormone from fat tissue can give protection against polycystic ovary syndrome

August 10, 2017
Obesity and reduced insulin sensitivity are common in polycystic ovary syndrome, PCOS. New research based on animal studies, and to be published in the journal PNAS, reveals that the hormone adiponectin can protect against ...

Study in mice may reveal insights into causes of miscarriages for some women

August 9, 2017
Researchers at St. Michael's Hospital have identified how natural killer cells in the mouse placenta can cause a fetus to fail to grow in the womb or cause miscarriages.

Insomnia, sleep apnea nearly double the risk of preterm delivery before 34 weeks

August 9, 2017
Pregnant women who are diagnosed with sleep disorders such as sleep apnea and insomnia appear to be at risk of delivering their babies before reaching full term, according to an analysis of California births by researchers ...

Elective freezing of IVF embryos linked to higher pregnancy rates in some cases

August 1, 2017
A delay in transferring embryos to the mother improves the success of in vitro fertilization in certain cases, according to a study by scientists at the Stanford University School of Medicine, Celmatix Inc. and several other ...

Negative birth outcomes linked to air pollution exposure early in pregnancy, study finds

July 27, 2017
Exposure to air pollution early in a pregnancy could increase risk for preterm birth and low birth weight, according to a study led by researchers at NYU School of Medicine, and published on July 27 in Environmental Health ...

0 comments

Please sign in to add a comment. Registration is free, and takes less than a minute. Read more

Click here to reset your password.
Sign in to get notified via email when new comments are made.