Five innovative research projects aiming to prevent premature birth were announced today by the Global Alliance to Prevent Prematurity and Stillbirth (GAPPS), an initiative of Seattle Children's.
The projects are funded through the Preventing Preterm Birth initiative, part of the Bill & Melinda Gates Foundation's Grand Challenges in Global Health. The initiative seeks to discover biological mechanisms that lead to preterm birth and develop innovative strategies for prevention, with particular focus on solutions relevant to low- and middle-income countries, where 99% of the world's infant deaths occur.
More than 320 applications were received from 50 countries, with the top five applications awarded grants of up to $2 million to fund their projects for 2-4 years.
"The volume and quality of applications we received are indicative of the widespread impact of preterm birth and the number of excellent researchers who are ready to tackle this global crisis," said Craig Rubens, MD, PhD, executive director of GAPPS. "These projects will greatly increase our knowledge of what causes premature birth, and hopefully catalyze additional resources and commitments to help make every birth a healthy birth."
Of the 15 million babies born too soon every year, more than 1 million die in infancy, making prematurity the second-leading cause of death for children under 5 worldwide. The burden in low- and middle-income countries is even more concerning, where sophisticated medical care is often not available. Throughout the world, many premature infants who survive face lifelong health complications such as asthma, cerebral palsy and developmental delays, making prevention paramount.
"Preterm birth is the leading cause of death for newborns, and the second leading cause of death in children before their fifth birthday, taking the lives of 1 million babies every year, affecting rich and poor countries alike," said Gary Darmstadt, Director of Family Health at the Bill & Melinda Gates Foundation. "We urgently need new tools and need to develop new solutions to give every baby a healthy start to life. These new projects are a critical step on the path to preventing preterm birth."
The causes of preterm birth are often unknown and strategies for prevention are limited. The projects funded by the Preventing Preterm Birth initiative will advance discovery of the underlying causes of preterm birth, particularly how infection, inflammation, and immune and hormonal responses disrupt healthy pregnancies. This innovative agenda spans the research spectrum from bench science to field research in low-and middle income countries, all with a focus on translating research to action. The grant recipients include:
•Dr. David Aronoff of the University of Michigan, 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.
•Dr. Margaret Hostetter from Cincinnati Children's Hospital Medical Center 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. Their goal is to investigate protective and pathogenic mechanisms of preterm birth and identify novel treatment strategies for vaginal fungal infections to prevent preterm birth.
•Dr. Kevin Kain of the University Health Network and the University of Toronto will be investigating 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.
•Dr. Sam Mesiano from Case Western Reserve University School of Medicine 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.
•Dr. David Olson from the University of Alberta will be working to better understand how infections can cause preterm birth. Using animal models and in later 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.