Health institutions tackle high rate of preterm birth

An estimated 15 million babies are born preterm every year and more than one million die within the first 30 days after birth. A coalition of leading health institutions is banding together to tackle this high rate of preterm birth and help prevent the health risks associated with it.

The Global Coalition to Advance Preterm birth Research (GCAPR) is a partnership initiated by the Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD), the March of Dimes Foundation, the Bill & Melinda Gates Foundation, as well as the Global Alliance to Prevent Prematurity and Stillbirth, an initiative of Seattle Children's. A total of 16 institutions are now members of the Coalition, which will advance needed research into the field of preterm birth, a blueprint of which was detailed in The Lancet Global Health in December 2013.

"This partnership will support research to help answer critical questions about the causes of preterm birth and the most effective ways to prevent it," said Alan Guttmacher, M.D., director of the NICHD. "Research on preterm birth will have a direct impact on the health of babies around the world and help them grow up to be healthier adults."

At its first annual meeting in Washington, D.C. on July 27-28, the Coalition identified its initial projects:

•Improve "interoperability" of research. A subcommittee will review materials from several existing research programs and recommend steps to make similar research more compatible. Materials will include questionnaires, standard operating procedures, protocols and definitions. When pregnancy researchers use similar materials across research projects, results can be compared and evaluated more easily.

•Evaluate interventions delivered. One area of implementation research that is ripe for attention is the evaluation of interventions and treatments that are delivered in combination. It is common for individual interventions to be evaluated separately, but delivered in conjunction with others. Careful analysis of outcomes will allow researchers to identify the role that each intervention plays in improving infant mortality.

•Accelerate discoveries into practice. Many successful scientific discoveries languish rather than being developed quickly into products or interventions to improve health outcomes. GCAPR members will share expertise to improve that process and speed results to the mothers and infants who need them.

•Ensure global applicability of products. Through collaboration and partnership, GCAPR will seek opportunities to conduct clinical trials across populations so that the resulting products and interventions are appropriate around the world.

Additionally, GAPPS, as the secretariat of GCAPR, will compile a registry of GCAPR members, improve transparency across funders and between funders and the scientific community, and seek to expand the membership of the coalition.

"This Coalition is an innovative collaboration among public, private, and non-profit organizations that share a common goal: to promote research and funding into the causes of preterm birth, one of the greatest global health crises in our world today," said Craig Rubens, MD, PhD, executive director of GAPPS. "We fully expect GCAPR to stimulate the field of preterm birth research and ultimately lead to new interventions to address preterm birth."

The creation of GCAPR reflects the growing attention to the issues of newborn and maternal mortality and morbidity. These issues were raised by the U.N. Secretary General's program and the Millennium Development Goals, as well as the U.N.'s Every Woman Every Child program and the recent release of the Every Newborn Action Plan by the World Health Organization (WHO) and UNICEF. Preterm birth, defined as birth before 37 weeks of pregnancy, is the leading cause of newborn death worldwide, and the second leading cause of death in children up to age 5, according to the WHO. Babies who survive an early birth often face the risk of lifelong health challenges, such as breathing problems, cerebral palsy, intellectual disabilities and others. Even babies born just a few weeks early have higher rates of hospitalization and illness than full-term infants. Reaching at least the 39th week of pregnancy is important to a baby's health because many organs, including the brain and lungs, are not sufficiently developed until then.

"The March of Dimes has made a commitment to invest new funds to support five discovery research centers aimed at finding the unknown causes of preterm birth," said Dr. Jennifer L. Howse, president of the March of Dimes. "We fully support the GCAPR agenda, and will continue to lead World Prematurity Day on November 17 as an open platform for organizations to focus attention on premature birth as the leading cause of newborn death and to advocate for further action on prevention."