By Craig E. Rubens | Thu., November 17, 10:28 AM | Comments ( 0 )
A premature baby boy lies in an incubator in the natal intensive care unit at an Imam maternity hospital in Karachi October 28, 2011. REUTERS/Insiya Syed
By Craig E. Rubens
My first rotation as a medical resident was in a newborn ICU in 1982. I remember barely keeping my composure while moms and dads held infants who were born too early and dying from complications. As a new dad myself, I couldn’t imagine wondering whether or not my son would ever make it home. I was awestruck by the lack of understanding of why preterm birth and stillbirths ever happened.
This is what set my search to end prematurity in motion: I needed answers and knowledge. With more research, we could surely decrease the number of parents who delivered prematurely or suffered the loss of a newborn child.
Nearly 30 years later, preterm birth is now the leading cause of newborn death around the world and takes the lives of more infants than HIV, tuberculosis and malaria combined. It is one of the few health crises that are just as likely to affect women in the U.S. and women in sub-Saharan Africa. An estimated 13 million babies are born prematurely each year, and tragically, nearly two million do not survive their first month of life. Within the United States, the rate of premature births have increased by 36 percent over the past 25 years and now one child in eight is born too soon.
Yet we know so little about why preterm birth happens. As a pediatrician and a professor, I teach my students—many of whom aspire to be OB/GYNs, pediatricians and scientists—that we can provide better treatment for preterm infants, but there is hardly any prevention to offer. In fact, the same two treatments for preventing preterm birth that have been studied over the past several years, smoking cessation and progesterone hormone therapy, are about the best we have.
Advances in treatment have certainly improved survival for preterm infants in the developed world—but survival is just the beginning. Premature babies who do survive have greater risks of short- and long-term health problems, including cerebral palsy, infections, respiratory problems, learning disabilities or trouble with hearing and vision. Families can pay considerable emotional and financial costs when a child is delivered prematurely. For hospitals and the U.S. health care system, short-term expenditures for the care of early births exceed $26 billion every year (in 2005 dollars). And this type of treatment is rarely available in developing countries.
As treatment improves for premature babies around the globe, it is critical that more resources are dedicated to fully investigating the causes of preterm birth. Funding for research and discovery into prevention is lacking—preterm birth research ranks 99th and perinatal health research ranks 52nd in research funding from the National Institutes of Health.
With research and funding, preterm birth can be prevented and hopefully one day eliminated.
It is encouraging that the Bill & Melinda Gates Foundation recently announced Grand Challenges: Preventing Preterm Birth, a new $20 million initiative to spur scientific innovation and research into the causes of preterm birth.
The program, stewarded by the Global Alliance to Prevent Prematurity and Stillbirth (GAPPS), an initiative of Seattle Children’s, is aimed at discovering new interventions and solutions to prevent premature labor and birth.
This is a momentous first step forward—although some might call it a baby step. Through this program, we at GAPPS will fund six or more new research projects over the next few years. I believe this research will help provide parents with answers and physicians with a prescription for prevention that works.
But this important investment won’t be enough. People around the world must raise their voices and share their stories to show this is a growing threat. The medical community needs more evidence-based, interdisciplinary research that explores the causes of prematurity in order to prevent many infant deaths and reduce health complications caused by early birth.
Families, whether in the U.S. or in a developing country, will always have birth experiences that vary, but premature births and stillbirths are a shared fear about which we know too little. These stories, wherever they happen, are rarely told. With the announcement of this new Grand Challenges initiative, I hope today will be the first day of a new dialogue, one where hope emerges from silent suffering and new interventions give young infants around the world their best shot at a healthy birth and a healthy life.
Craig E. Rubens, MD, PhD, is a pediatric infectious disease specialist and professor of pediatrics and global health at the University of Washington School of Medicine. He is the co-founder and executive director of the Global Alliance to Prevent Prematurity and Stillbirth, an initiative of Seattle Children’s.
Full bio:
Craig E. Rubens, MD, PhD
Executive Director
Craig Rubens is co-founder and executive director of GAPPS. An internationally recognized infectious disease expert, Craig leads GAPPS work in program development and strategic partnerships that leverage cross-disciplinary science to accelerate a discovery-to-delivery pipeline for preventing prematurity and stillbirth. Craig is a professor of pediatrics at the University of Washington School of Medicine, and the endowed chair of Pediatric Infectious Diseases sponsored by Seattle Children’s Hospital. His specific area of expertise is in exploring the mechanisms of infection during pregnancy and the early newborn period that result in poor pregnancy and newborn health outcomes. Insights from his work have helped identify new opportunities for vaccine development. Craig is a graduate of the University of Washington School of Medicine and received a PhD from the Department of Basic and Clinical Immunology and Microbiology, Medical University of South Carolina.
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