Sarah Alexander

In this guest post, Sarah Alexander—director of external relations for the Global Alliance to Prevent Prematurity and Stillbirth (GAPPS)—writes about the groundswell of momentum surrounding maternal and child health and the role research and development (R&D) can play in helping more babies have a healthy start to life. You may have noticed maternal and child health has been garnering a lot of attention lately. At the Saving Every Woman Every Child Global Summit in Toronto last week, the focus was on ending preventable deaths of mothers and children under 5, and the government of Canada pledged $3.5 billion toward those efforts. The week prior marked the launch of the Every Newborn series in The Lancet, as well as the endorsement of the Every Newborn Action Plan by the World Health Assembly in Geneva. Later this month, the Partnership for Maternal, Newborn & Child Health’s Third Annual Partners’ Forum will be held in Johannesburg. All of these events are building on each other and creating a groundswell that will help forge a blueprint for the post-Millennium Development Goal era.The momentum these efforts have gained is impressive, and great strides have been made in saving the lives of mothers and babies around the world. As the global health community looks toward the next 15 years, we are encouraged that more and more plans are incorporating R&D as pillars of a maternal and newborn health agenda. A focus on R&D will allow researchers to look upstream and investigate new ways of preventing problems from occurring in the first place—exemplifying the maxim that prevention is better than cure.There has been a groundswell of momentum for maternal and child health. There are many opportunities for high-impact R&D as part of the agenda. Photo: PATH/Mike WangAt the GAPPS—an initiative of Seattle Children's—we understand and advocate for all the great work that is being done to treat newborns—especially in low-resource settings—to give them a better chance of survival. With our focus on preterm birth and stillbirth, we envision a scenario where instead of treating infants born prematurely or laying to rest nearly 3 million stillborn babies every year, we could instead identify issues in utero and develop therapies to prevent preterm birth, stillbirth, and other pregnancy complications before they occur.Babies born too soon can face lifelong health complications, including respiratory issues, vision and hearing loss, cerebral palsy, developmental delays, and more. Stillborn babies are often not acknowledged with birth or death certificates, or prioritized in health efforts. While it’s essential that known interventions are scaled up to help save the lives of mothers and newborns, we are glad to see a comprehensive R&D movement picking up steam.There are many opportunities for high-impact R&D in maternal and newborn health. For example, new technologies allow for increased biomarker discovery and therapeutics development, which could allow doctors to screen for and treat conditions in pregnant women and their babies before birth, helping more babies have a healthy start to life.With so much momentum building around maternal and child health, we’re glad to see R&D into prevention is being prioritized so that one day every birth can be a healthy birth.

This post—written by Sarah Alexander, director of external relations at the Global Alliance to Prevent Prematurity and Stillbirth (GAPPS)—originally appeared in Seattle Children’s On the Pulse blog on March 5th. She shares about a new initiative aimed at developing new strategies to prevent preterm births. Globally, 15 million babies are born preterm each year, and more than 1 million of those do not survive their first month of life. Being born preterm—before 37 weeks gestation—increases the chance of birth complications, developmental disabilities, and lifelong health issues like cerebral palsy, asthma, and vision and hearing problems. Sarah Alexander, director of external relations at GAPPS. Last week, GAPPS—an initiative of Seattle Children’s—announced it is granting a total of $2.8 million to two international pregnancy research sites as part of its Preventing Preterm Birth initiative (PPB). The international sites will mirror similar sites GAPPS has developed in the US, and will enroll women early in pregnancy and collect information and biological specimens during their pregnancies and deliveries. The data and specimens collected will be used to advance innovative research into the causes of preterm birth and identify novel strategies for prevention. Areas of investigation will include studies of infection, inflammation, the microbiome, the immune response, and other pathways leading to increased risk of preterm delivery. Zambia In Lusaka, Zambia, Jeffrey Stringer, MD, an obstetrician and director of the University of North Carolina Global Women’s Health group, will oversee a team of Zambian and US researchers in enrolling 2,000 high-risk pregnant women over a 3-year period. Dr. Stringer, who lived and worked in Zambia for more than a decade, has seen firsthand how the prevalence of infant death impacts families. “There is nothing more devastating than the loss of a child. Whether you live in North America or Zambia, this is a universal truth,” Stringer said. He added, “We will set up a carefully monitored cohort of women and their newborns so we can evaluate the causes of prematurity and figure out ways to prevent it.” Bangladesh In Bangladesh, Anisur Rahman, PhD, head of the Matlab Health Research Centre at the International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b), will work with his team to enroll 4,700 pregnant women over three years. “We have a very good system for identifying pregnancy, as well as for staying in contact with mothers and babies after pregnancy to collect follow-up data and samples,” Rahman said. “Our center has the potential to contribute a lot to global research, because preterm birth is shared by both developed and developing countries.” Preventing Preterm Birth initiative (PPB) The PPB seeks to discover biological mechanisms that lead to preterm births and develop novel interventions to prevent them. GAPPS has funded seven research projects through the PPB, and those investigators will work in collaboration with these international cohorts of pregnant women, which will allow them to develop interventions to prevent preterm birth. “Increasingly, evidence suggests that poor maternal and fetal health set in motion an irreversible trajectory with serious negative consequences for health in infancy, childhood, and adulthood,” said Eve Lackritz, MD, senior program officer for GAPPS. “Preterm birth research has been hampered by a lack of well-designed pregnancy cohorts in low-resource countries, and developing these two new sites will help to fill that void and lead to broadly-applicable preventive and therapeutic interventions to prevent preterm birth and stillbirth.” For more information, check out these resources: - Preventing Preterm Birth initiative - Grand Challenges