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ARRA Investments in Addressing Pregnancy Complications and Infant Mortality and Morbidity

Public Health Burden
Pregnancy complications leading to preterm birth and infant mortality and morbidity are a challenging public health problem, with high economic costs for the nation and difficult emotional costs for families. The number of infants born at less than 37 weeks of gestation -- rose by 20 percent between 1990 and 2006. Rates of infant mortality, strongly associated with preterm birth, failed to decline in that period. Surviving preterm infants face high risks of cerebral palsy, vision and hearing problems, asthma, and other disabling and chronic conditions. The economic burden of prematurity is estimated at $26.2 billion.

Understanding the Causes and Mechanisms of Preterm Birth
Scientists have identified certain preterm birth risk factors, including maternal exposure to smoking or alcohol during pregnancy, a prior preterm delivery, short intervals between pregnancies, and intrauterine infection.   While some of these factors may be modifiable, better understanding of the mechanisms of pregnancy complications and preterm birth are an essential step to better diagnostic and treatment interventions for women and their newborns.  ARRA funding is used to support research on the causes and mechanisms of preterm birth, with a goal of helping scientists develop new interventions.  Key projects include studies that are designed to: 
  • Increase understanding of the genetic epidemiology of preterm birth, low birth weight and preeclampsia – three major pregnancy complications that often may lead to serious adverse health outcomes for mother and baby. 1
  • Develop a genetically modified model of uterine smooth muscle cell and identifying genes of interest, with the long-term goal of identifying therapeutic targets for treating preterm labor. 2
  • Investigate the molecular mechanism controlling the hormone that activates labor, with a long-term goal of understanding and preventing preterm birth.3
  • Use a novel approach to developing a vaccine against Group b streptocci infections in pregnant women and their infants, to eradicate an important cause of maternal and neonatal morbidity and neonatal mortality.4
  • Conduct basic research on a steroid treatment for premature labor late in a pregnancy, to reduce the risk of infant death or respiratory problems in surviving “late preterm” newborns, an increasing population.5
Clinical Management
For infants born with potentially life-threatening or disabling conditions, early detection and rapid treatment offers the best chance of lessening or preventing the adverse effects.  ARRA-funded grants support a range of research projects to enable clinicians to better detect and treat serious conditions in newborns, especially those born preterm.  These grants include the following:
  • Developing a new, more rapid diagnostic test for jaundice in newborns (hyperbilirubinemia) to allow clinicians to begin the prompt treatment that is critical to preventing brain damage in infants with severe hyperbilirubinemia.6
  • Developing a system to continuously analyze signals from bedside monitors in the neonatal intensive care unit, to enable clinicians to predict individual newborns’ risk of the dangerous interruptions in normal breathing known as apnea.7
  • Accelerating research on a potential marker, in infant saliva, of necrotizing enterocolitis, a potentially fatal intestinal disorder  for which extremely low birthweight infants are at high risk.8
  • Increasing analyses of imaging data on preterm infants with fetal growth restriction, a critical element in testing a hospital-based intervention for these infants.9
  • Increasing the number of compounds being tested to find new treatments for infants born with galactosemia, a rare inherited disorder that can often cause debilitating neurological complications in surviving infants.10

  1. 1R21HD060207-01 -- Maternal Genetic Variation and Risk of Adverse Pregnancy Outcomes -- Engel, Stephanie M. (NY)
  2. 1R21HD060127-01 -- Genomic Actions of Progesterone Receptors in Human Myometrial Cells -- Mesiano, Sam (OH)
  3. 1R21HD060077-01A1 -- Functional and Molecular Identification of TREK-1 Channel in Myometrium in Relati Koh, Sang Don (NV)
  4. 1R03HD056006-01A2 -- Development of a Univalent Vaccine against Group B Streptococci Infection --Hunter, Stephen K. (IA)
  5. 1R03HD060138-01 -- Antenatal Betamethasone in Late Preterm Gestation Lambs -- Lakshminrusimha, Satyanarayana (NY)
  6. 1R43HD062316-01 -- Lab-on-a-Chip for Neonatal Hyperbilirubinemia Screening -- Srinvasan, Vuay (NC)
  7. 1RC2HD064488-01 -- Neonatal Apnea: Online Risk Score from New Analyses of Bedside Monitor Waveforms -- Kattwinkel, John (VA)
  8. 3R01HD059140-01S1 -- Novel genetic and salivary glycan biomarkers for risk of NEC in ELBW infants -- Morrow, Ardythe (OH)
  9. 3R01HD046855-03S1 -- Preterm Fetal Growth Restriction and Developmental Care -- Als, Heidelise (MA)
  10. 3R01HD054744-04S1 -- Innovative Therapies and Clinical Studies for Classic Galactosemia -- Lai, Kent (UT)

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Page Last Updated on June 30, 2018 NIH...Turning Discovery Into Health®