GAPPS 2016 Annual Letter
2017 is a big year for GAPPS: we’re turning 10! As we reflect on the past decade working to prevent preterm birth and stillbirth, we’re struck by not only how much progress has been made, but also by how much awareness of the issues has increased. Ten years ago it was rare to hear parents share the story of their stillborn child, or for parents to become vocal advocates following the birth of their premature baby.
Today, through research, social media, videos, and grassroots advocacy, stillbirth and preterm birth are much more likely to be acknowledged as legitimate crises. Our weekly news roundup, LiveWire, has entire sections devoted to new preterm birth and stillbirth research and findings. However, research is still urgently needed. Stillbirth claims an estimated 2.6 million lives every year, and preterm birth is the leading cause of child mortality as well as a significant cause of many lifelong disabilities.
We’re proud of the work that’s being done by networks and partnerships around the world, and we’re optimistic that we can get ever closer to making every birth a healthy birth. Please read on for some highlights from 2016.
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Preventing Preterm Birth Initiative
In the five years since its launch, GAPPS has overseen 13 projects funded through the Preventing Preterm Birth initiative (PPB), and those projects have revealed important biological mechanisms for preterm birth and novel targets for prevention. These include identification of new molecules that block the inflammatory cascade leading to preterm birth, new interventions for prevention of adverse birth outcomes from malaria and Group B strep, and synthetic molecules that could modify the actions of progesterone receptors to maintain pregnancy.
International PPB field sites in Zambia and Bangladesh have successfully enrolled nearly 4,000 women and are on track to reach their targeted sample size. These cohorts represent a powerful approach to accelerating research to prevent preterm birth through rigorous, standardized, prospective studies of pregnant women in low- and middle-income settings, including standardized measurement of gestational age and fetal growth by early ultrasound, standardized clinical data, and samples of maternal blood, urine, vaginal swabs, placentas, and infant cord blood.
Click here to read more highlights of the PPB.
Every Preemie – SCALE
Every Preemie – SCALE (Scaling, Catalyzing, Advocating, Learning, and Evidence-driven) is a USAID-funded project implemented by a consortium comprised of GAPPS, Project Concern International, and the American College of Nurse-Midwives. Every Preemie provides practical, catalytic and scalable approaches to expand the uptake of preterm birth and low birthweight interventions in 25 USAID priority countries in Africa and Asia, and builds implementation research capacity by partnering with local investigators on questions that are central to moving evidence to action for preterm birth.
In 2016, Every Preemie launched a multi-country report on antenatal corticosteroid policy and implementation. The program also hosts a global technical working group on implementation challenges and solutions. Recent meetings focused on the safe and effective use of interventions for improved preterm birth outcomes, and took a comprehensive look at approaches to the prevention of preterm birth. Profiles on the status of preterm birth in each of the priority countries launched in late 2015 and are widely accessed worldwide. Learn more about Every Preemie here.
Click here for a list (pdf) of publications from GAPPS staff in 2016.
The GAPPS Repository, a biobank of pregnancy specimens and data, has enrolled more than 2,600 participants and collected nearly 140,000 specimens to date. The Repository has continued its involvement with the Integrative Human Microbiome Project (iHMP), the second phase of the NIH Common Fund’s Human Microbiome Project. Specifically, the Multi-Omic Microbiome Study-Pregnancy Initiative (MOMS-PI) of the iHMP, is a collaborative project led by a research team at Virginia Commonwealth University working to understand the impact of the vaginal microbiome on pregnancy. The Repository enrolled 602 participants in this valuable project, and continues to follow participants and collect samples and data through delivery.
Additionally, the GAPPS Repository has been selected to contribute to a novel research program called ECHO PATHWAYS, focused on how environmental factors during pregnancy affect childhood health outcomes. ECHO PATHWAYS is part of the larger NIH funded ECHO initiative (Environmental influences on Child Health Outcomes). ECHO is catalyzing research using existing cohorts (groups of women and children who have already participated in other research studies) to answer questions about the effects of a broad range of environmental factors – including maternal exposure to chemicals and stress – on child health and development.
The GAPPS Repository is providing specimens including urine, plasma, and placenta samples, as well as medical record abstractions and questionnaires completed by mothers throughout pregnancy. More than 1,100 Repository participants will also be recruited for follow up visits to understand the current health of the children. ECHO PATHWAYS is a collaborative effort between researchers at University of Washington, Seattle Children’s Research Institute, University of California San Francisco, and University of Tennessee Health Science Center. Learn more.
Maternal Immunization Project
GAPPS, in partnership with the Bill & Melinda Gates Foundation, is coordinating development of a roadmap for maternal immunization safety monitoring in low- and middle-income countries (LMIC). For this project, GAPPS is partnering with multiple international agencies, industry, researchers, and governments to examine existing pregnancy surveillance and vaccine safety monitoring systems in LMICs and understand capacity, feasibility, challenges, and opportunities in implementing safety monitoring systems. The work will culminate in a white paper that outlines recommendations for developing and implementing systems to monitor the safety of vaccination programs for pregnant women in LMICs, with a focus on establishing systems for reporting adverse events following immunization. Learn more.
Healthy Pregnancy 2030
We’re excited to announce that the actors Anna Faris and Chris Pratt, who have a son who was born preterm, have committed to supporting a multi-organization campaign aimed at raising awareness of preterm birth and advancing research toward prevention. The campaign is called Healthy Pregnancy 2030, and has the ambitious goal of reducing preterm birth by half by 2030. Keep an eye out in the coming months for more information on their participation and how you can get involved!
Global Coalition to Advance Preterm birth Research (GCAPR)
GCAPR was founded in 2013 by the Bill & Melinda Gates Foundation, March of Dimes, NICHD, and GAPPS, as an innovative collaboration among public, private, and non-profit foundations and funding organizations to promote communication and investment in preterm birth research. The coalition has grown to include 20 members and its annual meeting will take place in March in London. The meeting will define strategies for raising visibility, scientific effort, and investment into preventing preterm birth worldwide. Learn more at gcapr.org.
We are so grateful for our extended network of supporters around the world, including parents, researchers, advocates, funders, and our GAPPS Advisory Council. Each of you play a critical role in the journey to prevent preterm birth and stillbirth, and we appreciate your support, partnership, and collaboration. We are excited for 2017 and the opportunities and challenges ahead as we continue our quest to make every birth a healthy birth.
Craig E. Rubens, MD, PhD
Global Alliance to Prevent Prematurity and Stillbirth (GAPPS)