Because we have little understanding of the genetics and biology of normal pregnancy, we lack knowledge of the causes of stillbirth and prematurity. This knowledge gap is one of the greatest barriers to developing effective diagnostic, prevention and treatment interventions.
Successful interventions are the result of evidenced-based research in three areas:
Though GAPPS’ efforts are mainly focused on the first step — discovery science to identify the causes of prematurity and stillbirth — our work does not exist in a vacuum. We rely on the expertise in each of these research areas, and value continued collaboration to close the knowledge gaps and arrive at novel solutions.
GAPPS Supports Evidence-Based Interventions
GAPPS convened an international team of researchers to assess more than 80 preterm birth and stillbirth interventions that are relevant for use in low-resource settings. Of those reviewed, very few were judged to be effective in preventing preterm birth or stillbirth in those settings. Some interventions were shown to be ineffective; others require more evidence of effectiveness, or are too costly for wide distribution.
GAPPS supports the widespread use of recommended interventions, the end of ineffective or harmful treatments, and continued research on promising but unproven interventions.
GAPPS also encourages scale-up of effective interventions that are already available in low-resource settings. We must increase the use of existing evidence-based and cost-effective interventions to reduce preterm births and stillbirths in the short-term. At the same time, effective interventions currently only available in high-income countries need to be adapted for use in low-resource settings.
Through the GAPPS Repository and our work in helping to initiate a pregnancy and birth cohort registry, we contribute to data and specimens banks vital to research efforts that will lead to new interventions. GAPPS is also focused on strengthening harmonization efforts around the world to make it easier for investigators to do the work necessary to achieve groundbreaking interventions.
Research Results in Action: Existing Solutions That Work
GAPPS’ focus is discovery science, supporting research that will lead to new, evidenced-based interventions. We collaborate with other organizations that excel in developing and delivering new solutions. The following interventions began with an investigator designing a study. In some cases, their research led to the discovery of an intervention that has a positive impact on preterm newborns, or was shown to help prevent preterm birth or stillbirth.
GAPPS 2009 global report identified only two evidence-based interventions to prevent preterm birth in low-resource settings: smoking cessation and progesterone, which when given to mothers whose previous baby was born prematurely has been shown to be effective in preventing a second preterm birth. Even if these solutions were scaled up globally, they would only reduce the prematurity rate by about 4%. We urgently need more research to identify new and effective preventive measures.
To improve the survival of preterm newborns GAPPS supports:
To prevent stillbirths GAPPS supports:
GAPPS is working to ensure widespread use of recommended interventions, to help end use of ineffective or harmful treatments, and to explore promising but unproven interventions.