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Preventing Preterm Birth initiative yields promising research discoveries

Nov. 17, 2016 – In 2011, the Bill & Melinda Gates Foundation committed $20 million to the Global Alliance to Prevent Prematurity and Stillbirth (GAPPS), an initiative of Seattle Children’s, to fund the Preventing Preterm Birth initiative (PPB).

The PPB is part of the Grand Challenges in Global Health, and seeks to discover biological mechanisms that lead to preterm births and develop novel interventions to prevent them. In the five years since its launch, GAPPS has overseen 13 projects funded through the PPB and tremendous strides have been made in preterm birth research.

More than 15 million babies are born too soon every year, and preterm birth is the leading cause of death in all children under 5 worldwide. Despite this high global burden, few strategies have been found that can identify women at risk or prevent preterm birth.

GAPPS was asked to develop the PPB to evaluate if investment in a consortium of innovative investigators could advance the science of pregnancy and preterm birth and identify novel targets for preterm birth prevention. By bringing together experts from a variety of scientific disciplines and creating a collaborative research program, the PPB has yielded promising discoveries in pregnancy health.

“The strength of the PPB consortium is its ability to bring together a cadre of established investigators, both within and outside the reproductive biology community, who regularly question and critique each other’s work and direct ongoing activities to improve project outcomes,” said Dr. Eve Lackritz, GAPPS Deputy Director. “Collaborations among investigators have continued to expand, and increased communication among researchers has benefitted the program as a whole. We’re proud of the investigators and their innovation and accomplishments, which have more than fulfilled the vision of the PPB.”

Highlights of the PPB include:

The research projects funded through the PPB have identified novel targets for translational opportunity. These include:

Highlights from international research sites

The PPB also funded investigators working in Bangladesh and Zambia to implement and develop rigorous, standardized systems for the prospective collection of data and specimens among pregnant women and newborns in low- and middle-income countries. The sites emphasize accurate gestational age dating and characterization of maternal complications and preterm phenotypes. Their work has helped strengthen biorepository systems to accelerate preterm birth research both within the PPB consortium and to the research community more broadly. To date more than 2,600 pregnant women in Bangladesh and more than 800 pregnant women in Zambia have participated in the cohort, and new collaborations are underway. Utilizing the preterm birth field infrastructure and established biorepositories will accelerate discovery, reduce costs, and improve efficiencies in preterm birth research.

Using big data to predict and prevent preterm birth

High-dimensional systems biology technologies such as proteomics, transcriptomics, metabolomics, and metagenomics represent a novel approach to the study of complex biologic processes. Yet these techniques have not been widely used to study determinants of healthy and abnormal pregnancy. When they are utilized, most investigators have utilized a single platform (e.g., proteomics), an approach that has not allowed for an understanding of inter-relationships and pathways that contribute to pregnancy outcomes. The PPB made three awards to investigations utilizing multiple analytic tools and platforms, coupled with computational analysis. Through these projects, multiple biologic fluids collected throughout pregnancy undergo proteomic, metabolomic, and lipidomic analysis, and the vaginal microbiome will be characterized. The projects will serve as a collaborative consortium of investigators, sharing specimens and data, to identify potential biomarkers for healthy pregnancy and for preterm birth.

GCAPR: Advancing visibility and investment to accelerate global preterm birth research

The PPB also facilitated the development of the Global Coalition to Advance Preterm birth Research (GCAPR), in partnership with the Gates Foundation, NICHD, and March of Dimes, to advance investment, communication, and coordination of preterm research among funding organizations. GAPPS serves as the coalition’s Secretariat, and priority projects have been selected, including strategies to harmonize preterm birth research studies and accelerate data sharing. Progress in this particular area represents a critical step in building visibility and resources for the generally under-recognized field of preterm birth research.


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