The seemingly intractable problem of preterm birth is a complex disorder with many contributing factors. An integrated approach incorporating psychosocial and behavioral disciplines, as well as those not usually involved in the prematurity research, in addition to customary biological and physical sciences, is essential in order to shed new light in this area. Such a transdisciplinary approach was one of the recommendations of the Institute of Medicine report on preterm birth, as well as the 2008 Surgeon General’s Conference on the Prevention of Preterm Birth.
The budget required for such a large enterprise would be substantial and could not be supported by the March of Dimes alone. However, the March of Dimes intends to stimulate the creation of several centers – up to five – in the United States by developing partnerships with academic institutions interested in fostering transdisciplinary research. The March of Dimes recognizes that the components of these partnerships will vary with each institution based on the available strengths and resources. In addition, we expect that this initiative will derive additional strength from collaboration among transdisciplinary centers.
Transdisciplinary investigations should be an integrated effort of researchers from many disciplines, including but not limited to: basic sciences (such as genetics, genomics, molecular biology and developmental biology), clinical sciences, epidemiology, and social sciences (such as sociology and anthropology.) Moreover, it will need involvement of representatives of other fields, such as engineering, computer science and bioinformatics, as well as disciplines that are not traditionally associated with studying the problem of preterm birth who may be able to use their expertise to come up with new innovative approaches. Researchers in transdisciplinary settings would be encouraged to work jointly to develop and address a common conceptual goal instead of working independently and then attempting to combine their efforts.
Initiatives will be evaluated by novel methods that are in accord with the complexity and novelty of what is proposed. This evaluation will require suspension of some of the traditional critiques, and an acceptance of unorthodoxy, not as a norm, but as a characteristic. Predictions of the likelihood of their being successful will be difficult, but this is what happens in all pioneering efforts. The key determinant will be whether the proposed interaction will be stronger than the sum of independent projects, and therefore whether true synergy is demonstrated.
Multiple principal investigators from disparate disciplines are encouraged to participate for each specific research project within the centers, in order to foster integrated, transdisciplinary research. One of the Principal Investigators (PI) should act as the main contact person to provide coordination and leadership for the project. The participation of young investigators and postdoctoral students in these projects is an important aspect of these proposals, in order to optimize the impact of new approaches to prematurity research for a prolonged time period.
One center has just been inaugurated in California as the March of Dimes Prematurity Research Center at Stanford University School of Medicine. The March of Dimes expects to develop several of these centers and we are open to explorations with institutions that have an interest to engage in planning partnerships. Direct relevant inquiries to firstname.lastname@example.org or (914) 428-7100.
Yes. Premature babies are at increased risk of newborn health complications, including breathing and intestinal problems and bleeding in the brain. They also are at increased risk of death and lasting disabilities, including intellectual disabilities, behavioral problems, cerebral palsy and vision and hearing loss.
Late-preterm birth refers to babies born between 34 and 36 weeks of pregnancy. More than 70 percent of premature babies are born at this time. While these babies are usually healthier than babies born earlier, they are 3 times more likely to die in the first year of life than full-term infants. They also are at increased risk of newborn health problems, including breathing and feeding problems. Some late-preterm births result from early induction of labor or cesarean delivery due to pregnancy complications. However, in some cases, early delivery may occur without good medical justification. Unless there are medical problems, women should wait until at least 39 weeks to schedule an induced labor or c-section to prevent possible prematurity-related problems in their babies.
Three groups of women are at greatest risk. These include women who have had a previous premature birth, women who are pregnant with twins or more, and women with certain abnormalities of the uterus and cervix. Treatment during pregnancy with the hormone progesterone can help reduce the risk of another premature birth in some women who have had a previous premature birth. These women should discuss with their health care provider whether this treatment is right for them.