Improving the treatment of premature babies

For many years the March of Dimes has funded research aimed at improving the treatment of premature infants. Grantees have contributed to the medical advances that have greatly improved the chances of survival for even the smallest babies. However, premature birth remains a leading cause of infant death all over the world. Some survivors face lifelong health problems, including intellectual disabilities, cerebral palsy, blindness, hearing loss and other chronic conditions. Today's grantees continue to improve upon successful treatments and develop new ones to save even more premature babies and give them a healthier future.

Premature babies are at risk of many serious medical complications. One of these is respiratory distress syndrome (RDS). Babies with RDS struggle to breathe because their immature lungs do not produce enough surfactant, a protein that keeps small air sacs in the lungs from collapsing. March of Dimes grantees helped develop surfactant therapy, which was introduced in 1990. Since then, deaths from RDS have been reduced by half.

Although surfactant treatment was a major breakthrough, some RDS survivors develop a chronic lung condition called bronchopulmonary dysplasia (BPD) that resembles asthma. Current March of Dimes grantees are seeking to develop new ways to prevent and treat BPD, to further improve the outlook for RDS survivors. For example, David M. Bass, PhD of Duke University in Durham, North Carolina, is seeking to understand how treatment with supplemental oxygen may contribute to BPD, in order prevent it. Richard Lambert Auten, MD, also at Duke, is developing new approaches to deliver inhaled nitric oxide to where it is needed in the lungs to prevent BPD.

Lifesaving oxygen treatment also contributes to retinopathy of prematurity (ROP), a leading cause of blindness in premature babies. ROP results from abnormal growth of blood vessels in the retina, sometimes causing the retina to detach from the back of the eye. Katherine Amberson Hajjar, MD, of Weill Cornell Medical College in New York City, is investigating the role of a protein in this abnormal growth of retinal blood vessels, in order to develop drug treatment to help prevent ROP in premature babies undergoing oxygen treatment for lung disease.

Injury to the brain’s white matter is an important cause of lasting disabilities, such as cerebral palsy and learning problems, in premature babies. Stephen A. Back, MD, PhD, of Oregon Health and Science University in Portland, is studying the causes of these brain injuries in order to develop better ways prevent the injuries and the resulting disabilities. 

The outlook for premature babies has improved greatly. However, many of these babies face serious complications and lasting disabilities. Many March of Dimes grantees seek new ways to improve the care of these tiny babies, while others strive to prevent premature delivery.