Several organizational units within the NICHD support and conduct research on various aspects of infant care and infant health.
The mission of the NICHD's PPB is to improve the health of mothers and children, with focuses on maternal health, pregnancy, fetal well-being, labor and delivery, and the developing child. The PPB supports research to determine the basic mechanisms of normal and disease processes; identify new treatments, methodologies, and preventive strategies; assess the dissemination and actual impact of therapeutic and preventive interventions; and increase scientific resources through recruitment and training of investigators.
The NICHD, led by the PPB, has been the primary federal resource for research on sudden infant death syndrome (SIDS) since the SIDS Act of 1974 was passed. Its efforts have included and still include studies on the causes of SIDS, ranging from basic research with animal models to more applied methods involving responses to environmental risk factors; research on the incidence and prevalence of SIDS, especially among certain portions of the U.S. population; and outreach designed to educate parents, caregivers, and health care providers about ways to reduce the risk of SIDS, especially among those populations in which incidence is higher. Additional research strives to identify infants at risk for SIDS and to develop preventive approaches.
Through its program on Disorders of the Newborn, the PPB focuses on basic and clinical studies concerned with the etiology, pathophysiology, therapy, and follow-up of conditions such as disordered adaptation to extrauterine life, hyperbilirubinemia, and sequelae of prematurity (e.g., asphyxia, respiratory distress, bronchopulmonary dysplasia, hypoglycemia, anemia, and infection), that are associated with the perinatal and neonatal period.
The PPB also studies issues related to preterm labor and birth, currently a primary cause of neonatal mortality, with significant short- and long-term morbidities for those who survive. Research supported by the PPB is contributing to the state of understanding of optimal care (medical and behavioral-based care) of the preterm infant.
Recent PPB advances in infant health research include:
The NICHD's PGNB is supporting several areas of research pertinent to infant care and infant health. For example, the Growth and Development program is focusing on basic research about growth-promoting polypeptides and hypothalamic-releasing factors that interact to influence normal growth and physiological development. Basic and clinical studies of the etiology of growth retardation and treatment for this disorder are also being supported.
The PGNB's Nutrition program is studying the complex nutritional relationships between the mother and her fetus, the placental transfer of nutrients, and the role of nutrition in infant development. Research interests focus on the nutrient requirements of normal, premature, and growth-retarded infants and on the contributions of human milk and its components to optimal infant nutrition. Researchers are encouraged to assess how maternal factors affect milk composition and lactation performance. Read about a recent PGNB-supported finding within this research area:
The research priorities of the Prevention of Chronic Disease program include obesity, hyperlipidemia, and insulin resistance in childhood and adolescence. Special emphasis is placed on developing methods for detecting children with potential diabetes and for developing successful techniques of immunomodulation to prevent or mitigate the body's immune attack on the pancreatic beta cell. Similarly, studies of obesity and hyperlipidemia focus on the etiology, consequences, and prevention of childhood obesity and hyperlipidemia.
Newborn screening research initiatives within the IDDB have experienced considerable growth and reemphasis. Newborn screening enables the identification of infants who are at risk for congenital disorders (often biochemical, endocrinologic, and/or genetic) for which early interventions and treatments have the potential to reduce morbidity and mortality.
Although routine screening has occurred at the state level since the 1970s, the screening tests available have historically varied significantly by state; similarly, few states have systematically evaluated the rationale for or efficacy of the tests. Because these programs screen more than 4 million infants per year, newborn screening represents the most common form of genetic testing performed in the United States.
Research within the NICHD's DIR includes the development of vaccines for bacterial diseases, especially those found in children.
DIR investigators study, uncover, and reevaluate clinical, epidemiologic, and immunologic data. They evaluate investigational vaccines suitable for clinical study in experimental animals and then submit them to the appropriate institutional review board and the U.S. Food and Drug Administration for evaluation of their safety and immunogenicity in adults, children, and infants, and, finally, for their efficacy. Surface polysaccharides of gram-negative pathogens, capsules, or lipopolysaccharides are essential virulence factors (factors that enable the development of disease within the host) and protective antigens. The immunogenicity of polysaccharides can be improved by binding to carrier proteins. Bacterial toxins or toxoids and viral capsid proteins may be protective antigens and may serve as carrier proteins.
The mission of the DIPHR includes the design and conduct of original and collaborative research in reproductive, perinatal, and pediatric health; the determinants of health behavior; and statistical theory and methodology relevant to these problems.
The Upstate New York Infant Development Screening Program aims to determine whether infertility treatments, such as ovulation-stimulating medications and various assisted reproductive technologies, adversely affect the growth and motor and social development of children from birth through age 3 years. The study is also addressing the question of whether these technologies are associated with differences in the timing or rates of infant and child development, including motor and social development; the development of major and, especially; and minor neurodevelopmental impairments, and with physical growth patterns (e.g., length, weight, head circumference) and proportionality (weight for length).
In addition, the NICHD supports the two networks described below with the aim of increasing our understanding of preterm labor and birth and identifying their causes as well as improving treatment for preterm infants.
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