Preterm birth, defined as birth before the fetus is at 37 weeks’ gestation, is a major public health priority for the United States and a major research priority for the NICHD. In 2003, one out of every eight infants born was preterm—accounting for more than $18.1 billion in hospital expenditures. Preterm infants are at high risk for a variety of disorders, including intellectual and developmental disabilities, cerebral palsy, and vision impairment. These infants are also at high risk for long-term health issues, including cardiovascular disease (heart attack, stroke, and high blood pressure) and diabetes.
The NICHD supports and conducts a large portfolio on preterm birth. Among the main goals of this research is finding a way to prevent births from occurring before an infant is strong enough to survive outside the womb. Because women who have one preterm birth are considered to be at high risk for another preterm birth, investigators have focused their attention on trying to prevent preterm birth among these high-risk women.
Researchers have had success using a treatment of a specific type of progesterone—called 17P. Progesterone is a hormone that the body makes to support pregnancy. In fact, the word “progesterone” means “for pregnancy.” An NICHD Maternal-Fetal Medicine Units (MFMU) Network study, which began in 2003, set out to determine whether injections of 17P could reduce the number of preterm births among women who had already had one preterm birth. The results were remarkable: for women carrying one baby and with a history of preterm delivery, injections of 17P reduced preterm birth by one-third.
Women carrying two or more babies are also at risk for preterm delivery, so researchers in the MFMU Network studied whether or not injections of 17P could prevent preterm delivery among these women. Recently reported results from this study indicate that 17P is not effective at reducing preterm delivery among women carrying twins. However, the treatment is still a proven way to reduce preterm birth among women carrying a single baby who have had a preterm delivery before.
Studies are also underway to try and prevent preterm delivery among women with other risk factors for preterm delivery, including those who have a shortened cervix (the lower part of the uterus) and those who have certain infections.
The NICHD research portfolio on preterm birth includes not only preventing preterm labor and delivery, but also ways to care for infants who are born preterm. Research on the preterm infant ranges from ways to help the lungs mature to what types of facilities provide the best care for preterm infants. Some of the research extends beyond the infant period into childhood and adulthood, tracking developmental progress and cognitive features.
In this way, NICHD’s preterm birth and infant portfolio embodies the Institute’s mission of promoting healthy development through the lifespan.
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Originally Posted: August 13, 2007
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