Preterm labor and birth—defined as labor and birth before 37 weeks of pregnancy—have long been difficult problems to solve worldwide. Learning how best to care for tiny infants born preterm, both immediately after birth and later in life, is a major NICHD goal.
NICHD research has made great strides in addressing the full spectrum of issues related to preterm labor and birth, including the following:
- Home monitors are not effective at predicting preterm labor or birth, while a shortened cervix at a certain point in pregnancy is an effective warning sign.
- Women with a common parasitic infection called Trichomonas vaginalis were more likely to deliver preterm, but treating the infection during pregnancy did not prevent a preterm birth.
- Certain genetic variants, such as genes that control inflammation, increase the risk for preterm birth.
- Bed rest, long thought to prevent preterm labor from occurring, is not effective at preventing preterm birth. In fact, NICHD research found that for some women, bed rest could contribute to preterm labor and birth.
- Extreme environmental temperatures are linked to preterm birth.
- Vaginal delivery is safe in some cases of preterm birth.
In 2006, a study conducted by NICHD’s Maternal-Fetal Medicine Units (MFMU) Network found that a synthetic form of the naturally occurring hormone progesterone reduced preterm birth by one-third among women who had previously given birth preterm. The findings were so robust that the U.S. Food and Drug Administration approved the drug—called 17P—for the prevention of preterm birth among women at high risk.
Work to improve care for infants born preterm aligns well with efforts to understand and prevent preterm birth. NICHD’s Neonatal Research Network (NRN), established at the same time as the MFMU Network in 1986, studies treatments for the different health problems related to being born early. These and other findings and advances in technology have greatly increased survival rates for preterm infants over the last few decades. Some NRN findings include the following:
- Earlier jaundice treatment can reduce brain injury among preemies.
- Steroids given to pregnant women who are at risk for preterm delivery can improve survival and health among preterm infants.
- Advances in medical technology and neonatal intensive care have improved survival and long-term health of infants born at very low birth weights (less than 2.2 pounds).
- A maternal interaction intervention benefits preterm infants, who typically need to remain hospitalized after their mothers are discharged, by teaching mothers how to best interact with their babies and interpret their babies’ cues.
Other NICHD-funded research has also found that some preterm infants produce a protein that may help protect them from birth-related brain injury.