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How Stanford researchers are working to understand the complexities of preterm birth

News coverage of the first-of-its-kind World Health Organization (WHO) report on preterm birth has been headlined by the staggering number of preterm births (15 million a year, worldwide) and by dismal U.S. statistics that show a far higher preterm birth rate here than in any other developed country.

But some of the coverage mentions another shocking fact about babies born a week or more early: In about half of these early deliveries, we can't pinpoint a clear reason that the baby arrived too soon. And the reasons we've already identified for preterm delivery probably don't tell the whole story. For instance, the New York Times reports that

Dr. Gordon C. S. Smith, an expert in [preterm birth] at the University of Cambridge, noted that his native Scotland had many of the same risk factors as the United States — teenage pregnancies, poverty, obesity and older mothers — and yet had much lower rates.

“If somebody had a simple explanation of why the U.K. and Europe do much better, I wouldn’t believe them,” Dr. Smith said. “The reality is, for most preterm births, we just don’t understand the cause.”

But researchers at Stanford are working to change that. Last year, a generous funding commitment from the March of Dimes facilitated the opening of the March of Dimes Prematurity Research Center at Stanford University School of Medicine, which is taking a new approach to studying the causes of preterm birth. The "transdisciplinary" research center pulls scientists from across many disciplines together for collaboration at every stage of research, from developing hypotheses to analyzing the results.

Today I asked Gary Shaw, DrPH, co-investigator of the center and a professor of pediatrics at Stanford, for his take on the WHO report.

"The report highlights that this is a bigger problem than we had previously thought," Shaw said. "We don't know the causes of preterm birth, but we know we need a new approach toward finding answers."

Factors as diverse as an expectant mother's age, blood pressure, socioeconomic status, perceived stress level and the presence of infections are already known to influence preterm birth. So it makes sense to bring together experts a diversity of fields, many of whom may not have ever thought about preterm birth, to find out how such factors could interact to ultimately determine whether or not a baby arrives early, he said.

"This is a different way to approach team science... a different way to tackle a complex problem," Shaw told me. "And Stanford and the March of Dimes are the first to take on this new approach."

Previously: Hormone could prevent 10,000 preterm births per year, New research center aims to understand premature birth, Device designed to better detect preterm labor and Moms who were born prematurely more likely to have premature babies themselves
Photo by The Hudson Family

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