Preterm labor and birth is the most common cause of infant death. It is also the leading cause of long-term neurological disability. The NICHD conducts and supports research on preterm labor and birth, seeking ways to reduce incidence and prevent adverse effects to children and to mothers.
Institute Activities and Advances
The Institute's Program in Perinatal Research and Obstetrics manages a vigorous and varied research portfolio that includes studies done by the Perinatology Research Branch, a collaboration between NICHD and Wayne State University. Research focuses on mechanisms of disease responsible for preterm labor and delivery. The program also conducts research on how certain maternal antibodies might induce preterm labor.
The institute oversees two networks of clinical centers with emphases on maternal, fetal, and neonatal health. The Maternal-Fetal Medicine Units Network found that progesterone given to women at risk of preterm birth due to a prior preterm birth reduces chances of a subsequent preterm birth by one-third. Treatment of these women could prevent 10,000 preterm births annually. In addition, the network found that progesterone was not beneficial in other subgroups of women at risk of preterm birth, such as those with twins or triplets and nulliparous women with a cervical length less than that of the 10th percentile. The network also found that magnesium sulfate treatment of women at risk of preterm delivery reduced the risk of cerebral palsy in the offspring. The network is currently evaluating if treatment with antenatal steroids in the late-preterm period will improve infant outcome. It previously found that weekly steroid treatments were harmful.
NICHD's Neonatal Research Network completed a study showing that corticosteroids could be effective for improving infant survival and limiting brain injury when given to the mother as early as the 23rd week of pregnancy, although current recommendations suggest they not be prescribed until the 24th week.
Other work includes:
- Identifying the timing of cerclage to prolong pregnancy and improve infant survival rates
- Distinguishing women having true preterm labor from those having false labor
- Refining resuscitation methods for preterm infants to minimize lung injury
Other Activities and Advances
To achieve its goals for research on preterm labor and birth, the NICHD supports a variety of other activities. Some of these activities are managed through the components listed above; others are part of NIH-wide or collaborative efforts in which the NICHD participates. A number of examples are listed below.