A Bold Approach to Understanding the Biology of When Birth Happens

The goal of the Center for Prevention of Preterm Birth is to foster fundamental new insights into the biology of human pregnancy and pathogenesis of preterm birth to decrease the rate of prematurity and its complications.

The causes of preterm birth are usually unknown, with more than half of all preterm infants born early with no identifiable cause. Limitations in understanding the biology of human pregnancy and birth are the root of the failure to improve the rate of prematurity.

Louis Muglia, MD, PhD, director of the center, has pioneered the study of endocrine stress responses and the genetic factors leading to birth.

He uses genetics, comparative genomics, developmental biology, endocrinology and epidemiology to study the mechanisms controlling the timing of birth in human populations.

We're Experts in Caring for Fragile Infants

A leader in treating extremely premature babies, the medical center attracts the smallest and earliest-born children across the region. By looking at this population of patients, Muglia and his colleagues will have access to the patients they seek to help, as well as data collected on those patients.

The nature of the biological clock that meters the duration of human gestation remains a central question in reproductive biology. He and his team will seek to understand the molecular machinery comprising this biological clock to prevent or treat human preterm labor and delivery in the future.

While preterm rates have minimally declined over the past two years, they are 20 percent higher than two decades ago. In Ohio, the statistics are even more dramatic. The state ranks 37th in infant mortality, with a 12.3 percent rate of preterm birth.

The inability to improve outcomes is especially evident in the racial disparity in preterm birth − African Americans have twice the incidence of preterm birth, and four times the incidence of recurrent preterm birth, than either non-Hispanic Caucasian or Hispanic women, after adjusting for other known risk factors.

Our Transformative Plan

Recent advances in human genetic and genomic sciences, population biology and high-dimensional biological data analysis tools provide a foundation for transformative approaches to preventing preterm birth.

Within the center, we propose a unique transdisciplinary endeavor to reveal the biology of birth timing, the pathogenesis of preterm birth and to effectively apply scientific advances to impact public health regionally and nationally.

The Perinatal Institute at Cincinnati Children’s builds upon existing strengths to develop effective and widely applicable strategies to predict, treat or prevent prematurity. To accomplish this goal, both scientific discovery and community intervention will be necessary.

Our mission is to understand the causes of preterm birth and minimize the rate of preterm birth in Ohio and across the country by:

• Providing the intellectual talent and research infrastructure to promote discovery in mechanisms leading to preterm birth
• Working with local and regional community members who use the services of Cincinnati Children’s, the University of Cincinnati Department of Obstetrics and Gynecology and affiliated clinicians and scientists to investigate the mechanisms responsible for the racial disparity in preterm birth
• Inspiring the large graduate and postdoctoral student populations with an interest in developmental biology, reproductive sciences, immunobiology, social sciences and biostatistics to develop the next generation of investigators in prematurity, an area that has previously not been incorporated into developmental biology curricula

Significant resources and research will be dedicated to the study of prematurity at Cincinnati Children’s. The multidisciplinary Perinatal Institute combines the Divisions of Neonatology, Perinatal Biology, Reproductive Sciences, Pulmonary Biology and Developmental Biology and the Cincinnati Fetal Care Center.

The institute is at the forefront of much of the landmark research into newborn health issues, including medications to assist lung development, the role of uterine infection in prematurity and the use of breast milk to boost immunity. The institute is a regional and national leader in setting the standard for neonatal care. We already work on a local and national level to align efforts in public health, clinical care, quality improvement and research to decrease the incidence of prematurity and birth defects, and to improve the health of all newborns.

Many Disciplines Need to Work Together

Many risk factors for preterm birth have been identified. These factors are heterogeneous, encompassing both biological and social influences, and increase the complexity in deciphering mechanisms that will ultimately lead to prevention. Traditionally, investigators have applied research approaches that involve a single discipline at a time, with little cross talk between investigators in different disciplines.

We aim to develop an integrated, transdisciplinary research team that transcends usual boundaries and incorporates insights from distinct points of observation.

Prevention of preterm birth presents a problem in desperate need of the encompassing and innovative attack that a transdisciplinary approach will provide. Transdisciplinary research seeks to resolve real-world, socially relevant problems by breaking down traditional collaborative barriers.

Investigators from across basic sciences, clinical investigation, social sciences, quality improvement, and engineering will be assembled to:

• Articulate the complexity of preterm birth pathogenesis
• Appreciate the diversity of perceptions regarding influences leading to preterm birth
• Develop knowledge and practices that promote improved pregnancy outcomes
• Develop robust preclinical models of preterm birth that simulate human pathology