Preterm Birth Initiative – Improving outcomes for premature babies
Preterm birth accounts for nearly two thirds of infant deaths in Canada and is associated with increased morbidity throughout the life course and subsequent adult-onset chronic disease. In addition to these health effects, preterm birth has social and financial impacts on the affected individuals and their families, and places additional costs on society in terms of healthcare and education.
Preterm births in Canada have increased by 20% during the past two decades, to 7.8% in 2012. Canada is a significant funder of research in this field; however, the cause of 70% of preterm births remains unknown. Recognizing that major opportunities exist for developing innovative approaches to the understanding, prevention, and treatment of preterm birth, IHDCYH launched the Preterm Birth Initiative as part of its Healthy Developmental Trajectories priority area.
IHDCYH’s Preterm Birth Initiative addresses priorities identified during a consensus workshop of Canadian and international leaders in the field of preterm birth held in September, 2015. Specifically, there is a need for new and innovative ideas in preterm birth research, improvements to care and patient outcomes, improvements to the perinatal health system, better data linkage and access, and a national strategy for preterm birth prevention.
IHDCYH’s Preterm Birth Initiative aims to better understand how to care for premature babies, to strengthen health care services for high risk pregnancies and premature babies in all regions of the country, and to stimulate new avenues of research in preterm birth.
The Preterm Birth Initiative is supporting three separate efforts:
- Preterm Birth Network: A new pan-Canadian preterm birth collaborative research network led by Dr. Prakeshkumar Shah at Sinai Health System in Toronto that is working to improve health outcomes for premature babies;
- Perinatal Health Care System Improvement: A research team led by Dr. K.S. Joseph at the University of British Columbia and the BC Children’s Hospital that is focusing on improving the system of perinatal care for all mothers and their babies including those born prematurely; and
- Catalyzing Innovation in Preterm Birth Research: Six research projects focused on catalyzing research that will investigate new ways to predict and prevent preterm birth and improve health outcomes for premature babies.
Preterm Birth Network
Improving Outcomes for Preterm Infants and their Families: A Canadian Collaborative Network
Dr. Prakeshkumar Shah
Sinai Health System, Toronto, ON
The Improving Outcomes for Preterm Infants and their Families: A Canadian Collaborative Network led by Dr. Prakeshkumar Shah at Toronto’s Sinai Health System will bring together researchers, doctors, nurses, and families from coast-to-coast to improve the delivery of care and consequently the outcomes of preterm birth. The network will conduct research across the continuum of care for extremely preterm infants. Over the next 5 years, the network aims to increase the rate of preterm infant survival without complications by 30%. Read more
Perinatal Health Care System Improvement
A systems approach for enhancing perinatal care regionalization
Dr. K.S. Joseph
University of British Columbia, Vancouver, BC
Overall, Canadians benefit from excellent perinatal health care. However, the regionalization of care throughout Canada results in significant variability in maternal and infant outcomes, perinatal care practices, and health care system performance between provinces and territories.
A systems approach for enhancing perinatal care regionalization led by Dr. K.S. Joseph at the University of British Columba and the BC Children’s Hospital will analyze the perinatal health care system in Canada to determine the impact of regionalization on hospital services, emergency transport, access to care, and health outcomes from mothers and babies. The results will be used to formulate and implement recommendations for optimizing care in collaboration with provincial and territorial health ministries and perinatal care programs. Read more
Catalyzing Innovation in Preterm Birth Research
Together these six projects will advance our knowledge and understanding of the causes and mechanisms of preterm birth and guide new approaches to prevent preterm birth and improve health outcomes for premature babies.
Child developmental health, maternal psychosocial distress, and health system costs at 18 months corrected age: Effectiveness of a cluster randomized controlled trial of Family Integrated Care in Level II NICUs
Dr. Karen Benzies
University of Calgary, Calgary, AB
Dr. Karen Benzies at the University of Calgary will study the effect of an adapted Family Integrated Care (FICare) model of care on child development, maternal mental health and health care costs. This novel health services study will follow moderate and late preterm infants enrolled in an ongoing cluster randomized controlled trial (cRCT) of FICare. A follow-up study at 18 months will provide evidence of the sustainability of any effects and longer-term cost savings. This will inform policy decisions about full-scale implementation of FICare in Level II NICUs.
Biostatistical methods for estimating the cumulative impact of environmental contaminant exposures on preterm birth
Dr. Lawrence McCandless
Simon Fraser University, Burnaby, BC
Dr. Lawrence McCandless at Simon Fraser University will estimate the cumulative impact of a mother’s exposure to environmental contaminants on preterm birth. The project will improve the health outcomes of infants, children and youth in Canada by reducing fetal exposures. We will use state-of-the-art biostatistical methods to obtain better evidence that improves our understanding of the environmental causes and mechanistic pathways leading to preterm birth.
Control of expiration in the newborn period
Dr. Silvia Pagliardini
University of Alberta, Calgary, AB
Dr. Silvia Pagliardini at the University of Alberta will study the control of expiration – or breathing out – in preterm newborns as a way of treating irregular breathing during sleep.
Development of a genetic system for a pioneering member of the infant microbiota
Dr. Katherine Ryan
University of British Columbia, Vancouver, BC
Dr. Katherine Ryan at the University of British Columbia will identify the factors in the gut bacteria that protect infants from necrotizing enterocolitis, a serious disease affecting premature babies.
Magnetic Resonance Imaging of cervical morphology and maternal serum blood markers predict spontaneous human preterm birth
Dr. Oksana Shynlova
Sinai Health System, Toronto, ON
Dr. Oksana Shynlova, together with Drs. Stephen Lye, Wendy Whittle, and John Sled at Toronto’s Sinai Health System will develop a strategy to identify pregnancies at risk of premature delivery, based on maternal blood markers and cervical morphology using magnetic resonance imaging. The novel combination of imaging and maternal blood testing may lead to the development of an early screening tool to identify those at true risk and drive new research in therapeutic options for preventive strategies, while at the same time, those not at true risk can be spared these treatments.
Development of therapeutics for prevention and treatment of pre-eclampsia: One of the leading causes of preterm birth in Canada
Dr. Graeme Smith
Queen’s University, Kingston, ON
Dr. Graeme Smith at Queen’s University will develop new therapeutics for the prevention and treatment of pre-eclampsia – or high blood pressure – in pregnant women.
IHDCYH is pleased to share the news that on May 12, 2017 the Honourable Jane Philpott, Minister of Health announced an investment of $6.45 million in preterm birth and perinatal health care research. This funding will support a pan-Canadian preterm birth network grant, a team grant in national perinatal health care system improvement, and six catalyst grants in preterm birth research; all major components of our Preterm Birth Initiative. For the preterm birth network, this funding will be matched by $4.25 million of in-kind support from partnering health care institutions across Canada.
For more information about IHDCYH’s Preterm Birth Initiative, please contact:
Ruth Warre, Associate
Institute of Human Development, Child & Youth Health
Phone: 416-586-4800 x 7869
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