Predicting and preventing preterm births

Each year, 15 million babies worldwide are born prematurely, arriving at least three weeks before their due dates. Globally, prematurity is the largest cause of death before age 5, and even with excellent medical care, children who survive can have lasting physical, developmental and cognitive challenges.

Doctors don’t know what prompts most premature births. That’s why, over the last decade, Stanford’s top obstetricians, neonatologists, geneticists, microbiologists, immunologists, epidemiologists, health policy experts and bioengineers have been investigating the basic science of preterm birth. They’re explaining how it is triggered and what factors put a pregnancy at risk for ending early. At the same time, our clinicians continue to hone their ability to care for the highest-risk newborns, especially those whose premature arrival comes with complications such as rare genetic or congenital diagnoses. Ultimately, our experts aim to predict and prevent many preterm births, helping more babies arrive safely.

Because their lungs aren’t fully developed, breathing is premature babies’ first big challenge. Preemies can also suffer neurological and gastrointestinal complications of their early arrival, as well as vision and hearing loss.

Stanford researchers are studying treatment solutions such as the artificial lung surfactant being developed in Annelise Barron’s lab and the innovative methods for preventing and treating neurological injury that are deployed in the Neuro NICU at Lucile Packard Children’s Hospital Stanford. Because premature births happen everywhere, our researchers are also exploring how to improve neonatal care in low-resource settings around the world.

Nurse talking to concerned father while looking at the medical chart on clipboard of patient who is in an incubator at neonatal intensive care unit

Becoming the parent of a baby who arrives early can be quite overwhelming.

Stanford physicians and nurses have undertaken several projects to improve collaboration with preemies’ moms and dads, such as documenting the benefits of parents’ hands-on care, such as cuddling their baby or providing breast milk. Our teams also offer recognition and support for the trauma parents may experience when their child is ill.

Strategies helped California hospitals improve breast milk feeding rates for preemies, researcher says

Counseling parents of the earliest-born preemies: A mom and two physicians talk about the challenges

New breast pumping approach helps preemies’ moms to improve milk supply, says Packard/Stanford study

For most of the 380,000 premature births that occur across the country each year, physicians can’t pinpoint a reason the baby comes early. Stanford scientists are working to identify factors that increase the risk of premature births across the population. And they’ve developed a blood test for pregnant women that can measure gene activity signals in the mother, fetus and placenta to predict which pregnancies will end in premature birth.

Although the basic trajectory of pregnancy - nine months from conception to birth - has long been recognized, many of the details of its biology remain mysterious. Stanford scientists are uncovering previously unappreciated details such as how the placenta functions, how the mother’s immune system helps her body keep time during pregnancy and how certain maternal illnesses affect fetal development.

Across most regions of the United States, maternal mortality rates are on the rise. The exception is California, where maternal deaths have dropped substantially in the last 10 years.

Two research groups housed at Stanford, the California Maternal Quality Care Collaborative and the California Perinatal Quality Care Collaborative , have made the difference. They are coordinating a statewide effort to spread evidence-based practices that safeguard the health of pregnant women and infants before, during and after birth. Detailed toolkits for how to handle obstetric emergencies such as hemorrhage, blood clots and preeclampsia give medical teams across the state a road map for saving lives when every minute counts.

Every day, experts at the Johnson Center for Pregnancy and Newborn Services at Lucile Packard Children’s Hospital Stanford assist pregnant women and premature infants navigating high-risk diagnoses. Meet some of our Neonatal Intensive Care Unit graduates and their parents.