Science can prevent preterm births
reduction in the dose of the corticosteroids needed to treat this condition, thereby reducing these side effects. This could also enable the use of tablets instead of injections, making them much easier to administer.
Preterm babies are low in surfactants. These are substances produced in the mature lung that help keep them inflated and allows for the absorbance of oxygen into the blood. Products currently on the market are expensive and need skilled administration, putting these beyond the reach of most developing healthcare systems.
Innovations in surfactant products that would be more cost-effective and easier to administer are being tested now to help address this problem.
For long-term sustainable progress, there is need to invest in research to prevent preterm births. There is a recent report that deficiency of selenium, a micronutrient also found in the soil, could be linked to increased preterm births. The investigators used a clever methodology called a genome-wide association study done in a large database and then validated with independent data, both from high resource settings. Efforts are now underway to assess if this finding holds true for Africa and Asia, where selenium deficiency is widely prevalent. Selenium containing proteins play crucial roles in our body functions such as production of antioxidants that prevent inflammation. Many adverse pregnancy outcomes such as preeclampsia and preterm birth have been linked to inflammation. If confirmed, a very promising public health intervention might be to supplement selenium at a population level, as is happening with folic acid.
The birth of preterm babies is a global challenge. These exciting new discoveries offer great promise and could help both advanced as well as developing countries such as India, which, because of its sheer size, has the largest number of preterm births of any country, develop a serious response to this issue.
This piece has been coauthored, along with Nachiket Mor, by Jeffrey Murray, deputy director, family health and human development and Sindura Ganapathi, deputy director, MNCH, Bill & Melinda Gates Foundation. The views expressed are personal