Preterm birth

Among the many transformations that Brazil has undergone in the last 30 years is the change to an integrated and unified health system, one in which there has been striking progress in providing maternal and child health services. The number of women without access to any prenatal care has fallen from 10.7 % in 1995 to 2% in 2009, for instance, and over 90% of births occur in the hospital setting. Nevertheless, there remains variability in access to preventive interventions and in the quality of health services provided.

The problems associated with preterm birth in particular provide a window into women’s health in Brazil. Preterm birth is more than 10% of births in the country and contributes significantly to total neonatal mortality. Paradoxically, a significant fraction of these preterm births are iatrogenic and associated with the rising number of C-sections, which in 2009 for the first time outnumbered vaginal deliveries in Brazil. This trend highlights the need to stimulate behavioral changes of patients and healthcare providers to remove one of the roadblocks to preventing preterm birth. Another distinct roadblock to progress in the treatment of preterm infants is the incomplete uptake of established treatments, such as corticosteroids.

These and other roadblocks are the target of this request for proposals Grand Challenges Brazil: Reducing the Burden of Preterm Birth, which seeks innovative research to develop new prevention and treatment strategies and reduce the burden of preterm birth. As a research component of the “Stork Network,” this program would contribute to the goal of universal access and uptake of evidence-based healthcare policies and services.