Gates Foundation Funds UNC Childbirth Studies

Posted on May 2, 2019

A team of clinical researchers at UNC has received $14 million from the Bill & Melinda Gates Foundation to conduct two studies aimed at improving pregnancy outcomes in the world’s poorest countries.

An interdisciplinary team at UNC’s School of Medicine and its Gillings School of Global Public Health will lead the studies, both of which will explore the role of technology in predicting and addressing key risk factors associated with pregnancy, labor and delivery.

Each year, an estimated 300,000 women and 3 million babies worldwide die during childbirth or shortly thereafter, according to the World Health Organization. Major reasons include environmental and structural factors, underlying infectious disease burden, nutritional factors and underperforming health systems.

“In many parts of the world, the days surrounding childbirth are the riskiest period a mother and her newborn will ever face,” said Dr. Jeffrey Stringer, professor of obstetrics and gynecology in the medical school and adjunct professor of epidemiology in the public health school. He said the studies at UNC will aim to “develop resource-appropriate technologies to make that time much safer.”

The Limiting Adverse Birth Outcomes in Resource-Limited Settings study will focus on the period of pregnancy between the onset of labor through delivery. It will evaluate 15,000 women at high-volume clinical sites in three developing countries, including UNC’s flagship partnership in Zambia. The team will provide wearable physiologic sensors to monitor laboring mothers and their fetuses and document their clinical course and birth outcomes.

Using participant data, researchers will develop algorithms that can identify individual women’s risk of specific adverse outcomes and help predict and plan for the specific interventions women likely will need. The intent is to lead to earlier intervention and better health outcomes for mothers and newborns.

“The data produced by this study will allow us to create a new collection of precision medicine tools that can be used in developing countries to help medical providers better manage patients’ unique needs and result in healthier mothers and babies,” said Michael Kosorok, the W.R. Kenan Jr. Distinguished Professor and chair of biostatistics at the public health school.

The second study, the Fetal Age Machine Learning Initiative, aims to develop a robust, affordable ultrasound device that can be deployed in limited-resource settings to assess gestational age and other obstetric information while requiring minimal operator expertise. The team will produce sets of ultrasound data that can be used to train machine learning algorithms to assess gestational age and make other diagnoses.

Upon completion, data from both studies will be made publicly available through the Gates Foundation’s Knowledge Integration team for groups to access and continue improving maternal-child health.

Collaborators on the LABOR study are from the UNC schools of medicine (OB-GYN and pediatrics) and global public health (biostatistics and epidemiology), Brown University and Northwestern University. The FAMLI study team includes faculty members from the UNC OB-GYN and psychiatry departments and from the N.C. State University College of Engineering.

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