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The Mother Infant Research Institute (MIRI) currently centers its research on preterm birth and its complications, maternal obesity, and fetal and neonatal genomic medicine-- three topics of current clinical, public health and economic significance.
Prematurity and Complications
Preterm birth prior to 37 weeks of gestation is a major health problem. Even today, little is known about how to prevent preterm birth. At present, 12.3% of live births in the United States are preterm. Despite many advances in prenatal care, this rate has increased 31% in the past 27 years, from 9.4% in 1981 to 12.3% in 2008. Worldwide, 13 million babies are born prematurely. Africa has the highest rate of preterm birth, but surprisingly, North America has the second highest rate. Preterm birth presents a higher risk than full term birth for infant mortality and a broad range of lifelong health and developmental problems, including acute and chronic respiratory, gastrointestinal, immunologic, hearing, vision, motor, cognitive and behavioral disorders.
The annual costs of medical expenses in the U.S. related to preterm birth are approximately $26 billion. This does not begin to measure the emotional impact on an individual’s or family’s life or to society. In the U.S., from the time of preterm delivery until the infant is sent home, the average cost of the preterm newborn’s medical care is $51,000. However, for the smallest and sickest premature infant born at less than 28 weeks, medical costs in the first year of life average $190,467 (Source: Institute of Medicine Report on Causes, Consequences, and Prevention of Preterm Birth 2007). In contrast, a baby delivered at term incurs medical costs averaging $3,325. Furthermore, formerly preterm babies generate long-term health care costs related to treatment of conditions that are related to complications of their prematurity, such as chronic lung disease or developmental disorders.
Maternal Obesity and Complications
Maternal obesity is another major public health problem that has increased significantly over the past 20 years. Currently, 1 in 5 pregnant women in the United States is obese. Maternal obesity results in higher rates of cesarean section, higher rates of infant birth defects and a three-fold higher incidence of neonatal death. Babies born to obese mothers, even if born at a normal weight, have been shown to have multiple metabolic problems with lifelong consequences.
Prenatal and Neonatal Genomic/Personalized Medicine
Genomic medicine is an area in which the enormous amount of new knowledge generated by the Human Genome Project and the rapid advancement of high-throughput DNA sequencing technologies create new scientific and ethical challenges regarding how best to apply this information to the clinical care of pregnant women and their newborns.
Research Themes
The initial research themes of MIRI are:
- Prenatal Precursors of Disease -- examines how maternal conditions during pregnancy, such as obesity and diabetes, affect child health from cardiovascular, metabolic and inflammatory perspectives. This group will also examine how to prevent major pediatric problems by intervening during pre-conception, prenatal or neonatal care.
- The Womb, the Lung and Beyond -- combines basic science study of neonatal lung development and clinical and translational research, involving the epidemiology and prevention of preterm birth and its complications, neonatal clinical research, and long-term outcome studies.
- Therapies of Tomorrow -- investigates genetics, genomics and their related proteins in the diagnosis and treatment of various perinatal and pediatric problems. This group also develops novel computer algorithms to improve prenatal care.
- Brain, Behavior and Society -- combines basic neuroscience and clinical and translational research to investigate developmental and behavioral disorders, such as cerebral palsy and autism-spectrum disorders that arise as a consequence of preterm delivery.
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