The Brigham and Women’s Hospital (BWH) Global Newborn Health Lab is dedicated to improving the survival, health, and potential of mothers and newborns in low-income countries.
Childbirth is a time of high risk for mothers and babies, particularly for births occurring in low-resource settings. Globally, an estimated two million babies die during childbirth, and another two million die in the first month of life. The risk of a baby dying in childbirth in a developing country is 50-fold higher than if it were born in a high-income setting.
Newborn deaths in the first month of life account for the largest proportion of deaths among children under five years old. Almost all occur in low-income countries, and a majority could be prevented with feasible and evidence-based interventions. The most common causes are complications of preterm birth, infections, or “birth asphyxia.” Furthermore, babies who survive these illnesses carry increased risk of adverse health effects later in life, including poor growth, disability, and adult chronic diseases.
Research at the BWH Global Advancement of Infants and Mothers (AIM) Lab is focused on the prevention, management, and improvement of outcomes for the major newborn illnesses in low-income countries.
We aim to:
Our projects and field work are conducted in partnership with the Projahnmo Study Group in the Projahnmo field site in Sylhet, Bangladesh. Projahnmo is a collaboration between BWH, the Johns Hopkins Bloomberg School of Public Health, Child Health Research Foundation, Bangladesh’s Ministry of Health & Family Welfare, and Shimantik NGO.
We are currently engaged in the following projects:
Enhancing Prenatal Care in Rural Ethiopia: The ENAT (meaning “Mother” in Amharic) Study, is a pragmatic effectiveness study (ISRCTN15116516) that will test the impact of packages of antenatal interventions to optimize maternal nutritional status and infection management in pregnancy, on maternal and infant health outcomes in West Gojjam and South Gondar Zones of Amhara regional state, Ethiopia.
Screening and treatment of maternal genitourinary tract infections to prevent preterm birth in rural Sylhet, Bangladesh: A cluster randomized trial to determine the impact of community-based screening and treatment of mothers in early pregnancy for genitourinary tract infections (abnormal vaginal flora and urinary tract infections) to prevent preterm birth.
Vaginal Microbiota and Mucosal-Neonatal Inflammation: We aim to characterize the vaginal microbiome and inflammatory responses in pregnancy, particularly in relation to preterm birth and specific infections in a cohort of mothers in rural Bangladesh.
Alliance for Maternal and Newborn Health Improvement (AMANHI): The World Health Organization (WHO) AMANHI multicenter study aims to harmonize several large ongoing newborn health research studies in sub-Saharan Africa and South Asia to improve understanding of the epidemiology of maternal and neonatal morbidity and mortality. The primary objective of the gestational age validation study is to identify programmatically feasible methods for accurate assessment of gestational age.
Late pregnancy ultrasonography for prediction of gestational age in low-income countries: Our aim is to determine the accuracy of late (second and third trimester) pregnancy ultrasound biometry, including transcerebellar diameter, to predict gestational age.
Maternal anthropometrics and statistical modeling to improve prediction of gestational age before birth in low-income settings: We aim to develop standardized methods to measure symphysis fundal height and abdominal girth by frontline health workers, and to develop statistical models that include these measures to improve prediction of gestational age.
A simple toolkit and mobile phone application to improve community-based case management of premature and jaundiced infants: We aim to develop a mobile phone application based on Bangladesh’s national guidelines to aid frontline health workers in the identification, triage, and management of premature infants. We also will design and validate a simple, low-cost icterometer to more accurately screen babies at risk of severe jaundice.
A systematic review of the diagnostic accuracy of methods of gestational age determination: This systematic review will assess the range of methods currently available to estimate gestational age before and after birth. We will assess the accuracy, reliability, and precision of these methods to assess gestational age, the feasibility of these methods in low-income settings, and novel methods that may become applicable to lower-middle-income countries in the future.
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