The walls of the neonatal intensive care unit at Lucile Packard Children’s Hospital at Stanford are lined with tiny incubators.
The premature babies who lie inside, connected by tubes and wires to the most advanced medical technology, are a testament to modern medicine. Many of these babies, some born as early as 23 weeks’ gestational age, wouldn’t have survived only generations ago.
Yet for all this progress in raising the survival rate of increasingly premature babies, prematurity remains the leading cause of newborn death in the United States. One in eight babies born in the United States arrives early, a rate among the industrialized world that’s second only to Cyprus.
For nearly half the cases of premature birth, there is no clear cause. It’s a medical mystery. And although some factors are known to influence preterm birth — such as an expectant mother’s age or socioeconomic status — this knowledge has not led to a decrease in preterm births in this country. In fact, the premature birth rate in the United States has risen by 36 percent over the past 25 years. The babies in those tiny incubators, then, are also a testament to the limitations of modern medicine.
In 2011, with generous support from the March of Dimes, the Stanford University School of Medicine and Packard Children’s established the world’s largest multidisciplinary research center to study the causes of preterm birth, to move beyond the limitations of modern medicine.
At the March of Dimes Prematurity Research Center at Stanford, over 130 researchers from diverse fields in the life sciences, physical sciences and social sciences are searching for answers to the prematurity riddle. They are studying the interactive biologic and environmental factors that cannot be understood with singular studies from isolated disciplines. Among the initial Stanford research projects:
• Pediatrician/bioinformaticist Atul Butte, MD, PhD, is taking a “big data” approach, analyzing databases to identify genes and environmental factors that interact to raise the risk for premature birth.
• Richard Mahoney, PhD, director of robotics at SRI International, is using pattern-recognition software to pinpoint geographic regions at high risk for premature birth.
• Stanford microbiologist David Relman, MD, is exploring how disturbances in the balance of microbes in a pregnant woman’s body can lead to premature birth.
Here at Stanford, it is the limitations that motivate us. We are attracted to the most difficult and intractable problems, those that require innovative approaches where traditional methods have failed. This issue of Stanford Medicine magazine, produced with the support of Packard Children’s, explores how far modern medicine has come in advancing maternal and pediatric care, how far we have to go, and some of the ways we at Stanford Medicine are collaborating and innovating our way to better health for the youngest among us.
Lloyd Minor, MD
Carl and Elizabeth Naumann Dean of the School of Medicine
Professor of Otolaryngology - Head & Neck Surgery