A team of clinical researchers from the University of North Carolina at Chapel Hill has received $14 million from the Bill and Melinda Gates Foundation to conduct two studies designed to improve pregnancy outcomes in the world’s poorest countries. An interdisciplinary team at the UNC School of Medicine and the UNC 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 some 300,000 women and three million babies worldwide die during childbirth or shortly thereafter, according to the World Health Organization. Environmental and structural factors, underlying infectious disease burden, nutritional factors and underperforming health systems are just some of the major reasons for this.
“In many parts of the world, the days surrounding childbirth are the riskiest period a mother and her newborn will ever face,” said Jeffrey Stringer, professor of obstetrics and gynecology in the UNC School of Medicine and adjunct professor of epidemiology in the UNC Gillings School of Global Public Health. “These studies will develop resource-appropriate technologies to make that time much safer.”
The Limiting Adverse Birth Outcomes in Resource-Limited Settings (LABOR) 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-Chapel Hill’s flagship partnership in Zambia. The team will provide wearable physiologic sensors to monitor laboring mothers and their fetuses and carefully document their clinical course and birth outcomes.
Using participant data, researchers will develop new algorithms that can both identify individual women’s risk of specific adverse outcomes and help predict and plan for the specific interventions women will likely need. These precision approaches can 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 UNC Gillings School.
The second study, the Fetal Age Machine Learning Initiative (FAMLI), aims to develop a robust, affordable ultrasound device that can be deployed in limited-resource settings to assess gestational age and other important obstetric information while requiring minimal operator expertise. The team will produce large sets of ultrasound data that can be used to train machine learning algorithms to assess gestational age and make other diagnoses. “An ultrasound scanner is as important as a stethoscope to the obstetrician, yet these devices are frustratingly absent from prenatal clinics in much of the developing world. The FAMLI project will leverage new techniques in artificial intelligence and machine learning to develop a simplified ultrasound device that can radically improve care in settings where skilled sonographers are not available,” Stringer said.
Upon completion, data from both studies will be publicly available through the Gates Foundation’s Knowledge Integration team for interested groups to access and continue improving maternal-child health.
Collaborators on the LABOR study are from the UNC schools of medicine (OBGYN and pediatrics) and global public health (biostatistics and epidemiology), Brown University and Northwestern University. The FAMLI study team includes faculty members from the UNC OBGYN and psychiatry departments and from the N.C. State University College of Engineering.
The Gates Foundation grant supports For All Kind: The Campaign for Carolina, UNC-Chapel Hill’s historic fundraising drive that expects to raise $4.25 billion by Dec. 31, 2022. The campaign supports the Blueprint for Next, the University’s overall strategic plan built on two core strategies: “of the public, for the public,” and “innovation made fundamental.”
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