University of Lethbridge neuroscience researcher Dr. Gerlinde Metz is part of a global team working to answer a simple question with no clear answer: Why do some women go into premature labour?
While more than 60 per cent of premature babies are born in south Asia and sub-Saharan Africa, preterm births also occur in developed regions.
In fact, Alberta has Canada's highest provincial rate for premature births, accounting for more than nine per cent of babies born each year.
Metz and her research team at the Canadian Centre for Behavioural Neuroscience (CCBN) are part of a broader effort led by University of Alberta researcher Dr. David Olson and colleagues from universities in Montreal, Australia and China.
The group recently received more than $1 million in funding from the Preventing Preterm Birth Initiative, a Grand Challenge in Global Health administered by the Global Alliance to Prevent Prematurity and Stillbirth (GAPPS) an initiative of Seattle Children's Hospital, in Seattle, WA.
The GAPPS program seeks to discover biological mechanisms that lead to preterm birth and develop novel interventions to prevent them. In total, there were 320 applications from 50 countries and five were selected to receive funding.
"The support we have received will advance our ability to hopefully change a large-scale health problem, and is really exciting for me, my colleagues at the CCBN, and our students to be able to play a part," says Metz. "This is foundational research that could change how people generations from now live."
Metz says her team's role in the project is to work with a unique animal model developed at the CCBN that allows the researchers to reliably test methods that reduce the inflammation-like triggers that the researchers believe cause premature labour.
"There are several steps that collectively cause labour to take place, but in a preterm birth situation, they start much earlier, and with significantly more risk to the mother and baby," says Metz.
"It's a complex problem that is surrounded by mystery. For instance, in half of all cases of preterm birth, there is no known cause. In all cases, it is difficult to prevent preterm birth."
For the past five years, Metz has been a member of the Alberta-based Preterm Birth and Healthy Outcomes Team, an interdisciplinary group of Alberta Innovates—Health Solutions (AIHS)-funded researchers who have already conducted a significant amount of research to advance the understanding of premature labour. This new funding will allow the group to move forward more quickly with their work.
"What we have learned so far is that there's a cascading effect which starts with an inflammation – or what the body thinks is an inflammation," says Metz.
"This triggers white blood cells to go into defensive mode. Members of our team have discovered that where there is a risk of preterm birth, the white blood cells respond differently to some type of change in the body, and we will be looking at how to identify and reduce this inflammatory trigger."
A preterm birth is characterized by a gestational period lasting less than 37 completed weeks – generally a baby born a month or more premature.
The most frequent cause of infant death, preterm births are a global health problem. Each year, approximately 15 million babies are born prematurely worldwide – and more than a million of those infants die.
Survivors, meanwhile, can face a range of health issues, including cerebral palsy, developmental delay and vision and hearing impairment.
Metz adds that by learning more about the interplay of inflammation, stress, hormonal changes or other factors that affect preterm births, the researchers can apply more than one idea to her model and, by extension, speed up the project.
"For example, work in my laboratory has discovered that maternal stress experienced by one generation can affect the risk of preterm birth among offspring well into the future," says Metz. "Other members of our team are looking at how molecules change with the onset of preterm birth symptoms, and are developing a low-cost method of early diagnosis and treatment of the symptoms caused by the change in molecular structure. This has shown promise in early testing."
Students who show promise as researchers have played a key role in driving Metz's research forward. In addition to postdoctoral fellows, several undergraduate and graduate students – as well as a "particularly ambitious" high school student – work with Metz in the lab.
There, the assistants are learning the intricacies of academic research by handling a variety of responsibilities, including developing ways to measure maternal health among rats.