Look into the Future

Reproductive Health and Birth Outcomes

Research Opportunity		Forecast
In developing countries, health services research to improve access to affordable and effective reproductive health services		Improved understanding of medical system characteristics in developing countries necessary to improve specific reproductive health outcomes In many countries, reduced fertility and reductions in maternal, fetal, and neonatal mortality as access to appropriate services is improved
Extend ability to predict, diagnose, and treat congenital abnormalities		Prediction and diagnosis of many congenital conditions will improve substantially; treatment will lag behind
Develop a better understanding of the pathways leading to spontaneous preterm birth		Effective preventions and treatments targeting specific pathway components will lead to a reduction in spontaneous preterm birth
Develop a better understanding of the mechanisms leading to the vasoconstriction and vascular damage seen in preeclampsia and fetal growth restriction		Understanding of the molecular events will evolve slowly; effective prevention will ultimately be based on an understanding of the mechanisms of such events
Learn the mechanisms permitting plasticity of brain development in fetuses and infants		As the factors that promote plasticity are better understood, interventional programs that optimize long-term neurologic outcomes will be developed
Improvement of neurodevelopmental outcomes of preterm infants		Increasing understanding of the mechanisms responsible for brain injury will lead to the development of pathway-specific therapies with stem cells and growth factors
New strategies to mature the fetus		Using specific modulators of lung, gut, and brain development, induction of specific fetal organ maturation prior to preterm birth will be possible
Minimize bronchopulmonary dysplasia		Using specific mediators of lung development to promote alveolarization, it will be possible to target injury pathways with inhibitors
Optimize nutrition and growth after preterm birth		Use of growth factors and promoters of gut function will enhance growth and development of preterm newborns
Decrease cerebral palsy		Targeting of specific antenatal and postnatal causes of perinatal brain damage will result in a slow decline in cerebral palsy

Authors: Robert L. Goldenberg, MD, Department of Obstetrics and Gynecology, University of Alabama at Birmingham School of Medicine; Alan H. Jobe, MD, PhD, Pediatrics/Neonatology, Cincinnati Children's Hospital Medical Center