Am J Perinatol 2021; 38(02): 202-204
DOI: 10.1055/s-0039-1695774
Commentary

New Strategies to Tackle the Combined Biological and Social Context of Preterm Birth

1   Division of Neonatology, University of Pennsylvania School of Medicine, Attending Neonatologist at the Children's Hospital of Philadelphia, Philadelphia, Pennsylvania
,
Ramzi G. Salloum
2   Department of Health Outcomes and Biomedical Informatics, University of Florida, Florida
,
Scott A. Lorch
3   Department of Pediatrics, Division of Neonatology, University of Pennsylvania, Philadelphia, Pennsylvania
› Author Affiliations

Abstract

Objective Preterm birth rates in the population and associated racial inequities have remained relatively unchanged in the United States despite research aimed at prevention. This is potentially the result of the multifactorial pathophysiologic pathways that result in preterm birth, where biological and social drivers intersect in unique ways for different women. The field of dissemination and implementation (D&I) science may address this issue by promoting the contextually-aware uptake of science into health and health care delivery.

Study Design In this paper, we describe how the field of D&I science may afford new perspectives on preterm birth prevention to researchers and tools to design studies that translate clinical trial data into measurable changes at the level of the population. We discuss key examples where the perspectives and tools of D&I science have been used in conjunction with quality improvement methodology to change preterm birth rates in large population studies. We build on these case studies and suggest future D&I science-informed studies that could be explored.

Conclusion Incorporating D&I scientific principles into the design of studies to prevent preterm birth may allow future research to better address the varied ways in which social forces comingle with biological risk factors to result in preterm birth.



Publication History

Received: 12 April 2019

Accepted: 16 July 2019

Article published online:
03 September 2019

© 2019. Thieme. All rights reserved.

Thieme Medical Publishers, Inc.
333 Seventh Avenue, 18th Floor, New York, NY 10001, USA

 
  • References

  • 1 Goldenberg RL, Culhane JF, Iams JD, Romero R. Epidemiology and causes of preterm birth. Lancet 2008; 371 (9606): 75-84
  • 2 Ferrero DM, Larson J, Jacobsson B. et al. Cross-country individual participant analysis of 4.1 million singleton births in 5 countries with very high human development index confirms known associations but provides no biologic explanation for 2/3 of all preterm births. PLoS One 2016; 11 (09) e0162506
  • 3 Stevenson DK, Wong RJ, Aghaeepour N. et al. Understanding health disparities. J Perinatol 2019; 39 (03) 354-358
  • 4 Lorch SA, Enlow E. The role of social determinants in explaining racial/ethnic disparities in perinatal outcomes. Pediatr Res 2016; 79 (1-2): 141-147
  • 5 Norman JE, Bennett P. Preterm birth prevention-time to PROGRESS beyond progesterone. PLoS Med 2017; 14 (09) e1002391
  • 6 Brownson R, Golditz G, Proctor E. eds. Dissemination and Implementation Research in Health: Translating Science to Practice. 2nd ed. New York, NY: Oxford University Press; 2017
  • 7 Jacobs SR, Weiner BJ, Bunger AC. Context matters: measuring implementation climate among individuals and groups. Implement Sci 2014; 9 (01) 46
  • 8 Sampson UKA, Chambers D, Riley W, Glass RI, Engelgau MM, Mensah GA. Implementation research: the fourth movement of the unfinished translation research symphony. Glob Heart 2016; 11 (01) 153-158
  • 9 Iams JD, Applegate MS, Marcotte MP. et al. A statewide Progestogen Promotion Program in Ohio. Obstet Gynecol 2017; 129 (02) 337-346
  • 10 Newnham JP, White SW, Meharry S. et al. Reducing preterm birth by a statewide multifaceted program: an implementation study. Am J Obstet Gynecol 2017; 216 (05) 434-442
  • 11 Holtrop JS, Rabin BA, Glasgow RE. Dissemination and implementation science in primary care research and practice: contributions and opportunities. J Am Board Fam Med 2018; 31 (03) 466-478
  • 12 Balas EA. From appropriate care to evidence-based medicine. Pediatr Ann 1998; 27 (09) 581-584
  • 13 Brownell MD, Chartier MJ, Nickel NC. et al; PATHS Equity for Children Team. Unconditional prenatal income supplement and birth outcomes. Pediatrics 2016; 137 (06) e20152992