A research team from New York University (NYU) and the International Healthy Outcomes of Pregnancy for Everyone (HOPE) Consortium has developed a new tool, the Preterm Birth Actionable Risk Index (PTB-ARIx). This innovative tool aims to identify pregnant individuals at high risk of experiencing a preterm birth, defined as delivery before 37 weeks of gestation. The PTB-ARIx connects risk assessment to timely medical interventions, focusing on factors that have effective treatments available.
Professor Laura Jelliffe-Pawlowski, senior associate dean of research at NYU Rory Meyers College of Nursing, led the research. “Our goal is to move from reacting to preterm birth to preventing it by providing families and health care professionals with knowledge that they can act upon,” she stated. The team presented their findings today, November 17, 2023, coinciding with World Prematurity Day.
The Urgent Need for Effective Solutions
The rising rates of preterm births pose a significant public health challenge. Each year, over 350,000 babies are born prematurely in the United States alone, contributing to health care costs exceeding $25 billion annually. Preterm birth is the leading cause of child mortality worldwide and is associated with various health complications for the newborn.
Despite extensive research, the rate of preterm births in the U.S. has increased from 8% in 2016 to 8.7% in 2023 for singleton births. Disparities exist in treatment uptake, particularly among racial groups. Studies indicate that Black individuals are less than half as likely to receive mental health treatment during pregnancy compared to their White counterparts (19.1% vs. 40.7%). “The consistently low uptake of interventions known to improve maternal health and reduce preterm birth risk represents a critical missed opportunity, particularly in populations already experiencing health inequities,” Jelliffe-Pawlowski emphasized.
Translating Risk into Action
To effectively quantify risks and address treatment gaps, the PTB-ARIx was developed using data from 1.9 million live singleton births in California from 2016 to 2020. The index considers 18 specific risk factors during the first and second trimesters. These factors encompass clinical issues, such as preeclampsia and diabetes, as well as behavioral concerns like smoking and social determinants including food insecurity and housing instability.
By inputting these risk factors, the PTB-ARIx generates a score ranging from 0 to 3+ to assess the risk of preterm birth for each pregnancy. “This index offers a critical opportunity to improve patient-provider communication and increase the timely use of evidence-based, preventive care,” Jelliffe-Pawlowski stated.
The research team continues to explore the PTB-ARIx’s integration with treatment data to better validate its effectiveness in reducing preterm birth rates. Additionally, Jelliffe-Pawlowski and her colleagues at the University of Alabama are working on a blood test to measure immune system signals during early pregnancy. This test aims to screen for preterm birth risk in conjunction with the PTB-ARIx.
Ultimately, the goal is to create a digital platform that empowers health care providers and patients to collaboratively identify pregnancies at risk for preterm birth. By improving proactive prenatal care, the research team hopes to significantly reduce preventable premature births.
The research team includes key contributors such as Audrey Lyndon from NYU Rory Meyers College of Nursing and Dana Gossett, Justin Brandt, and Sasha Hernandez from NYU Grossman School of Medicine, as well as investigators from UC San Francisco, UC San Diego, University of Michigan, UCLA, California State University Northridge, Medical College of Wisconsin, University of Iowa, Indiana University, University of Illinois Urbana-Champaign, and University of Alabama.