Network of Partners Works to Reduce High Preterm Birth and Stillbirth Rates

A network of healthcare partners across Ontario has joined forces to form the Ontario Alliance for the Prevention of Preterm Birth and Stillbirth, or simply, The Alliance.

The Alliance is a group committed to working on ensuring that more women in Ontario safely carry their babies to full term. The Alliance is led by Dr. Jon Barrett, its medical director, who hopes to reduce the number of preterm deliveries in Ontario by 15%.

Groundbreaking Research

Dr. Barrett, the chief of maternal medicine at Sunnybrook hospital, is also a pioneering physician and researcher.

His landmark study that led to the findings was published in The New England Journal of Medicine, considered the “holy grail” for medical researchers.

While this was an accomplishment for Dr. Barrett, he found that he was “…informed practice, but the trouble with informing practice is that it doesn’t change practice”. He wanted to foster knowledge about preterm birth, and not just in twins.  This led to the eventual creation of The Alliance, which was launched in 2017.

What is Preterm Birth?

The World Health Organization (WHO) defines preterm or premature birth as delivery prior to 37 weeks of gestation. Many babies born prematurely are perfectly healthy. However, complications from significant premature birth are one of the leading causes of death of children under 5.

Preterm Birth and Disability

Every year, more than 15 million babies (one in ten) are born prematurely. This number has been increasing.

In Canada, approximately 8% of pregnancies a year are premature (more than 25,000 annually). Many children who survive a significant pre-term birth have disabilities, resulting in a lifelong impact on the child and their family.

Addressing Preterm Birth

Dr. Barrett notes that in the past there was nothing that could be done to predict or prevent a premature birth, or to treat a premature delivery. However, research has since progressed, and the focus now should be on how knowledge gained through this research can be incorporated into practice to prevent preterm birth and to save lives.

In order to successfully do this, Dr. Barrett says that researchers must collaborate instead of working in separate academic silos.

The Alliance

The Alliance is a collaboration of families, maternal new-born care providers, data experts, and researchers. Its goal is to spread knowledge about screening tests and treatment options that are proven to reduce preventable preterm births and stillbirths as a means of improving infant health and quality of care.

Similar networks built on the notion of collaboration exist in the U.S., Ireland, and the Netherlands.

The Alliance’s first focus is to secure funding. Dr. Barret notes the difficulties with obtaining funding from existing sources, who generally fund research but not health care implementation:

It’s a tragedy that babies are dying, yet we know we can prevent it…[i]t became very frustrating for me to know that there’s this body of evidence that can prevent babies from dying, but I’d have to wait on a 15% chance [of funding] rate in order to implement it. I’m not the kind of person who likes those odds.

Once funding is obtained, the Alliance will then focus on obtaining blood samples from pregnant women in the first trimester, evaluating their DNA and protein levels, and correlating these findings with later outcomes.

The group also wants to:

• develop clinical trials to generate new knowledge;
• instruct health care providers and prospective parents on how to prevent preterm birth and stillbirth safely and inexpensively;
• identify at-risk women by linking data with screening programs;
• improve care coordination so that early labour that cannot be avoided happen in hospitals equipped to deal with them;
• implement a “bundle” of standard treatments through its networks.

Standardizing Care

Dr. Nir Melamed, an associate scientist in the Women & Babies Research Program at SRI and maternal-fetal medicine specialist at Sunnybrook and member of the Alliance says that the group also hopes to standardize care and enable researchers to do joint projects noting:

It doesn’t make sense that different physicians who are practising only a few kilometres from each other will do things so differently when it comes to the care of low- and high-risk pregnancies…there are some questions you simply don’t have enough patients in a single centre to address, so by doing multicentre studies we have [this] power.

The Alliance is hopeful that their work will have an impact. Dr. Melamed has noted:

We have a real opportunity. When you make a small change in your own hospital, you can affect a small number of patients. When you make a similar change across a much broader population, such as across the GTA or eventually throughout the whole province, what you do can have a much greater impact on the health of women and their babies.

Prenatal Testing Errors

While research has progressed, and wonderful programs such as The Alliance are being created to further inform health care providers, prospective parents, and others, the reality is that there are often prenatal testing errors and other similar errors that can occur which can impact a child and their family.

Expectant parents rely on their OB-Gyn and other doctors to monitor the well-being of their developing baby, to keep them apprised about the health of their unborn child,  and to identify any potential risks, conditions, or abnormalities. However, medical errors or oversights by doctors, hospitals, or testing laboratories sometimes occur and such risks are not always identified.

If your child was born with a disability that should have been identified prior to their birth, you may have grounds for legal action. Contact Sommers Roth & Elmaleh to speak with one of our knowledgeable, compassionate medical malpractice lawyers. We have significant experience assisting families in this situation and can help you understand your options, fight for your rights, and protect your family going forward. Call us at 1-844-777-7372 or contact us online for a free consultation.