February 09, 2016

UAB awarded Gates Foundation Grand Challenge awards to address maternal-fetal health in South Africa

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rubin pillayThe University of Alabama at Birmingham School of Medicine is partnering with researchers at Sefako Makgatho Health Sciences University in Pretoria, South Africa, to address pregnancy-related problems in developing countries, funded by two $2.5 million grants from the Bill & Melinda Gates Foundation.

The Gates Foundation’s All Children Thriving initiative received 54 letters of intent — or preliminary applications for funding — in the current funding round. UAB investigators submitted five of the 54. The All Children Thriving initiative focuses on creating new tools and methods that ensure safe, healthy births for both infants and mothers.

Rubin Pillay, M.D., Ph.D., assistant dean for global health innovation at the UAB School of Medicine and professor of health care innovation and entrepreneurship in the UAB Collat School of Business, says nine proposals — including three from UAB — were invited to make full submissions. “Of those, three grant awards were made, and UAB received two,” he said.

In the first project, UAB researchers are looking to develop a low-cost, one-time blood test for gestational diabetes, a disease that increases the risk of birth injury, cesarean delivery and stillbirth and has lifelong adverse health consequences for both mothers and infants. Currently, the diagnosis of gestational diabetes relies on glucose tolerance testing, which is expensive and time-consuming to administer. UAB researchers are working to develop an improved diagnostic method that is reproducible, inexpensive, requires only one blood draw, and can be performed at a wide range of gestational ages.

Doctors and researchers at Sefako Makgatho Health Sciences University will recruit pregnant South African women at 20 to 28 weeks pregnant who will be screened for gestational diabetes with routine glucose tolerance testing. Metabolomics analyses, an innovative technology that can measure thousands of analytes simultaneously, will be performed to identify unique biomarkers of gestational diabetes, insulin resistance and hyperglycemia. Researchers will then identify the biomarkers with the greatest sensitivity and specificity for gestational diabetes and combine them into a single test.

The second project aims to develop an easy-to-use and cost-effective cervical pessary — a device placed at the opening of the cervix to close it — with sensors to detect and prevent preterm labor. In South Africa, approximately eight out of every 100 infants are born prior to 37 weeks of gestation, according to Pillay. This amounted to approximately 84,000 preterm births in South Africa in 2011.

“These projects give UAB the opportunity to partner with a new medical school in South Africa for truly innovative research that could have a transformative impact on the lives of women and children in developing areas. The fact that we received two of the three project awards shows our competitiveness in patient-centered research and highlights our successful efforts to increase UAB’s impact on global health care delivery.”

A short cervical length is one of the best predictors of subsequent, spontaneous preterm birth. Pillay says the two best interventions to prevent preterm birth are the use of vaginal progesterone and the placement of a cervical pessary, but significant barriers to care in developing countries — such as access to needed medical equipment and patient compliance — limit effectiveness and success of the treatments. The UAB pessary would have sensors to detect preterm labor that link to a mobile phone to alert women of cervical shortening and dilation and would also contain progesterone, which would be administered directly to combat cervical shortening.

Pillay says the research and development effort is a multidepartment, multischool collaboration across UAB and includes the Department of Pharmacology and Toxicology and the Department of Obstetrics and Gynecology in the School of Medicine; the School of Engineering; the Department of Computer and Information Science in the College of Arts and Sciences; and the Department of Biomedical Engineering, a joint department in the Schools of Medicine and Engineering.

“These projects give UAB the opportunity to partner with a new medical school in South Africa for truly innovative research that could have a transformative impact on the lives of women and children in developing areas,” said Selwyn M. Vickers, M.D., senior vice president for Medicine and dean of the School of Medicine. “The fact that we received two of the three project awards shows our competitiveness in patient-centered research and highlights our successful efforts to increase UAB’s impact on global health care delivery.”

Pillay thinks that the product development experience could produce long-lasting benefits for the Birmingham economy, as well as for patient care in the United States.

“While we’re developing the cervical pessary, we’re also hoping to spin off other products, like for example, a sensor-based device to monitor cervical dilation of women in labor, so women don’t need to be digitally examined every hour,” he said. “A big part of the future of health care is going to involve sensor-based technology, so I think this project will provide invaluable lessons and expertise for local scientists and researchers. This project is going to help us build capacity locally.”

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