Research & Innovation
Team science to transform pre-term infant outcomes
Health outcomes in infancy are not only important for infants, they are a foundational time point in everyone’s life course, affecting health and well-being until the end of life. “What happens to infants has a lasting impact on the rest of their lives,” said Erika C. Claud, MD, Director of Neonatology Research. “So, the critical question is, ‘How can we intervene early in life to avoid or reduce chronic disease later?’”
The answers won’t all emerge from a group of neonatologists studying infant development. “We can’t do this alone,” said Claud. But some of the best minds in the world at the University of Chicago, working collaboratively in diverse fields, can help create much-needed practical and personalized interventions for vulnerable infants.
In 2021, Claud led the launch of the Center for the Science of Early Trajectories (SET), inspired by the “unique cross talk” between departments at the University of Chicago Medicine, which allowed her to see the overlap between her research on infants and the research of other scientists and physicians caring for children and adults. She wanted to promote and capitalize on the common research goals between distinct disciplines to create more collaborations and pioneering care for her patients.
Erika C. Claud, MD, Director of Neonatology Research
“We are leveraging the expertise of the entire University of Chicago community to optimize the early-life care of infants — especially pre-term infants — to enable them to thrive over their entire lives,” said Claud. SET encourages scientists from multiple fields — data science, lab or bench science, molecular materials engineering, adult medicine, obstetrics, pediatrics and economics — to apply their research to revolutionize outcomes for pre-term infants.
“We are providing the resources, seed funding and training to ground researchers in the challenges of pre-term infants,” said Claud. For example, neonatologists currently measure a pre-term infant’s development in terms of gestational age and weeks of life, which is not a very advanced or personalized rubric. “We hope our scientific community will identify biomarkers of normal development for individual organ systems,” she said. “Knowing where a pre-term infant is on the developmental continuum will enable us to target our care to enhance the healthy maturation of each organ.”
Research at SET will span a range of fields, from molecular analysis of patient samples from pre-term and full-term infants to identify and clarify the role of the microbiome in lifelong health, to using bioinformatics analysis to evaluate clinical signs of an impending health event. A biorepository for patient samples and a data platform have been established to allow other investigators to use analyses that have already been performed to help answer their own research questions.
Researchers at UChicago Medicine recently investigated the association between the gut microbiome in pre-term infants and head-circumference growth, a proxy for neurodevelopment. The researchers found that infants with suboptimal head-circumference growth trajectories had a depletion in the abundance and prevalence of two microbes. The team of investigators will build on that work with the Host-Microbe Metabolomics Facility at the Duchossois Family Institute (DFI) at the University of Chicago to develop therapeutics that will replace the microbes and metabolites that pre-term infants are missing. Another joint project with the DFI involves collecting data and biospecimen samples from pre-term infants in the neonatal intensive care unit and from a full-term infant cohort, and following the babies to age 5 to study their neurodevelopment and physical development, as well as microbiome maturation in both groups.
Other current collaborations include working with Bozhi Tian, PhD, Professor in the Department of Chemistry, to create materials that mimic the placenta and amniotic fluid, to help mitigate stress and provide comfort to pre-term infants during illness to improve their development. Another collaboration is with geriatrician-scientist Megan Huisingh-Scheetz, MD, MPH. While her research focuses on frailty in the elderly, the functions she is working to preserve — mobility, activities of daily life and cognition — are similar to the developmental milestones that infants and children born prematurely struggle to achieve.
The center has a special focus on the impact of health inequities and socioeconomic factors in pre-term birth and infant outcomes, including how stress and nutrition can impact lifelong development. SET is actively collaborating with Kathryn Keenan, PhD, Professor of Psychiatry and Behavioral Neuroscience, in a study about the impact of prenatal stress in Black mothers on Medicaid on the neurodevelopment of their infants. The next phase of this research will evaluate if supplements taken during pregnancy can limit the effects of stress in this vulnerable population.
“If we can understand what establishes a healthy child and what allows that child to become a healthy adult, we can begin to address some health inequities,” said Claud. She expects that the work at SET can inform best practices and treatments that will benefit predominantly Black, urban, pre-term infants at Comer Children’s and their families. “We want to help moms and families and babies get the strongest start possible, regardless of challenges they might face due to lack of resources,” Claud said.
Over time, Claud envisions that the bench-to-bedside center will incorporate all elements of the scientific process in supporting patient care. “Our goal is to figure out when and how things change between kids who are doing well and kids who aren’t, and what factors in their environment and diet are associated with those changes,” she said. “We need to begin with understanding biology and environment together to deliver the best interventions.”