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Drs. O’Shea and Fry

North Carolina has been ranked by the Centers for Disease Control (CDC) as having the 12th highest premature birth rate in the country (I). According to data from the CDC’s National Center for Health Statistics, more than 10% of births in 2016 in North Carolina occurred prior to 37 weeks of gestation (compared to 9.85% national rate, 7.8-13.7% range across states).

To learn more about this growing health issue, UNC researchers T. Michael O’Shea, MD, MPH and Rebecca C. Fry, PhD, have been collaborating with research centers nation-wide as part of the ELGAN-ECHO Research Study, now in its third stage. ELGAN (Extremely Low Gestational Age Newborns), is a collaboration across 12 study sites with 800 active participants born between 2002-2004. ECHO (Environmental influences on Child Health Outcomes) consists of 83 research cohorts with hopes to reach 50,000 children by 2023. Together, ELGAN-ECHO tracks children born prematurely to determine how gestational age and environmental exposures can effect health as preterm children develop.

“The overall objective is to learn how the environment can be modified to improve the health of children in the United States,” Dr. O’Shea said in a joint statement with Dr. Frye. ELGAN-ECHO is particularly focusing on 4 key pediatric outcomes: 1) neurodevelopmental disorders (such as autism spectrum disorder), 2) obesity, 3) upper and lower airway disorders (such as asthma), and 4) adverse pregnancy outcomes (II). This study has also given investigators insight into traits of preterm pregnancies, including uterine inflammation and bacterial presence within placenta, according to the study’s website.

Babies born prior to 37 weeks often face considerable health issues, including delays in development, breathing disorders, and hearing loss. Long-term health costs for these children represent a considerable health burden statewide.

The study began in fall 2001 and as of March 2018, 144 peer-reviewed manuscripts have been published with conclusions drawn from the study.