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Research Focus Areas

The Mother Infant Research Institute (MIRI) currently centers its research on several topics of current clinical, public health and economic significance.
MIRI Research Assistant, Francesca Carasi-Schwartz, using a pipette with test tubes in Tupper Research Building lab.

Topics

Premature birth and its complications

Premature birth is a major health problem. Even today, little is known about how to prevent it. Currently, 12.3% of live births in the U.S. are preterm. Despite many advances in prenatal care, this rate increased by 31% from 1981 to 2008. Globally, 15 million babies are born prematurely. Africa has the highest preterm birth rate, and North America has the second highest rate. Preterm birth presents a higher risk than full-term birth for infant mortality and a broad range of lifelong health and developmental problems, including acute and chronic respiratory, gastrointestinal, immunologic, hearing, vision, motor, cognitive and behavioral disorders.  

Preterm births cost the U.S. approximately $26 billion in medical expenses annually. This does not begin to measure the emotional impact on an individual’s or family’s life or on society. For the smallest and sickest premature infant born at less than 28 weeks, medical costs in the first year of life average $190,467 (Source: Institute of Medicine 2007). 

In contrast, a baby delivered at full term incurs medical costs averaging $3,325. Furthermore, formerly preterm babies generate long-term healthcare costs for treatment of conditions such as chronic lung disease or developmental disorders related to complications of their prematurity.

Prenatal opioid exposure and the developing brain

Infants born following in utero exposure to opioids suffer from a constellation of withdrawal signs, called Neonatal Abstinence Syndrome (NAS) or Neonatal Opioid Withdrawal Syndrome (NOWS). With a five-fold incidence in the last decade and cost exceeding $2 billion a year, NAS remains a public health problem that lacks robust biological mechanisms and objective diagnostic measures. 

Through non-invasive salivary transcriptomic and brain imaging, we begin to understand how opioids dysregulate feeding receptors conveniently located in proximity to the drug receptors, resulting in a hallmark withdrawal sign, i.e., uncoordinated and excessive sucking (hyperphagia), that is distinct across sex. Utilizing these non-invasive platforms, researchers at MIRI aim to develop multifaceted, objective measures to predict withdrawal severity and enable short-and long-term precision medicine for high-risk infants.

Reduction of adverse affects on mother and child due to maternal obesity

Maternal obesity is a major public health crisis that has emerged over the past 20 years. Maternal obesity results in higher rates of cesarean section, higher rates of infant congenital disabilities and a three-fold higher incidence of neonatal death. 

Babies born to obese mothers, even if born at an average weight, are predisposed to obesity and metabolic dysregulation throughout their lives. Data from the National Institute of Child and Human Development suggests that excessive weight gain in pregnancy, regardless of pre-pregnancy body mass index, also predisposes to hypertension, preeclampsia and infant cardiac defects.

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