June 28, 2011

Senate Health Policy Committee calls on Health and Human Services to keep PRB at Wayne

The Michigan Senate Committee on Health Policy has adopted a resolution requesting that the National Institutes of Health maintain its Perinatology Research Branch at the Wayne State University School of Medicine.

The committee on Tuesday passed the resolution introduced by Sen. Jim Marleau (R-North Oakland County) urging the Secretary of the U.S. Department of Health and Human Services continue the PRB at WSU. In April, the House adopted a similar resolution introduced by State Rep. Gail Haines, (R-Waterford).

A National Institutes of Health research center in maternal-fetal medicine, the PRB has been at the WSU School of Medicine, housed at Hutzel Hospital, since 2002 under a 10-year research grant. That contract may be up for renewal next year.

"This resolution, again, shows that our elected officials understand the necessity for such a valued center of research to remain in Michigan and Detroit," said Valerie M. Parisi, M.D., M.P.H., M.B.A., dean of the School of Medicine. "The researchers of the Perinatology Research Branch have changed the way maternal-fetal medicine is practiced around the world, saving thousands of lives and reducing health care costs associated with pre-term birth. In addition, they have assisted more than 20,000 Michigan mothers and their infants, saving countless lives."

Marleau, who chairs the Senate Committee on Health Policy, introduced the resolution, noting the number of pregnant women - most from indigent households - who receive "world-class" care through the PRB and the WSU School of Medicine.

He also noted that the School of Medicine and the Detroit Medical Center made significant investments in infrastructure to house the center.

"The work being done at Wayne State through the PRB program has made some of the most notable differences in the prevention of pre-mature births in recent times and has done so amongst our most vulnerable residences," Marleau said. "There is no question these achievements make this program an appreciating asset in Michigan's health care economy."

The city of Detroit, in 2008, experienced a premature birth rate of 17 percent, a rate that exceeds the national average of 12.5 percent. Those preterm births accounted for more than 70 percent of infant deaths that year, according to the Michigan Chapter of the March of Dimes. The city's high infant mortality, preterm delivery rate and ethnic disparity in birth outcomes were key considerations in the NIH's decision to establish the PRB in Detroit. The branch allows women to obtain state-of-the-art medical care and join medical studies to improve prenatal diagnosis, monitor fetal growth, predict preeclampsia and prevent preterm birth.

The most recent example of that cutting-edge medicine was announced in April. A groundbreaking study by PRB researchers found a new method for preventing premature birth in millions of women annually. Published in the medical journal Ultrasound in Obstetrics & Gynecology, the study shows that the rate of preterm delivery in women pregnant less than 33 weeks can be reduced by 45 percent simply by treating them with a low-cost gel of natural progesterone during the mid-trimester of pregnancy until term.

The study, said Roberto Romero, M.D., chief of the PRB, offers hope to millions of women, children and families. More than 12 million premature babies are born annually, 500,000 in the United States. Many of those children born prematurely go on to suffer debilitating health effects.

"Our clinical study clearly shows that it is possible to identify women at risk and reduce the rate of preterm delivery by nearly half, simply by treating women who have a short cervix with a natural hormone -- progesterone," said Dr. Romero, principal investigator of the study.

Sonia Hassan, M.D., lead author of the study and associate professor of Obstetrics and Gynecology for the WSU School of Medicine, said numerous studies -- many by the PRB -- over the past decade have shown that ultrasound of the uterine cervix can identify pregnant women who are at high risk for preterm delivery. The ultrasound examination is simple to perform, painless and can be performed between the 19th and 24th weeks of pregnancy. Pregnant women with a short cervix (one that is less than 20mm) are at very high risk for preterm delivery.

Dr. Romero said that once a high-risk mother for preterm delivery has been identified she can be offered treatment with progesterone. Progesterone reduced the risk of preterm delivery not only at less than 33 weeks, but also at less than 28 weeks. It also reduced the rate of respiratory distress syndrome, the most common complication in premature babies.

Marleau's resolution also recognized the tremendous economic impact the PRB has in Michigan. The branch employs more than 130 physicians, researchers and staff members, many of them in high-paying technology positions the region needs. A 2010 study conducted by the School of Medicine estimated that the center resulted in an additional $35 million in economic activity in Michigan.