Why should I research premature infants? I am neither a neonatologist nor a pediatrician.

The SET Center’s study of premature infants produces several pioneering advantages for our research and for that of our collaborators. Current research into biological development using non-human subjects such as zebrafish, mice, flies and other animals limits the translatability to our patients who are currently visiting our clinics. Instead, we can observe human development occurring in our hospital in incubators that would traditionally occur out of sight (in-utero). Additionally, preterm infants are typically hospitalized for several weeks or as long as 5 months, with every aspect of their care measured and mutable. Their long-term risk for prevalent health conditions also gives us greater insight into these diseases and vastly increases the impact of our research.

One example would be the effect on the lungs, which do not finish developing in a fetus until the third trimester of a pregnancy. Bronchopulmonary dysplasia (BPD), a condition where oxygen cannot move easily through the air sacs in the lungs, uniquely impacts premature infants. Neonatologists treat BPD in the NICU with medications and supplemental oxygen. As these formerly preterm infants grow, we know that patients both with and without BPD are more likely to develop asthma as children, and are also at higher risk to develop chronic obstructive pulmonary disease (COPD) in adulthood. Infants who enter the world needing to breath oxygen with immature lungs have their development abruptly interrupted by preterm birth, putting them on a suboptimal trajectory.

COPD is not a condition that is specific to patients who were born premature but this patient population can teach us a lot about its origins. This is just one example. We know that premature infants are more likely to develop autism spectrum disorder, ADHD, diabetes, cardiovascular disease, psychiatric disorders, among others. UCMC pediatricians also discovered that children born premature are less likely to be ready for kindergarten as their full-term peers, an outcome that can be exasperated further by their families’ socioeconomic status.

The SET Center is working with researchers from diverse specialties across the university to identify biomarkers of organ development. Infants born premature are at high risk to be on a suboptimal developmental trajectory, both during infancy and later in life. For any number of reasons, our other patients in the clinic have stepped off their trajectories as well, causing new diseases and diagnoses. By following the development of premature infants, we can outline the best path for our patients both young and old, preventing disease and supporting healthy futures.

Learn more about the State of Preterm Birth, and its incidence nationally and locally.

How can I apply my research to premature infants?

Neonatologists are the experts in premature infants, but are lacking the expertise in specific areas of development. Nearly every system is immature when an infant is born preterm and science has not produced a tool to say how immature is a particular organ or biologic process. One of the only tools available to providers in the Neonatal Intensive Care Unit (NICU) is post-menstural age (PMA), or the number of weeks between the pregnant parent’s last period and the birth of the infant, added to the number of weeks the infant has been alive. PMA is a measure of time but does not tell us how developed individual organs are, nor does it take into effect the interconnectedness of the various systems.

Premature infants provide an opportunity to study human development across the life course. We would like to build multi-disciplinary teams that study alternative biomarkers, e.g., from the immune, endocrine, epigenetic, metabolic, and microbiome systems. Other specialties will be vital in identifying and interpreting the biomarkers such as nutrition, obstetrics, chemistry, engineering, and physics. These teams will combine expertise to identify biomarkers that will inform healthcare providers when a patient is not on the optimal developmental trajectory. The SET Center has an abundance of data, samples, and other resources to support new research questions in these areas.

What are the benefits of partnering with the SET Center?

The SET Center’s existing outcomes data, longitudinal biospecimens, and continued follow-up of subjects through neurodevelopmental and physical assessments provide a window into how their development is affected long-term by their health status in their first days and weeks of life. Our approach takes into account the interconnectedness of the different organ systems and how the underdevelopment or maldevelopment of one organ can negatively impact another years or decades later. Additionally, our model incorporates how the health of one or more organs can affect neurodevelopment, cognition, and quality of life.

The SET Center built the PreSET Platform, which makes available de-identified data on hundreds of patients, including gene sequencing on thousands of biospecimens. The platform supports the SET mission by bringing together data from studies examining the microbiome during all phases of life. This data can be used for future research on the microbiome during various developmental stages of our patients both young and old. New data and projects are added regularly, so please reach out to the PreSET team if you have questions about what is available.

Only UChicago or UCMC faculty, staff, or students will have access to the PreSET Platform. You must be connected to VPN or a secure UChicago network (uchicago-secure) in order to access the platform.