What We Do
Eliminating Negative Health Outcomes for Premature InfantsWhy We Study Premature Infants
Prematurity is not a disease, but rather it is a developmental state that is happening in suboptimal conditions
The Center for the Science of Early Trajectories was founded by Erika Claud, MD, who has dedicated her career to better understanding the foundational life stage where all of our lives began, infancy. Neonatologists like Dr. Claud have spent decades trying to improve outcomes for premature infants with mixed success. Full-term infants complete their gestation in-utero, where our prenatal development evolved to occur. For infants born premature, or before 37 weeks gestational age, they must complete this developmental stage instead in our Neonatal Intensive Care Unit (NICU). Survival rates for preterm infants has increased significantly in recent decades, with the first infants benefiting from modern practices reaching adulthood and some are nearing middle age. What we have unfortunately found is that their immaturity and underdevelopment at birth has lasting consequences.
Preterm infants are at higher risk than their full-term peers for several common diseases and disorders such as asthma, autism spectrum disorder, diabetes, cardiovascular disease, among others. These conditions also affect children and adults who were born full-term. By studying the development of premature infants in the NICU and after they graduate, we can pinpoint the origins of these health outcomes and create targeted interventions, preventing them in the first place. The SET Center aims to do this by identifying biomarkers for organ development.
Incubator of Research
The SET Center is as an incubator that brings together the pioneering expertise at the University of Chicago to identify biomarkers of human development throughout the life course by studying premature infants. Identified biomarkers for organ development would allow healthcare providers to intervene when a patient has veered off the optimal developmental trajectory for their age, whether due to preterm birth or other influences, and put them back on the best path. We have the potential to prevent disease for all patients from the moment they are born.
In order to achieve this goal, the SET Center brings together scientists from diverse areas of study. We will have the greatest impact studying alternative biomarkers simultaneously given that development is a complex process involving multiple systems. Our strategic approach mobilizes research teams from across the institution by breaking down barriers to answer this broad research question, and bring in novel ways of thinking. We have the resources to support whatever need a project may have.
What is a biomarker?
The NIH defines biomarkers as a subcategory of medical signs and can be detected through different tests and procedures. Examples of biomarkers include:
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- Blood pressure and body temperature.
- LDL cholesterol level and red blood cell count.
- Tumor detected by contrast MRI or bone fracture detected by X-ray.
Bridge-Building
The SET Center knows that neonatologists alone cannot solve all the health problems that premature infants face while in the NICU or after they graduate. We have developed a wide network across the University of Chicago and the University of Chicago Medical Center of experts who share their knowledge and collaborate to answer questions about biological development. We have built teams that include scientists from the Department of Chemistry, Pritzker School of Molecular Engineering, Adult Medicine, Neonatology, Pediatric Oncology, Human Genetics, Maternal-Fetal Medicine, among others.
Breaking Down Barriers
The SET Center knows that many established research labs are interested in hypotheses that relate to biological development but are missing a resource needed to start a new project. That is where we come in. We have extensive experience supporting the needs of scientists intrigued by a new line of questioning. In the past, we have offered the following assistance to projects:
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- Regulatory Support
- Patient Data and Biospecimens
- Bench Science Skills
- Grant Support
- Grad student, clinical fellow, or postdoc
- Micro Grants and Pilot Grants
Interested in learning how we can support your lab? Find out more information on How to Get Involved.
Biorespository
Often a barrier to starting a novel project is the very foundation of clinical research, obtaining patient data and biospecimens. The heart of the SET Center’s work is better understanding the long-term effects of the healthcare we provide today. However it is cost-prohibitive to run an ongoing-outcomes study for each research question. For this reason, the SET Center has built a biorespository that collects and integrates several cohorts from across UChicago to represent all the life stages.
The biorespository includes clinical data on hundreds of patients, outcomes data collected through ongoing neurodevelopmental and physical assessments, thousands of biological samples from various sources, and multi-omics analyses. Some of this data can be accessed by University and UCMC scientists on our data platform, PreSET. Users must be connected to the University network or its VPN to login.
Current Research Areas:
- Modeling microbiome development and its relation to neurodevelopment
- Biomarkers for development
- Outcomes for small for gestational age infants
- Lung maturation and extubation from airway ventilator
- Risk of Type 1 diabetes in formerly premature infants
- Breast milk and infant immune development
- Cell-free DNA in maternal blood and premature birth
- Microbiome development of pediatric oncology patients
- Microbiome development in geriatric patients
SET Center Pilot Grant
The SET Center awards an annual Pilot Grant to University of Chicago faculty members. The grant program was intentionally designed to invite new researchers to study biological development who need funding to start a novel project. We have funded two projects since 2023.
The FY 2025 Funding Cycle is now open! Details about the grant can be found on our Pilot Grant page.
2024 Awardee – Epigenomes in the Neonatal Brain
When compared to their peers who are born full-term, infants born preterm have impaired brain development over time. Even at 10 years of age, scientists have found a correlation between brain volume and the gestational age at birth. Children and adults who were born premature are more likely to have neurodevelopmental delays and psychiatric disorders than people born full-term. What is happening in the brain during the final weeks of pregnancy that does not happen for preterm infants in our NICU? The development in the infant brain in the third trimester and in the first weeks of life impact the health and well-being of our patients for the rest of their lives. But this development is not currently understood.
The brain is comprised of incalculable numbers of diverse cell types, anatomical structures, and neural circuits. Each of these have specific epigenomes, or combinations of regulatory information associated with the genome that can turn on and off specific genes in different cells. The postnatal brain possesses uniquely dynamic epigenomes that can shift and evolve as the neural pathways are set. This provides us an opportunity to optimize the development, in particular for vulnerable patients such as premature infants. The challenge lies in the fact that the brain is complex, and would require the study of epigenomic regulation for each cell type, brain region, and neural circuits. The epigenome of the developing neonatal brain is uncharted and can offer fundamental knowledge of brain plasticity and critical insights into various brain disorders.
The SET Center is excited to award its second Pilot Grant to Zhuzhu Zhang, PhD, from the Department of Human Genetics. Dr. Zhang will use her expertise to study the role of epigenetic regulation in postnatal brain development. The knowledge gained from her research will enable us to better understand what is happening in the brains of newborns, and eventually could lead to treatments that support optimal neurodevelopment.
2023 Awardee – Artificial Skin-to-Skin Contact
While infants are hospitalized in NICUs, they can struggle to adjust to life outside the womb and may face several health challenges due to their underdevelopment. Many preterm infants have challenges regulating their body temperature, maintaining appropriate sleep-wake cycles, and fighting infections. They also typically have higher cortisol levels, indicating they have higher stress.
Skin-to-Skin Contact (SSC) is one intervention that has been shown to increase survival and decrease morbidity when implemented. Also called Kangaroo Mother Care (KMC), SSC is the practice of placing an infant directly on a parent or caregiver’s bare chest in an upright position. To name just a few benefits, SSC in several studies has been shown to decrease pain, improve an infant’s body temperature regulation, lowered the risks of infections, and lowered cortisol levels. One study even demonstrated that infants who received SSC scored higher on neurodevelopmental assessments at 6 months, and at 10 years old, had better stress responses, improved cognitive control, and slept better.
What happens when families are not able to be present in the NICU to provide the kangaroo care that we know offers so many advantages for long-term development? Often when infants are born prematurely, the birthing parent is hospitalized for their own health concerns and frequently they have undergone a caesarean section. Socioeconomic factors often stand in the way. As the only high-income country that does not offer paid parental leave, the majority of parents must return to work shortly after giving birth. We have also found that parents with other children in the home are less able to visit the NICU while they are caring for older siblings. Travel to and from the hospital can also hinder parents’ ability to provide SSC. Our patient population on the South Side of Chicago is at even higher risk of these barriers due to historic disinvestment in the local communities and neighborhoods.
To solve this complicated problem, the SET Center awarded its inaugural Pilot Grant to the team of Leah Fox, MD and Bozhi Tian, PhD, a neonatologist and chemist respectively, who are developing an artificial skin-to-skin tool that mimic’s the physiologic features of SSC that can be implemented in the NICU. This new care regimen would provide innumerable advancements to infants’ development during their hospitalization and long into the future.
