Despite the extensive advances made in the care of premature babies, scientists still don't know what prompts preterm birth. In fact, they don't know what specifically causes labor at any time.
"It's embarrassing that we know so little about this," said Dr. Joe Leigh Simpson, senior vice president of research and global programs at the March of Dimes, a nonprofit that works to end premature birth, birth defects and infant mortality.
It's difficult to solve a problem that you don't understand.
"We don't really understand why some women go into labor early and why other women don't," said Dr. Robert Goldenberg, a professor of obstetrics and gynecology at Columbia University who has been researching preterm birth for nearly four decades. "Until we really understand that better, I don't think we're going to make much progress in terms of reducing the preterm birth rate."
Research in this area has traditionally been conducted by maternal-fetal medicine specialists, obstetricians and gynecologists, but a new line of thought is emerging through the March of Dimes: Since the factors contributing to preterm birth are so diverse, the doctors studying it should be as well.
Researchers and nonprofits around the globe have dedicated themselves to uncovering the cause. The National Institutes of Health spent $223 million on research in 2015 and projects a similar level of spending in fiscal 2017 ($230 million). The March of Dimes and the Bill & Melinda Gates Foundation have also made preterm birth a priority.
"It's going to take physicists, geneticists, biomedical experts from Silicon Valley, different types of engineers, social scientists and more," said Simpson, who oversees March of Dimes research programs.