The Saving Lives at Birth: A Grand Challenge for Development recently shortlisted 53 finalists from around the world from more than 400 entries. Only 22 teams were awarded grants for their bold, new ideas to save the lives of mothers and newborns in developing countries. The Research Institute at Nationwide Children’s Hospital was one of the four institutions in the competition to be awarded transition-to-scale grants (up to $2 million for four years) for the development of a low-cost paper-based urine test for early diagnosis of preeclampsia to reduce preeclampsia-related morbidity and mortality in resource-limited areas.
This project is a multidisciplinary team effort led by Irina Buhimschi, MD, director of the Center for Perinatal Research at The Research Institute at Nationwide Children’s and a professor of Pediatrics at The Ohio State University College of Medicine. “We developed a method of diagnosing and predicting preeclampsia that is innovative, low cost, sustainable and scalable,” says Dr. Buhimschi. The paper-based urine test enables early diagnosis by revealing altered proteins through Congo Red—a readily available dye used worldwide in textiles, wood pulp and paper.
Other collaborators include Dr. Catalin Buhimschi (chief of the division of Maternal Fetal Medicine, Department of Obstetrics and Gynecology, The Ohio State University Wexner Medical Center), Dr. Hemant Tagare and Dr. Michael Choma (Yale University School of Medicine), Dr. Robert Pattinson and Dr. Pedro Mulder (University of Pretoria, South Africa), Dr. Thomas Easterling (University of Washington, Seattle), Dr. Hillary Bracken and Dr. Beverly Winikoff (Gynuity Health Projects).
Proof-of- principle seed funding for the team’s idea was provided by the Bill and Melinda Gates Foundation Grand Challenges Explorations (GCE).
In limited-resource settings, morbidity and mortality from preeclampsia results from a delayed or lack of diagnosis of preeclampsia, a hypertensive condition unique to human pregnancy. Drawing upon the team’s basic science findings, the team developed the paper-based urine test for diagnosing and predicting preeclampsia, which has the potential to decrease maternal and fetal mortality worldwide.
The innovation is rooted in the team’s scientific discovery that preeclampsia is similar to Alzheimer's disease at the molecular level, through derangements in protein structure. The team provided novel evidence that the urine of preeclamptic women is highly enriched in these altered proteins. Using the dye Congo Red, a prototype dye for identifying Alzheimer plaques, the team could quantify the altered proteins in urine of pregnant women.
Other transition-to-scale award nominees were from Africare of Dakar, Senegal; the Epidemiological Research Center in Sexual and Reproductive Health in Guatemala City, Guatemala; and Massachusetts General Hospital in Boston. The nominees will now enter into final negotiations before awards are issued.
The Saving Lives at Birth partnership, launched in 2011, includes the U.S. Agency for International Development (USAID), the Government of Norway, the Bill& Melinda Gates Foundation, Grand Challenges Canada (funded by the Government of Canada), and the United Kingdom’s Department for International Development (DFID). The grand challenge is a global call for groundbreaking, scalable solutions to prevent infant and maternal deaths around the time of birth.