The second Childx symposium was held in April 2016. It launched a four-year rotational Life Course program that focuses on a series of transdisciplinary topics aimed at improving health for expectant mothers and infants. The program featured speakers who advanced our understanding of human development from conception to birth, and the events during pregnancy that influence lifelong health and disease. Six transdisciplinary thematic sessions span topics ranging from stem cell biology, fetal development, prematurity, and innovative technologies to the evolving microbiome, pathogens that threaten the fetus, and how to thrive in a changing world. The Childx Symposium is hosted by the Stanford Child Health Research Institute with support from the Stanford School of Medicine, Stanford Children’s Health, and Lucile Packard Foundation for Children’s Health.
Session 1: Conception and Early Development
The revolution in stem cell biology has lead to a greater understanding of the earliest events in human development revealing new insights into the unique features of each cell prior to implantation as well as how cell division is regulated at these early times. This is the time when the very earliest decisions are made that direct cells to become, either the embryo or its supporting tissues, the placenta. Our understanding of these events is now being opened up through the development of methods that allow us to observe events that were previously hidden from view as the embryo implants into the mother’s womb, a crucial time that is exactly when the body plan is being fashioned. This session focuses on these very early events and we will hear about cellular checks and balances that ensure healthy embryos and fetuses, discuss new technologies that improve in vitro fertilization, and learn about the consequences that result from failure in these early developmental steps.
Session 2: Development to Term
Human fetal development is a complex biologic phenomenon. There are numerous adverse outcomes of pregnancy, including birth defects, and preterm birth. Among all infants, 1 in 33 is born with a structural birth defect and 1 in 9 is born prematurely. Despite the tremendous medical, economic, social, and family impact of birth defects and preterm birth, causes for both remain largely unknown. To solve complex human problems such as birth defects and preterm birth, it will be imperative to integrate many different kinds of data from various levels of multidisciplinary inquiry in order to investigate causal pathways that may ultimately be targeted for preventing certain adverse outcomes of pregnancy. Speakers will highlight some of the biologic pathways being pursued to improve scientific understanding about human birth defects and prematurity.
Session 3: Literacy and Health: A Framework for Addressing Social Determinants during Early
Premature birth involves deliveries before 37 weeks gestation. Approximately 15 million babies are born preterm every year in the world. Prevalence of preterm birth in the US is approximately 11%. Annual costs in the US associated with preterm birth exceed $26 billion. Prematurity is the leading cause of under-five child mortality worldwide. Surviving preterm babies remain at increased risk for a variety of neurodevelopmental, gastrointestinal, and respiratory complications, many of which extend well beyond the neonatal period and indeed contribute to lifelong challenges for individuals and their families. Speakers will highlight some of the many complications that accompany an infant born too soon.
Session 4: Technological Advancements in Perinatal Care
Innovative tools and technologies are emerging at the interface between computer science, bioengineering, translational bioinformatics, and pediatrics that will improve maternal and newborn health and refine how we diagnose and treat pediatric disease. Here we will focus on those innovations that have the potential to reduce the incidence of preterm birth change how we care for preterm infants to avert the consequences of preterm birth, improve perinatal health by enabling early diagnosis, and help ensure healthy child development.
Session 5: Microbes and Pregnancy
From normal flora to pathogens, microbes constitute a major portion of the human ecology, and as the microbiome, are integral in maintaining maternal-infant health, controlling timing of delivery, causing disease and leading to birth defects. In this session we will focus on the mechanisms by which we think microbes may mediate these effects in mothers and infants. We will examine the correlation between the maternal, fetal, and infant microbiome, and preterm delivery. We will also discuss methods of preventing infection by microbes that affect fetal development, and hear the current understanding of Zika virus as an emerging pathogen, and its effects on the developing fetus.
Session 6: Thriving in a Changing Environment
Many interventions are available to promote healthy pregnancies and births, and to support the health and development of young children around the world. Yet an estimated 2.6 million stillbirths and an additional 2.7 million newborn deaths continue to occur each year. Health systems in low and middle income countries are poorly designed and capacitated to reach adolescents and to engage effectively with communities to ensure that science and culture are aligned in promoting healthy behaviors and social norms. Moreover, beyond survival, the need to support families in providing nurturing care for young children is increasingly recognized as critical to ensuring that children reach their human potential and societies are propelled out of poverty. This session features global leaders in maternal and child health who are addressing these issues at the frontiers of policy, research and programmatic action.