Bioservices Projects

Preventing Preterm Birth Initiative

As part of the Preventing Preterm Birth Initiative, GAPPS funds two international research sites for the investigation of preterm birth and stillbirth in low-and middle- income countries. These sites contribute to a biorepository developed to accelerate research in pregnancy health through broad access to data and specimens and use of standardized, harmonized methods to ensure quality, based on the model developed by GAPPS’ domestic biorepository. The research sites enroll women early in pregnancy and collect information and biological specimens during their pregnancy and delivery. Particular attention is given to accurate determination of gestational age and complications of pregnancy. Data and specimens are used to advance innovative research into the causes of preterm birth and identify novel strategies for prevention. The sites also serve as an established infrastructure for researchers to conduct preterm birth and pregnancy related research. GAPPS and our partnering institutions work with other researchers to implement their research projects within the cohorts.

Learn about the exciting research discoveries from the Preventing Preterm Birth initiative.


The GAPPS Repository has been selected to contribute to a novel research program called ECHO PATHWAYS, focused on the effect of environmental factors during pregnancy on childhood health outcomes. ECHO PATHWAYS is part of the larger NIH funded ECHO initiative (Environmental influences on Child Health Outcomes). ECHO is catalyzing research using existing cohorts (groups of women and children who have already participated in other research studies) to answer questions about the effects of a broad range of environmental factors – including maternal exposure to chemicals and stress – on child health and development.

The GAPPS Repository is providing specimens including urine, plasma, and placenta samples, as well as medical record abstractions and questionnaires completed by mothers throughout pregnancy. More than 1,100 Repository participants will also be recruited for follow up visits to understand the current health of their children. ECHO PATHWAYS is a collaborative effort between researchers at the University of Washington, Seattle Children’s Research Institute, University of California San Francisco, and University of Tennessee Health Science Center.


GAPPS continues our involvement in the iHMP project, the second phase of the NIH Common Fund’s Human Microbiome Project. The Multi-Omic Microbiome Study-Pregnancy Initiative (MOMS-PI) of the iHMP, is a collaborative project led by a research team at Virginia Commonwealth University working to understand the impact of the vaginal microbiome on pregnancy. The MOMs-PI project web page can be found at

By adapting the MOMs-PI collection protocols to GAPPS’ established and standardized operations (kit production, database systems, clinical workflow, specimen tracking, chain of custody and banking operations), we were able to provide the MOMs-PI team with over 30,000 high quality specimens collected from 600 pregnancies.


INTERGROWTH-21st, an Oxford University project focused on developing standards describing optimal fetal growth, preterm growth, and newborn nutritional status, has expanded its efforts to include a broader community of women.

The importance of a standard language for preterm birth was identified as a priority by stakeholders at the 2009 International Conference on Prematurity and Stillbirth convened by GAPPS. As a result, GAPPS organized an international team of investigators led by Dr. Jose Villar at the University of Oxford, United Kingdom, to establish a shared global preterm birth classification system. The group wrote three manuscripts presenting the conceptual issues behind the new classification and guidelines for the use of the unified classification system.

“Preterm birth is a complex condition with different causal factors. Without clearly defining the different subgroups and their causes it has been very difficult to identify effective preventive strategies and treatments,” said Dr. Villar, MD, senior fellow in perinatal medicine, INTERGROWTH-21st, Oxford. “In our previous studies, we attempted to consolidate all preterm birth into a single category rather than define specific subgroups. As a result, we may have abandoned some true silver bullets that were only good for some mothers but not for others; our target was too wide. We hope to reach that specificity with the new classification.”


The InterBio-21st Project ( is an extension of the INTERGROWTH-21st study that seeks to understand the causes of intrauterine growth restriction, small for gestational age and preterm birth syndromes at the clinical, biochemical and molecular levels. GAPPS has been a major supporting partner in the InterBio21st project operations. The InterBio team drew on GAPPS expertise in pregnancy cohort creation to design a comprehensive set of validated collection protocols and used GAPPS kit manufacturing facilities to provide all collection kits for the project. Ultimately, GAPPS produced and shipped 27,000 collection kits to 7 sites on 5 separate continents, resulting in over 170,000 banked samples to be used in pregnancy research.

GONet (Global Obstetrics Network)

GONet (Global Obstetrics Network) is a collaborative group of international investigators that perform clinical trials and observational studies in maternal fetal medicine and obstetrics. The group was formed to bring together those performing similar studies to exchange information and explore areas for collaboration.


PremUp The Foundation for Scientific Cooperation on Pregnancy and Prematurity (PremUp) is composed of 100 independent researchers representing 16 areas of research. Studies include the maternal environment’s influence on placental function, the physiopathology of premature delivery and cerebral and pulmonary lesions in the premature baby, predictive biomarkers and new tools for medical imaging.


PREBIC The International Preterm Birth Collaborative (PREBIC) was initiated to support and enhance international networking among researchers in preterm birth, and to establish multinational research projects on preterm birth.

The Global Pregnancy CoLaboratory

The Global Pregnancy CoLaboratory is a research and academic medical center consortium that brings together investigators to share pregnancy clinical data and biological samples for collaborative studies related to adverse pregnancy outcomes, with a special focus on preeclampsia.

Pregnancy & Birth Cohort Registry

As part of GAPPS efforts to standardize pregnancy and birth research, we are leading the effort to build a “database of databases”—a centralized global database of pregnancy and birth cohort data and sample collections that will work as a “ for researchers.”

The pregnancy and birth cohort registry will accelerate discovery by:

  • Facilitating collaboration between investigators
  • Helping philanthropic organizations better target funding efforts (For example, funders will be able to search the registry to learn how many sites around the world are studying preeclampsia and where they are located. This will help them to fund preeclampsia studies that will best complement or build on ongoing investigations.)
  • Informing future collection standards by providing a snapshot of the specimens researchers are currently collecting and how they are being collected