In honor of Women’s Health Month, reproductive health researcher and Assistant Professor Scott Barnett from the Department of Biochemistry & Molecular Biology shares the sobering reality of the rising rate of preterm labor, a crisis that has taken a serious toll on mothers and infants in the U.S., including his own family, in this first-person narrative. But there’s hope. Barnett and his team of researchers are closing in on a breakthrough: a safe, effective drug to stop early labor – a problem that currently has no FDA-approved solution.
As a researcher in maternal and reproductive health, I’ve spent much of my career asking a deceptively simple question: Why do some pregnancies end too soon?
My connection to this issue is personal. My twin sons were born prematurely, and one spent more than a month in the neonatal intensive care unit. Watching him hooked up to monitors brought home the realities of preterm birth in a way that no textbook could. That sobering experience continues to fuel my research and advocacy for stronger support and understanding of reproductive health to protect women and their unborn children.
In recent years, my research has focused on developing safe medical solutions to stop early labor without crossing the placenta and harming the unborn child. Unlike current medications, most of which are used off-label for unrelated conditions, these new medications are being specifically developed to prevent preterm labor, with maternal and fetal safety at the core.
Preterm birth: a silent public health crisis
The national and local statistics on childbirth – something as natural and ancient as life itself – are alarming. Consider this:
- Preterm birth is the leading cause of death for children under 5 worldwide.
- Nearly 400,000 babies are born preterm each year in the U.S.
- Babies born at 22 weeks have just a 6% chance of survival.
- Â鶹ӰÊÓ 80% of infants born at or before 31 weeks face lasting medical issues, including cerebral palsy, learning disabilities, heart conditions, or mental and behavioral health challenges.
- There are no FDA-approved drugs to stop preterm labor.
"Â鶹ӰÊÓ 80% of infants born at or before 31 weeks face lasting medical issues, including cerebral palsy, disabilities, heart conditions or mental and behavioral health challenges."
For those of us in Nevada, this should hit close to home: Our state has the highest rate of preterm birth among all Western states and has been graded a D+ by the March of Dimes.
What is a preterm birth?
A full-term pregnancy lasts about 40 weeks. Births before 37 weeks are considered preterm and occur in roughly 10% of pregnancies – around 1,000 a day in the U.S. That rate has been rising in recent years.
The earlier the delivery, the greater the risk to both infant and mother. The financial toll is just as alarming – more than $30 billion a year in the U.S., with each preterm birth averaging $65,000. Better solutions are long overdue.
Yet in 2025, there are still no FDA-approved drugs to stop preterm labor. Despite the urgent need, few treatments are in development by major pharmaceutical companies. Thanks to support from the National Institutes of Health and private funders, my research team is working toward a new drug to safely stop early labor.
Why can’t we stop preterm labor?
Preterm labor is often what triggers preterm birth. Between 50% and 70% of women who go into preterm labor end up delivering early.
"The earlier the delivery, the greater the risk to both infant and mother. The financial toll is just as alarming – more than $30 billion a year in the U.S., with each preterm birth averaging $65,000."
It sounds simple: If the uterus is contracting too soon, just stop the contractions – problem solved. But the reality is far more complicated. While some factors that may lead to preterm labor are obvious, such as infections or consumption of drugs and alcohol and smoking, about half of all preterm labor has no known cause; it’s something called idiopathic or spontaneous preterm labor. That is where my ”basic science” and ”translational” researchers such as myself come into the picture. It is foolhardy to develop new drugs to treat spontaneous preterm labor without first knowing the root cause, and our job is to discover what is happening in dysfunctional cells so that we can create new approaches to treating disease.
Why “off-label” drugs fall short in treating preterm birth
Tocolytics – drugs used to stop labor – typically target the uterus muscle (myometrium), which generates the force needed for delivery.
“It is foolhardy to develop new drugs to treat spontaneous preterm labor without first knowing the root cause.”
But in today’s health care system, available tocolytics are used “off-label” because they were originally developed for conditions such as high blood pressure or asthma. At best, they delay labor for a few hours or days. They do not improve outcomes for newborns, and many pose significant risks to the fetus.
Why so it so hard to stop preterm labor?
For starters, the myometrium – the muscle surrounding the uterus – is unlike any other in the body. It must stretch dramatically during pregnancy, growing from the size of a plum to a watermelon, and stay relaxed for the 40 weeks of pregnancy. No other muscle is asked to do so much for so long.
It’s no surprise, then, that drugs designed to relax other muscles don’t work well in the uterus. Developing safer, more effective tocolytics means understanding how the myometrium truly works. That’s where my team comes in.
A solution in progress
A key insight I have discovered in my research is that combining multiple medicines might be more effective than relying on just one. I’ve tested a combination of treatments, including a compound from black licorice and an FDA-approved bladder medicine, and found they work synergistically to calm the uterus and prevent premature labor. I’ve also developed a method to link two drugs together, which could reduce their transfer to the baby, making treatment safer for both mother and child. I’m now testing these ideas on animals, with the hope of moving to human trials soon.
University researchers and Renown® hospital build one of the nation’s largest uterus tissue biobank
The Myometrial Function Group at the Â鶹ӰÊÓ, Reno, has amassed one of the country’s largest myometrial biobanks, with over 1,100 unique patient samples. This biobank is key to their groundbreaking research on preterm labor. Our researchers – myself, Iain Buxton, Heather Burkin and Craig Ulrich – are creating a “molecular map” of the uterus during preterm labor.
"Continued government support of women’s health research is critical to the development of new medicines to prevent preterm birth"
The group’s work is supported by access to human myometrial biopsies, made possible through a strong affiliation with Renown® hospital. Pregnant patients undergoing cesarean sections consent to provide tissue samples, enabling the team to examine the differences between preterm and uncomplicated pregnancy tissue. The availability of human tissue to elucidate the causes of preterm labor provide researchers at the University a unique opportunity to develop new drugs that will benefit the health of Nevadans and the world at large.
