Along with excitement for the future, a new year brings the opportunity to reflect on highlights from the previous 12 months. As detailed in our Looking Back on NICHD Research in 2023 showcase, last year we continued to make advances in understanding human development, improving reproductive health, promoting women’s health, enhancing the lives of children and adolescents, and optimizing abilities for all.
In 2023, researchers announced results from two NICHD-supported clinical trials that promise to improve medical practice. The A-PLUS study, which enrolled more than 29,000 women in seven low- and middle-income countries, found that giving a single oral dose of the safe and inexpensive antibiotic azithromycin during labor reduced the risk of postpartum sepsis and death by one-third—from 2.4% with placebo to 1.6% with azithromycin—among women who delivered vaginally. These findings mark an important step toward reducing the global burden of maternal sepsis, a life-threatening condition caused by the body’s exaggerated response to infection. Our role in this collaborative work was recognized with a Charles A. Sanders, M.D., Partnership Award from the Foundation for the National Institutes of Health 
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In addition, a large national study found the Eat, Sleep, Console (ESC) care approach to be more effective than using the Finnegan Neonatal Abstinence Scoring Tool (FNAST) to assess and manage newborns who were exposed to opioids during pregnancy. Infants cared for with ESC were medically ready for discharge from the hospital almost a week earlier than those who received usual care with FNAST, and they were less likely to receive treatment with opioids to manage their withdrawal symptoms. These findings support use of ESC as a standard treatment approach, reducing variability in care and improving outcomes.
We also made important strides in addressing our nation’s maternal health and stillbirth crises. As part of its Implementing a Maternal health and PRegnancy Outcomes Vision for Everyone (IMPROVE) initiative, NIH established Maternal Health Research Centers of Excellence to develop and evaluate innovative approaches to reduce pregnancy-related complications and deaths and to promote maternal health equity in the United States. To lower the rate of stillbirths—traumatic events that more than 20,000 families across the nation experience each year—an NICHD-led working group developed recommendations for research and prevention efforts, which we are now starting to implement. We look forward to continuing to work with our federal colleagues, experts in fetal and maternal health, and people with lived experience of stillbirth to advance toward our shared goal of healthy pregnancies and healthy children.
Improving the health of children and adolescents is a central part of NICHD’s mission. In 2023, we made several advances in this area, including a study supported by our National Center for Medical Rehabilitation Research that may help prevent chronic traumatic encephalopathy (CTE), a serious condition that can lead to dementia and eventually death, among people who play contact sports. This study of youth, high school, and college football players found that the force of blows to the head better predicted CTE than the number of concussions, suggesting that strategies to lower the number of head impacts and the force of the hits could decrease the odds that athletes develop CTE.
Another key focus for NICHD is understanding and improving women’s health across the life course. As I highlighted in my December 2023 blog post, we are continuing to accelerate efforts to definitively diagnose, prevent, and treat endometriosis, a disease that affects an estimated 10% of women in the United States and is a major cause of pain and infertility. We also are making advances in understanding uterine fibroids, the most common non-cancerous tumors in women of childbearing age. A recent study by NICHD investigators suggests that exposure to chemicals used in grease- and water-resistant coatings for food packaging and other consumer products may influence the growth of existing fibroids during pregnancy. This year, I look forward to working with colleagues across the federal government to further advance research on women’s health needs under the auspices of the White House Initiative on Women’s Health Research.
Finally, basic science research helps to enhance understanding of living systems and life processes and lays the foundation for future advances toward improving our health. It remains a critical part of NICHD’s portfolio. Last year, NICHD researchers and their colleagues developed a zebrafish model that provides new insight into how the brain acquires essential omega-3 fatty acids. The findings may improve understanding of lipid transport across the blood-brain barrier and aid design of drug molecules that are capable of directly reaching the brain.
These are only a few examples of the broadly impactful work that NICHD researchers, staff, and grantees accomplished last year. Please take a moment to read Looking Back on NICHD Research in 2023, a selection of highlights that also includes progress toward developing a non-hormonal contraceptive for men, reducing disparities for children with intellectual and developmental disabilities, and improving care for pediatric injury and illness, among other topics. Our quarterly Research Highlights from the Division of Intramural Research showcase summarizes additional scientific advances from researchers at NICHD. I look forward to another productive and informative year in 2024!
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