The Spring 2023 issue of Dædalus takes a transdisciplinary approach to understanding the dilemmas facing humanitarian health actors, and to finding room for innovation in humanitarian health delivery. Recognizing that shared compassion cannot be proscribed but must be felt, the issue also draws on the power of the arts, and features paintings, poetry, photography, fiction, and creative nonfiction by artists whose lives have been shaped by violent conflict and displacement.
Preterm birth (PTB) is the leading cause of death in children under five, yet comprehensive studies are hindered by its multiple complex etiologies. Epidemiological associations between PTB and maternal characteristics have been previously described. This work used multiomic profiling and multivariate modeling to investigate the biological signatures of these characteristics. Maternal covariates were collected during pregnancy from 13,841 pregnant women across five sites. Plasma samples from 231 participants were analyzed to generate proteomic, metabolomic, and lipidomic datasets. Machine learning models showed robust performance for the prediction of PTB (AUROC = 0.70), time-to-delivery (r = 0.65), maternal age (r = 0.59), gravidity (r = 0.56), and BMI (r = 0.81). Time-to-delivery biological correlates included fetal-associated proteins (e.g., ALPP, AFP, and PGF) and immune proteins (e.g., PD-L1, CCL28, and LIFR). Maternal age negatively correlated with collagen COL9A1, gravidity with endothelial NOS and inflammatory chemokine CXCL13, and BMI with leptin and structural protein FABP4. These results provide an integrated view of epidemiological factors associated with PTB and identify biological signatures of clinical covariates affecting this disease.
The disruptive power of the pandemic has rippled across the social determinants of child health. Just several months after the first cases were detected in the United States, the unemployment rate reached levels not seen since the depths of the Great Depression, with the majority of lost jobs concentrated in low-wage industries. Two-thirds of child care centers closed by April 2020, one-third remaining closed by April 2021. Recent reports estimate that more than one-third of households with children were experiencing either housing hardships or inadequate food, privations that fell disproportionately on racial and ethnic minority families. School closures have been widespread with wildly uneven capacities to respond by district. This has resulted in disparities potentially affecting children’s long-term learning and patterns of mortality over the life course.