Preterm birth is the leading cause of death in children under five worldwide. It affects one in ten pregnancies. And until now, there has been no reliable diagnostic test and no effective treatment. The incidence is not declining; it is rising. For decades, the field has been stuck.
Driven by a lifelong fascination with how the body adapts under the most extreme conditions, Dr. Brice Gaudilliere has devoted his career to solving one of medicine’s most stubborn problems. Along the way, he came to recognize that pregnancy is among the most extreme environments the human body encounters.
The Immunology of Pregnancy
Pregnancy is one of biology’s most remarkable paradoxes. Half the genes in a developing fetus come from the father. That makes the fetus, in immunological terms, a foreign body. Yet a healthy pregnancy requires the mother’s immune system to tolerate this disruption for nine months. It is an exquisitely delicate balance, an immunological dance. When that balance is disrupted — for reasons science is only beginning to understand — the result can be labor that begins too soon.
In 2017, Dr. Gaudilliere’s team made a landmark discovery: an “immune clock” governs how the maternal immune system adapts, week by week, in pregnancy. Deviations from this clock can signal that something is wrong — potentially weeks or months before a mother shows any symptoms.
This study uncovered an extraordinary truth: the immune system was always tracking pregnancy—we just hadn’t learned to read it yet. We now know the immune system holds a key to predicting preterm birth.
The Digital Twin: A New Kind of Medicine
Since that landmark discovery, Dr. Gaudilliere’s lab has built a first-of-its-kind platform to map the maternal immune system—one cell at a time. His team can now construct a virtual model, called a “digital twin,” of an individual mother’s immune system from a small sample of her blood, mapping billions of data points across millions of cells. That model can then simulate how different drugs might affect her, before a single treatment is administered.
The concept has its roots in engineering — the same modeling used to test a spacecraft before launch. In pregnancy, it represents a fundamental shift. Instead of testing one drug at a time in years-long clinical trials, researchers can now screen hundreds of potential therapies virtually, identify the most promising candidates, and recruit only the patients most likely to respond. A trial that would have enrolled thousands of participants in the past can now be conducted in hundreds of patients, decreasing the timeline for promising therapies from a decade to two or three years. This kind of “smart” clinical trial has never been done before in any area of medicine.
A Breakthrough Already in Motion
The digital twin platform has already yielded a startling discovery: a combination of aspirin and Prevacid—two safe, widely available drugs—shows powerful potential to prevent preterm birth by regulating the maternal immune system in precisely the right way. Neither has ever been used for this purpose.
The Gaudilliere Lab is preparing to launch a multi-site clinical trial later this year, representing the first new treatment trial to prevent preterm birth in 30 years. If effective, the implications are massive: a safe, affordable intervention that could protect millions of mothers and babies worldwide.
Join us in supporting once-in-a-generation opportunities to transform child and maternal health. Make a gift to the Big Science Innovation Fund.
Help End Preterm Birth
The Path Forward
Dr. Gaudilliere’s vision is a future where dangerous pregnancy complications are predicted and prevented before they begin. Philanthropy has been essential to getting to this stage; it funded the early, high-risk research on the immune clock that changed how we think about the maternal immune system and made the digital twin platform possible. The next chapter requires the same bold investment.
Launching the First Clinical Trial in 30 Years to Treat Preterm Birth
The aspirin + Prevacid clinical trial represents a once-in-a-generation opportunity to prove that preterm birth can be prevented. Philanthropic support will help launch, scale, and accelerate this work, and ensure that a successful result reaches mothers everywhere.
Expanding the Digital Twin Platform
The digital twin is a platform, not a single solution. With investment, Dr. Gaudilliere’s lab can use it to identify the next generation of therapies for preterm birth and other pregnancy complications. Research that once took decades of trial and error can now be accomplished in years.
Deepening the Science of the Maternal Immune System
A fuller understanding of what drives individual deviations in the immune clock will open the door to new therapeutic targets. This foundational work requires the flexible funding that only philanthropy can provide.
Jennifer Stameson, Phó chủ tịch, Quà tặng lớn
Support Research Like This!
