Finding a cure to polio and reducing preterm births may seem like very different goals, but what they represent is an evolution. As the March of Dimes observes National Birth Defects Prevention Month in January, one of its top officials described how the work of yesterday informs the mission it pursues today.

“Not only was polio causing death, it was causing long-term disability,” said Dr. Rahul Gupta, March of Dimes’ chief medical and health officer. “If you look today, preterm birth is the same type of situation. If children are born preterm, there are long-term impacts—not only immediate death, but long-term cognitive, behavioral, and developmental effects. It’s very similar.”

The organization began in 1938 as the National Foundation for Infantile Paralysis, and its goal was to cure polio. The NFIP became known colloquially as March of Dimes after a famous fundraising appeal for polio research in which millions of donors sent dimes to President Franklin Roosevelt, who suffered from the disease. In the late 1950s, after Dr. Jonas Salk developed a vaccine for polio, the organization shifted its mission focus to preventing birth defects.

“With polio, there is one virus, and we developed one vaccine. There were simple solutions,” Gupta said. “Today, we have complex problems, and they require complex solutions.”

Eradicating birth defects is a complex problem because it has multiple causes, including preterm births. March of Dimes had hoped to reduce preterm births significantly by 2020, but in each of the last four years, the numbers have gone up. That trend, Gupta said, can be linked to several factors—decreasing healthcare access, increasing maternal age, and increasing obesity, diabetes, and high blood pressure—that cannot be cured in a laboratory.

“We are not going to have a vaccine for infant and maternal health. Those solutions lie within understanding the conditions under which people live,” Gupta said. “You cannot expect a healthy baby without a healthy mom. Access to healthcare, transportation, homelessness, poverty-driven factors all contribute. We are dealing with a problem that is not in one dimension. We believe that policy intervention and public health intervention will help reduce preterm birth and improve maternal health.”

And while the organization understands that the complete solution isn’t in a lab, it knows some answers are there. It has founded six prematurity research centers to study the causes of preterm birth.

During National Birth Defects Prevention month, March of Dimes focuses on educating women about how to have healthy pregnancies, including getting pre-pregnancy checkups and taking folic acid. But the work continues year round. In one program, the organization groups women together for prenatal classes, an approach that Gupta noted improved women’s knowledge, self-care, and self-advocacy.

“It’s those kind of programs, mixed with policy and discovery [in research labs], that are going to be able to address a complex problem,” he said.

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