Hypertensive disorders of pregnancy, or HDP, are responsible for nearly 50,000 deaths every year. They are the most common medical disorders that occur during pregnancies, and are the leading cause of maternal and perinatal mortality today.
Reducing the risks of these disorders is a challenging global health issue — but thanks to the innovative work of one scientist, we’re closer to safer pregnancies for all. For his work on evidence-based, low-cost global interventions in maternal and child health, doctor and obstetrician José Belizán was named a John Dirks Canada Gairdner Global Health Award laureate.
A global health issue
“I used to see a lot of women very worried about developing pregnancy hypertension,” says Belizán, principal investigator in the Department of Research in Maternal and Child Health, Institute for Clinical Effectiveness in Argentina.
“[T]hat is a very severe disease that involves around 50,000 women […] and half a million children dying every year around the world.”
Belizán, who is also an associate professor at Tulane University and the University of North Carolina at Chapel Hill, focuses his research on improving care for children and pregnant people during the perinatal period. Spanning the year before a child’s birth to approximately two years following birth, this period is associated with a number of health-related risks for both the child and the parent.
Calcium intake during pregnancy
One of Belizán’s most innovative and impactful discoveries has to do with the importance of calcium intake during the perinatal period. After noticing that Guatemalan Mayan women tend to have low rates of HDP, Belizán set out to investigate whether their traditional cooking methods could help lower the rates of HDP in other populations.
“I was surprised that the […] Mayan Indigenous population have a very low incidence of this serious complication of pregnancy,” Belizán explains.
“So I started to think, ‘What’s going on here?’ And then seeing the diet of the women, all the components of the nutrients are very low […] but surprisingly, they have a very high consumption of calcium.”
Along with his collaborators, Belizán undertook a long series of research projects which eventually allowed him to uncover a link between calcium intake and blood pressure. He found that women receiving calcium supplements had lower incidences of preeclampsia, which is a serious hypertensive disorder of pregnancy.
This is a profound discovery, as an estimated three billion people lack access to sufficient calcium intake worldwide.
“In our dream […] every woman before and during pregnancy could have a good calcium intake, and could be mediated by pills,” Belizán says.
To help achieve this goal, Belizán and his collaborators are developing calcium-fortified wheat, flour, and water. Belizán’s work has also led to policy changes at the international level, introducing more effective and equitable global health practices.
Improving wellbeing and care during pregnancy
This is just one example of how Belizán’s work has impacted pregnant people and children across the globe. Belizán has also carried out extensive research into Caesarean sections, and was the first to document and implement interventions addressing the unnecessary increased use of Caesarean sections during birth. In low- and middle-income countries especially, where access to comprehensive obstetric care can be limited, unnecessary Caesarean sections can have long-lasting health risks.
Belizán’s research has also helped to decrease unnecessary routine episiotomies — a procedure to widen the vaginal opening for childbirth. Once a routine practice during childbirth that could come with various health risks, Belizán’s research helped demonstrate why routine episiotomies are not necessary in all cases.
Belizán has greatly improved the health outcomes of parents and children during the perinatal period, and continues to advocate for representation from low- and middle-income countries in global health research. At both the community and international level, he has had a profound impact on healthcare during pregnancy.
“The Gairdner Award signified for us the validation of what we have done, and also to continue what we are doing,” Belizán says.
“[W]e feel really very pleased about that, to be recognized by […] such a prestigious committee. It really was for us an amazing surprise — unbelievable.”
