Jan 24, 2021

OPERA – Optimal Pregnancy Environment Risk Assessment


An international group of researchers, care providers, foundations and agencies dedicated to women at risk for preterm birth.

OPERA is an international, interdisciplinary program of women’s health researchers, care providers, foundations and international agencies dedicated to discovering and disseminating inexpensive and accessible tools to diagnose those women at risk for preterm birth (PTB) or other adverse pregnancy outcome as early as possible in pregnancy and to promoting effective interventions to mitigate these risks. OPERA’s initial efforts focus on risk diagnosis in populations of vulnerable women in any jurisdiction. OPERA receives support from WUN and the March of Dimes (MOD) and is recognized by the World Health Organization (WHO).

OPERA is building a sustainable international organization that will provide guidance and support for studies of cohorts of pregnant women in order to develop evidence to 1) determine how to assess risk for preterm birth and other adverse pregnancy outcomes simply, inexpensively and as early as possible in pregnancy, 2) identify the women in the highest (20%) at-risk group (with 80% precision), and 3) share this information with other studies, care-providers and interested parties. OPERA is not a funding organization but instead provides support in terms of special skills, study design, data evaluation and sharing, guidance, advocacy, informs about best practices and communicates discoveries and achievements to partners and target audiences.



Three new Co-Directors have been appointed:

  • Dr Gerlinde Metz, PhD, Department of Neurosciences, University of Lethbridge, Lethbridge, Alberta, Canada.
  • Dr Richard Saffery, PhD, Murdoch Children’s Hospital Research Institute, University of Melbourne, Melbourne, Australia.
  • Dr Craig Pennell, MBBS, PhD, Department of Obstetrics & Gynaecology, University of Newcastle, Newcastle, Australia.

Publications: 11 in total; three most significant:

  • Olson DM, et al. (2019) Recent Canadian efforts to develop population-level pregnancy intervention studies to mitigate the effects of natural disasters and other tragedies. J Developmental Origins of Health and Disease, Jan 10:1-7. PMID: 30626455.
  • Ettinger A, et al. (2019) Contemporary environmental stressors and adverse pregnancy outcomes. In, Handbook of Prenatal and Perinatal Psychology: Integrating Research and Practice. (K. Evertz, L. Janus, R. Linder, eds.) Springer.
  • Linder R, et al. (2019) Early care networks in Germany and initiation of the Pforzheim Studie. In, Handbook of Prenatal and Perinatal Psychology: Integrating Research and Practice .  (K. Evertz, L. Janus, R. Linder, eds.) Springer.

External Funding:

  • Canadian Institute of Health Research Planning and Dissemination Grant. Applying Lessons Learned from Research on the Health Effects of the 2016 Alberta Wildfire: A Strategy for Knowledge Exchange and Research Dissemination. 2019. Principal Investigator: Professor Stephanie Montesanti, U Alberta, David Olson, U Alberta.
  • Alberta Innovates Summer Studentship. Testing the Leukocyte Migration Assay in Chongqing, China. 2019. Summer Student: Jenelle Chen, University of Alberta, David Olson, University of Alberta.
  • Canadian Institutes of Health Research. “Prevention of preterm birth (PTB) and fetal inflammation (FI): the pharmacology and toxicology of targeting interleukin (IL)6 with HSJ633, a small peptide allosteric IL6 receptor antagonist.” 2019-2024. David Olson, University of Alberta.

Scholarly events: 10 in total; three most significant:

  • “OPERA and Indigenous Health: What is OPERA and why does it want to be involved in Indigenous people” Invited symposium presentation to the DOHaD 2019 Satellite, “Social Determinants and the Health of Indigenous Peoples.” Darwin, Australia. October 18.
  • “Lessons learned from the MommyBabyFMM study.” Presentation at the CIHR-sponsored public forum, Knowledge Exchange Forum: sharing lessons from research on Alberta wildfire 2016. Fort McMurray, Alberta. Nov 9.
  • “Adverse pregnancy and newborn outcomes and risk related to maternal stress.” Hindustan College of Science and Technology, Murthra, Uttar Pradesh, India, February 23.

Policy inputs and impact: 3

  1. Recommendations of how to deal with pregnant women after a climate crisis event such as a natural disaster and also recommendations how to build resilience in communities before and after these events to improve pregnancy outcomes.
  2. Changing the ways obstetricians ask their pregnant patients about previous abusive events in their lives. These were shown to be associated with a higher risk for preterm birth.
  3. The commercialization of new diagnostics / therapeutics with the merger of two companies to create Maternica Therapeutics, Inc., the world’s first company with both a diagnostic and a therapeutic for preterm birth.

Other outputs:

Two students from the University of Alberta, Han Lee and Jenelle Chen, worked up to 8 months in our collaborative laboratory at Chongqing Medical University to test our preterm birth diagnostic in a population different from Canada.


OPERA welcomed new WUN+ Partners – Bea van den Berge from Government of Flanders, Ashley Aimone from University of Toronto/ Moi University, Kenya  and representatives from City of Pforzheim, Germany: Rupert Linder, Thomas Berner, Brigitte Joggerst.

Publications: 7 in total; three most significant:

  • Nesari M, Olson JK, Vandermeer B, Olson DM. Does a maternal history of abuse before pregnancy affect pregnancy outcomes? A systematic review with meta-analysis. BMC Pregnancy Childbirth. 2018 Oct 16;18(1):404. doi: 10.1186/s12884-018-2030-8, 2018.
  • Olson DM, Breamault-Phillips S, King S, Metz GAS, Montesanti S, Olson JK, et al. Recent Canadian efforts to develop population-level pregnancy intervention studies to mitigate effects of natural disasters and other tragedies. J DOHaD, 2019 10:1-7.
  • Brémault-Phillips, S., Pike, A., Olson, J. K., Olson, D. M. Expressive Writing as a Spiritual Practice to Promote Resilience and Post-Traumatic Growth

Policy Inputs:3

  • Dr Olson received support for Die Pforzheim Study from the City of Pforzheim to establish a longitudinal birth cohort of women and children from the city.
  • Dr Olson received an invitation from the University of Ghana to work in developing a longitudinal birth cohort.
  • Dr Olson is collaborating with three Strategic Clinical Networks (Maternal-child, metabolic disease, and mental health) of Alberta Health Services to coordinate observations/discoveries from the CIHR Wildfire grant.

Scholarly events: 3

  • China OPERA Update, Chongqing Medical University, 17-18 September 2018. 32 national and international speakers attend and presented oral reviews and updates of latest work relative to OPERA and healthy pregnancy outcomes.
  • OPERA Europe meeting, Pforzheim, Germany, 11-12 December 2018. 24 academics presented and another 24 participants from Europe, Australia and North America attended.
  • Dr Olson was invited to participate in a lecture tour of agricultural and technical universities in northern India in February (Hiryana and Uttar Pradesh states) along with climate change and agronomy experts.

Other outputs:

Han Lee MSc received a Mobility award to Chongqing Medical University for 3 months. The research was highly successful and enabled the cross referencing of data between pregnant women in China and Canada.


OPERA members are involved in a CIHR-funded study to develop a predictive tool for risk and an intervention to improve resilience, decrease stress and thereby improve pregnancy outcomes for the pregnant and pre-conception women evacuated from Fort McMurray due to the 2016 wildfire. Partners include The Canadian Institute of Health Research and the Autonomous National University of Mexico (UNAM)

Publications: 6 (not listed)

Scholarly events:

  • Dr Olson met with Professor Felipe Vadillo-Ortega in Mexico City at UNAM to discuss OPERA regional meeting.
  • Dr Olson met in Edmonton with Wildfire team members and members of communities to develop study plans.

External Funding:

Canadian Institutes of Health Research, Wildfire Grant, “Intervention to improve the perinatal outcomes following the 2016 Alberta wildfires: administration, effectiveness and community implementation.” 2017-19, Professor David Olson, University of Alberta


A China Opera Workshop was held in Chongqing on 12 November 2016. Eight Chinese universities, five foreign universities and 75 people attended.


The OPERA group held its first meeting on March 23-24, 2015 in San Francisco. The purpose of this meeting was to:

  • discuss and generate enthusiasm to achieve the goals of OPERA, to appreciate why early assessment of risk is important;
  • identify what is meant by populations of vulnerable women and to listen to some of their stories;
  • hear about mechanisms of risk and what we can learn from them regarding development of risk assessment tools;
  • learn more about the studies in progress and how they are assessing risk for preterm birth and other adverse pregnancy outcomes;
  • identify a few intervention strategies that may mitigate risks;
  • discuss how to move the OPERA agenda forward toward a sustainable program that provides genuine benefit for women, their babies and care providers.

Selected outcomes

For the latest updates and events please visit www.operamtg.org