Navigation Links
'Science' features PRB, WSU, DMC advances in preterm birth
Date:8/15/2014

DETROIT The Aug. 15 edition of the prestigious journal Science features a major article about the most important problem in obstetrics: preterm labor. The article, "Preterm labor: one syndrome, many causes," delivers a powerful message: preterm birth is not one condition, but many, and provides a framework for meeting this challenge.

"There are 15 million preterm babies born annually, and the condition affects 5 percent to 15 percent of all pregnancies, with the highest rates in North America and Africa. Prematurity is the leading cause of infant death up to age 1and the second-leading cause of childhood death before the age of 5," said Roberto Romero, M.D., D.Med.Sci., chief of the Perinatology Research Branch of the Eunice Kennedy Shriver National Institute of Child Health and Human Development located at Wayne State University and the Detroit Medical Center. "We have made progress by identifying the causes of premature labor, and now we propose that it is possible to reframe the problem and make it tractable."

A common belief is that preterm labor is merely labor that starts too soon. This perception derives from the fact that labor, whether term or preterm, has the same features increased uterine contractility, opening of the cervix and rupture of the membranes. "However," Dr. Romero said, "the fundamental difference is that normal labor at term occurs when the uterus and placenta cannot continue to support the growth of the fetus within the womb. In contrast, preterm labor results from several disease states."

Dr. Romero considers premature labor a syndrome a collection of syndromes and signs caused by multiple disease processes. A typical example of these disease processes is a "silent" intra-amniotic infection. Bacteria normally present in the vagina sometimes ascend into the amniotic cavity, triggering inflammation that in turn initiates premature labor.

From an evolutionary perspective, Dr. Romero explained, the onset of premature labor in the context of infection can be considered to have survival value, because it allows the mother to expel infected tissue (the membranes and fluid) and maintain reproductive fitness for a future pregnancy. This unique mechanism of maternal host defense comes at a price: prematurity.

Physicians and scientists at the PRB are now asking why some women develop a "silent" infection that can cause preterm labor and rupture of membranes, and some do not.

Other patients do not have infection, but have other disease states. For example, some women present with vaginal bleeding and uterine contractions, and they have inadequate blood supply to the placenta. Studies at the PRB, WSU and DMC show that some patients with premature labor have very narrow spiral arteries, which fail to expand and do not provide sufficient blood supply to the placenta. Researchers are investigating biomarkers in maternal blood that can identify these patients.

Another fascinating discovery is that maternal anti-fetal rejection can explain some cases of premature labor. The fetus and placenta express both maternal and paternal antigens, and are therefore allografts (or transplants). The placenta has been considered the most successful transplant in nature. However, sometimes the mother rejects the paternal antigens expressed in the placenta, and this causes preterm labor. New research taking place at WSU, DMC and the PRB is focused on the identification of biomarkers responsible for maternal anti-fetal rejection.

Premature labor can also begin by a decline in progesterone action. Progesterone is essential for the maintenance of pregnancy and keeps the cervix closed until the onset of labor at term. A decline in progesterone action leads to a short cervix, which predisposes to premature labor. The administration of vaginal progesterone to patients with a short cervix can reduce the rate of preterm birth by 45 percent, as well as the rate of respiratory distress syndrome, the most common complication in premature babies. A policy of universal cervical screening is being implemented in Detroit, coupled with the administration of vaginal progesterone.

"Progress in the prevention of premature labor will require deciphering the mechanisms of disease, the identification of specific biomarkers and implementation of therapeutic interventions," Dr. Romero said. "The PRB, Wayne State University and the Detroit Medical Center have created a unique partnership to study the biome of pregnancy and how it is altered in premature labor. This promising initiative will support a new knowledge-based economy in Detroit."

Dr. Romero recognized the exceptional vision of WSU President M. Roy Wilson, the University's Board of Governors, WSU School of Medicine Dean Valerie M. Parisi, M.D., M.P.H., M.B.A.; the leadership of the DMC; and the city of Detroit for "making possible many of the discoveries described on the pages of Science, for much of this work has taken place in Detroit."


'/>"/>

Contact: Julie O'Connor
julie.oconnor@wayne.edu
313-577-8845
Wayne State University - Office of the Vice President for Research
Source:Eurekalert

Related medicine news :

1. NuMale Medical Center Brings to Albuquerque Its Comprehensive, Science-Based Approach to Men’s Health
2. NIH awards $20 million grant to Oak Crest Institute of Science
3. Lauren Sciences LLC research team at Ben-Gurion University awarded grant from The ALS Association to develop V-Smart™ Therapeutic for ALS
4. Drexel College of Medicine’s Graduate School of Biomedical Sciences & Professional Studies to Host Conference to Help Graduate Students Find Careers Beyond the Bench
5. Global and Chinese Veterinary Vaccine Industry 2009-2019 Market Research Report Now Available at LifeScienceIndustryResearch.com
6. Diet Doc’s Medical Weight Loss Programs Announces Diet Plans That Incorporate Medical Science with Modern Technology to Generate Fast Weight Loss in Hard to Reach Areas
7. AxoGen, Inc. to Present at the Wedbush 2014 Life Sciences Management Access Conference
8. US Pharmaceutical Packaging Products Worth $22.1 Billion by 2018 Says a New Research Report at LifeScienceIndustryResearch.com
9. NSU’s Graduate School of Computer and Information Sciences to Host ITPalooza
10. Register to Join the Merrill DataSite's Webinar - Built to Sell: The Life Sciences Deal Climate
11. BioTechniques: The International Journal of Life Science Methods Announces the Publication of the July 2014 Issue—Available in Print and Online as an Open Access Journal
Post Your Comments:
*Name:
*Comment:
*Email:
(Date:4/25/2017)... , ... April 25, 2017 , ... A stressful work ... work can also decrease overall productivity and performance in the workplace. The goal of ... During the last few weeks of April, Clearview Resolution Services will be shutting down ...
(Date:4/25/2017)... ... April 25, 2017 , ... Patients who would like to ... a fraction of the time as traditional braces – Wilckodontics®. Dr. Victoria Chen, ... offers this revolutionary treatment with or without a referral. , Wilckodontics is ...
(Date:4/25/2017)... ... 25, 2017 , ... Saad B. Chaudhary, MD is committed to providing the highest quality of ... I focus on preventative care with all my patients to alleviate possible future issues. I ... free to contact my office and my trained staff will assist you in any way ...
(Date:4/25/2017)... ... April 25, 2017 , ... Amendia, ... continuation of its strategic partnership with and platinum sponsorship of Global Spine Outreach ... safe and effective management of complex spine deformity cases, particularly in children. , ...
(Date:4/24/2017)... ... April 24, 2017 , ... Ridgecrest Herbals makes it a point ... strategies to reduce waste, and support renewable energy. They believe this is a crucial ... to find solutions for health issues, and maintain that destroying the environment in the ...
Breaking Medicine News(10 mins):
(Date:4/20/2017)... , April 20, 2017  CVS Pharmacy, the ... unveiled a new store design to enhance the ... healthier food, health-focused products and expanded beauty selections ... help customers discover new offerings. Together with its ... evolution of the customer experience at CVS Pharmacy.  ...
(Date:4/20/2017)... 2017  AbbVie (NYSE: ABBV), a global biopharmaceutical ... chronic hepatitis C virus (HCV) infected patients with ... compensated cirrhosis (Child-Pugh A) achieved sustained virologic response ... its investigational, pan-genotypic regimen of glecaprevir/pibrentasvir (G/P). These ... 12 weeks of G/P treatment without ribavirin. Patients ...
(Date:4/20/2017)... PARIS , April 20, 2017 ... EyeCET platform, the first non-viral gene expression technology that ... in the eye to address a wide range of ... UK Medicines and Healthcare products Regulatory Agency (MHRA) to ... ...
Breaking Medicine Technology: