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

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

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