FOR IMMEDIATE RELEASE: October 26, 2005
Contact: Sharon Boston, sboston@umm.edu
Ellen Beth Levitt, eblevitt@umm.edu 410-328-8919

UNIVERSITY OF MARYLAND RESEARCHERS RECEIVE $2.8 MILLION TO INVESTIGATE CAUSES OF PRETERM BIRTH

Five-year, Multi-Center Project Will Enroll 500 Women

Researchers from the University of Maryland Department of Obstetrics, Gynecology and Reproductive Sciences will soon begin analyzing biological samples, including genetic material, from pregnant women who are at risk for recurrent preterm birth. The goal is to find clues into the causes of this devastating problem, which affects 12 percent of pregnancies in the United States.

The scientists are using a $2.8 million dollar grant from the Centers for Disease Control to investigate possible causes of preterm birth and the effects of a specific hormone, progesterone, which has been reported to reduce the risks of recurrent preterm birth. They will also study whether women of various ethnic backgrounds respond differently to the treatment and then seek a genetic explanation. During the five-year project, researchers will enroll 500 women who have already had a preterm birth, which is the single biggest risk factor for having another child prematurely.

“The number of preterm births in the United States is increasing, and we do not understand the causes,” says Carl Weiner, M.D., the principal investigator and a professor of obstetrics, gynecology and reproductive sciences at the University of Maryland School of Medicine.

“There are no drugs that effectively stop preterm birth. At best, we can delay delivery by up to 72 hours. Through our research, we hope to find genetic factors that put women at risk for preterm birth, and with that information, develop interventions to prevent it,” adds Dr. Weiner who is also a maternal/fetal medicine specialist in the Center for Advanced Fetal Care at the University of Maryland Medical Center.

The new research builds on the team’s previous studies that identified five proteins in amniotic fluid that detect two known causes of preterm birth: inflammation and decidual hemorrhage, which is bleeding in the lining of the uterus. The researchers hope to find other protein biomarkers that will lead them to genes that may be involved in preterm birth.

“The available evidence suggests a strong genetic component to preterm birth,” says Dr. Weiner. “For example, we know that women who have mothers or sisters who delivered prematurely are more likely to have a preterm birth. Another fascinating aspect to preterm birth is that there’s a recurrence risk at all; because if there’s a problem with a particular pregnancy, say infection or decidual hemorrhage, the problem should be gone once the patient delivers. The recurrence rate for women who have had a preterm birth demonstrates there is something different about either how they fight infection or how the baby implants into the lining of the uterus.”

The researchers will also look at whether a hormone treatment with progesterone produces a different response in women of different ethnic backgrounds. Progesterone, which has shown some promise in previous studies, is given early in the second trimester of pregnancy by weekly injection.

Dr. Weiner says, “This research is a major undertaking involving thousands of biologic samples. Our goal is to discover new biomarkers that will lead us to the genes underlying preterm birth. With that knowledge, we can begin for the first time to develop targeted interventions that prevent it. We would not need a drug to stop preterm birth, because it would not occur.”

Most doctors describe a birth as preterm if it occurs before 37 weeks gestation; a full term pregnancy lasts about 40 weeks. With modern technology, babies born as early as 24 weeks can survive, but they may face serious health problems including long term disability and death.

In addition to the researchers at the University of Maryland School of Medicine, the multidisciplinary team also includes experts at the University of Maryland School of Pharmacy, Yale University and the University of Tennessee.

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