Saturday, October 30, 2021

Healthy Habits: Diagnosing and Treating Preterm Birth

A study published last week in Nature Communications highlights how March of Dimes’ Prematurity Research Center at Imperial College London has developed a first-of-its-kind testing device that can help advance diagnosis and treatment of preterm birth.

The testing device was a part of a study that analyzed more than 1,000 samples collected from approximately 400 women throughout their pregnancy. The results show the device has the ability to rapidly and accurately detect changes in vaginal bacteria and a corresponding immune response, and was found to be just as effective, faster, and more cost-effective at detecting preterm birth risk compared to other “gold standard” chemical profiling tests.

I had a chance to interview Stacey D. Stewart, President and CEO of March of Dimes and Dr. David McIntyre to learn more.

Why did March of Dimes conduct this research? (Stacey D. Stewart, CEO + President of March of Dimes)

As the leader in maternal and infant health, March of Dimes is dedicated to advancing knowledge and solutions for preterm birth.  Sadly, preterm birth remains a major cause of death worldwide in children under age five and here in the United States 1 in 10 babies are born too sick and too soon. Women of color are up to 50 percent more likely to have a preterm birth and their children face a 130 percent higher infant death rate.  This innovative test is groundbreaking for March of Dimes because it showcases how our Prematurity Research Centers, like Imperial College, London are working to reduce preterm birth and to give every baby a fair chance for a healthy full-term birth.  We hope this will soon be widely available to help empower pregnant women with information to navigate their pregnancies and improve birth outcomes.


What implications does this have for pregnant women? (Dr. David A. MacIntyre, Reader in Reproductive Systems Medicine, Institute of Reproductive and Developmental Biology Department of Metabolism, Digestion and Reproduction at Imperial College London)

While we are still in the research stage, a number of studies have shown that the collection of microbes in the reproductive during pregnancy, called the “microbiome”, can influence the risk of a women delivering preterm. These studies have also highlighted the fact that not all women have the same immune response to bacteria and microbes in the reproductive tract. For the first time, our testing device provides a way to rapidly diagnose both the type of microbes present in the reproductive tract and whether or not they are causing inflammation. This offers a way forward in the future for rapid screening of women during pregnancy, which could help identify those women at risk. While the testing device is only available for research use currently, we hope to make it widely available over the next couple of years. 

Are there certain risk factors that women need to be aware of in terms of bacteria and pregnancy?

Reproductive tract infection during pregnancy is a risk factor for preterm birth. We often think of these infections as being caused by a specific type of bacteria or pathogen, which causes inflammation and can lead to early onset of labor. However, our studies and those of others, have shown that an imbalance in the normal, healthy bacteria that live in the vagina during pregnancy can also cause inflammation leading to an increased risk of preterm birth. Therefore our advice is that women should do whatever they can to maintain their normal, healthy bacteria. This includes avoiding vaginal douching and only taking antibiotics in pregnancy when they are really needed. 

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