Recent Advances in Genomic Studies of Gestational Duration and Preterm Birth
Preterm birth (PTB) is the leading cause of infant mortality and morbidity. For several decades, extensive epidemiologic and genetic studies have highlighted the significant contribution of maternal and offspring genetic factors to PTB. This review discusses the challenges inherent in conventional genomic analyses of PTB and underscores the importance of adopting nonconventional approaches, such as analyzing the mother –child pair as a single analytical unit, to disentangle the intertwined maternal and fetal genetic influences. We elaborate on studies investigating PTB phenotypes through 3 levels of genetic analyses: sin...
Source: Clinics in Perinatology - April 3, 2024 Category: Perinatology & Neonatology Authors: Amit K. Srivastava, Nagendra Monangi, Vidhya Ravichandran, Pol Sol é-Navais, Bo Jacobsson, Louis J. Muglia, Ge Zhang Source Type: research
Estimating Gestational Age and Prediction of Preterm Birth Using Metabolomics Biomarkers
Preterm birth (PTB) is a leading cause of morbidity and mortality in children aged under 5 years globally, especially in low-resource settings. It remains a challenge in many low-income and middle-income countries to accurately measure the true burden of PTB due to limited availability of accurate measures of gestational age (GA), first trimester ultrasound dating being the gold standar d. Metabolomics biomarkers are a promising area of research that could provide tools for both early identification of high-risk pregnancies and for the estimation of GA and preterm status of newborns postnatally. (Source: Clinics in Perinatology)
Source: Clinics in Perinatology - April 3, 2024 Category: Perinatology & Neonatology Authors: Victoria Ward, Steven Hawken, Pranesh Chakraborty, Gary L. Darmstadt, Kumanan Wilson Source Type: research
Predicting Spontaneous Preterm Birth Using the Immunome
Throughout pregnancy, the maternal peripheral circulation contains valuable information reflecting pregnancy progression, detectable as tightly regulated immune dynamics. Local immune processes at the maternal –fetal interface and other reproductive and non-reproductive tissues are likely to be the pacemakers for this peripheral immune “clock.” This cellular immune status of pregnancy can be leveraged for the early risk assessment and prediction of spontaneous preterm birth (sPTB). Systems immunolog y approaches to sPTB subtypes and cross-tissue (local and peripheral) interactions, as well as integration of multipl...
Source: Clinics in Perinatology - April 3, 2024 Category: Perinatology & Neonatology Authors: Dorien Feyaerts, Ivana Mari ć, Petra C. Arck, Jelmer R. Prins, Nardhy Gomez-Lopez, Brice Gaudillière, Ina A. Stelzer Source Type: research
Etiologically Based Functional Taxonomy of the Preterm Birth Syndrome
Preterm birth (PTB) is a complex syndrome traditionally defined by a single parameter, namely, gestational age at birth (ie, ˂37 weeks). This approach has limitations for clinical usefulness and may explain the lack of progress in identifying cause-specific effective interventions. The authors offer a framework for a functional taxonomy of PTB based on (1) conceptual principles established a priori; (2) known etiologic factors; (3) specific, prospectively identified obstetric and neonatal clinical phenotypes; and (4) postnatal follow-up of growth and development up to 2 years of age. This taxonomy includes maternal, pla...
Source: Clinics in Perinatology - April 3, 2024 Category: Perinatology & Neonatology Authors: Jose Villar, Paolo Ivo Cavoretto, Fernando C. Barros, Roberto Romero, Aris T. Papageorghiou, Stephen H. Kennedy Source Type: research
Overview of the Global and US Burden of Preterm Birth
Preterm birth (PTB) is the leading cause of morbidity and mortality in children globally, yet its prevalence has been difficult to accurately estimate due to unreliable methods of gestational age dating, heterogeneity in counting, and insufficient data. The estimated global PTB rate in 2020 was 9.9% (95% confidence interval: 9.1, 11.2), which reflects no significant change from 2010, and 81% of prematurity-related deaths occurred in Africa and Asia. PTB prevalence in the United States in 2021 was 10.5%, yet with concerning racial disparities. Few effective solutions for prematurity prevention have been identified, highligh...
Source: Clinics in Perinatology - April 3, 2024 Category: Perinatology & Neonatology Authors: Victoria C. Ward, Anne C.C. Lee, Steven Hawken, Nancy A. Otieno, Hilda A. Mujuru, Gwendoline Chimhini, Kumanan Wilson, Gary L. Darmstadt Source Type: research
The Complex Puzzle of Preterm Births
Preterm birth is a complex medical issue with immense health and economic consequences worldwide.1,2 Even in economically well-resourced nations with advanced obstetric and neonatal services, preterm births account for nearly three-fourths of all neonatal deaths and over half of cases with long-term disability. Efforts to improve perinatal outcomes in the past have (paradoxically) resulted in higher preterm births.3 Some of this increase is attributed to an increase in medically indicated early births with an intention to reduce the impact of perinatal complications, such as hypertensive disorders, intrauterine growth reta...
Source: Clinics in Perinatology - April 3, 2024 Category: Perinatology & Neonatology Authors: Lucky Jain Tags: Foreword Source Type: research
Preventing Preterm Birth
This review examines the complexities of preterm birth (PTB), emphasizes the pivotal role of inflammation in the pathogenesis of preterm labor, and assesses current available interventions. Antibiotics, progesterone analogs, mechanical approaches, nonsteroidal anti-inflammatory drugs, and nutritional supplementation demonstrate a limited efficacy. Tocolytic agents, targeting uterine activity and contractility, inadequately prevent PTB by neglecting to act on uteroplacental inflammation. Emerging therapies targeting toll-like receptors, chemokines, and interleukin receptors exhibit promise in mitigating inflammation and pre...
Source: Clinics in Perinatology - March 26, 2024 Category: Perinatology & Neonatology Authors: Tiffany Habelrih, B éatrice Ferri, France Côté, Juliane Sévigny, Thalyssa-Lyn Augustin, Kevin Sawaya, William D. Lubell, David M. Olson, Sylvie Girard, Sylvain Chemtob Source Type: research
Predicting Preterm Birth Using Proteomics
We describe methods for proteomics analyses, proteomics biomarker candidates that have so far been identified, obstacles for discovering biomarkers that are sufficiently accurate for clinical use, and the derivation of composite signatures including clinical parameters to increase predictive power. (Source: Clinics in Perinatology)
Source: Clinics in Perinatology - March 23, 2024 Category: Perinatology & Neonatology Authors: Ivana Mari ć, David K. Stevenson, Nima Aghaeepour, Brice Gaudillière, Ronald J. Wong, Martin S. Angst Source Type: research
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Source: Clinics in Perinatology - March 23, 2024 Category: Perinatology & Neonatology Source Type: research
Preterm Birth
This Special Issue of Clinics in Perinatology covers the topic of “Premature Birth” and includes a range of articles by experts with various perspectives. The articles included in this Special Issue discuss the complexities of solving the puzzle of preterm birth (PTB); the overall burden of PTB globally and in the United States; recent advances in genomics stu dies of gestational duration; the role of social determinants; computational approaches used to connect maternal stress and PTB; the impact of the ambient environment and epidemiology of PTB; prediction of PTB using cell-free RNA, proteomics, metabolomics, microb...
Source: Clinics in Perinatology - March 23, 2024 Category: Perinatology & Neonatology Authors: Ronald J. Wong, Gary M. Shaw, David K. Stevenson Tags: Preface Source Type: research
Computational Approaches for Connecting Maternal Stress to Preterm Birth
This article describes the potential of computational methods to provide new insights into this relationship. For this, we outline existing approaches for stress assessments and various data modalities available for profiling stress responses, and review studies that sought either to establish a connection between stress and PTB or to predict PTB based on stress-related factors. Finally, we summarize the challenges of computational methods, highlighting potential future research directions within this field. (Source: Clinics in Perinatology)
Source: Clinics in Perinatology - March 15, 2024 Category: Perinatology & Neonatology Authors: Amin Mirzaei, Bjarne C. Hiller, Ina A. Stelzer, Kristin Thiele, Yuqi Tan, Martin Becker Source Type: research
Untangling Associations of Microbiomes of Pregnancy and Preterm Birth
This review illuminates the complex interplay between various maternal microbiomes and their influence on preterm birth (PTB), a driving and persistent contributor to neonatal morbidity and mortality. Here, we examine the dynamics of oral, gastrointestinal (gut), placental, and vaginal microbiomes, dissecting their roles in the pathogenesis of PTB. Importantly, focusing on the vaginal microbiome and PTB, the review highlights (1) a protective role of Lactobacillus species; (2) an increased risk with select anaerobes; and (3) the influence of social health determinants on the composition of vaginal microbial communities. (S...
Source: Clinics in Perinatology - March 15, 2024 Category: Perinatology & Neonatology Authors: Anna Maya Powell, Fouzia Zahid Ali Khan, Jacques Ravel, Michal A. Elovitz Source Type: research
Social Determinants of Premature Birth
Social determinants of health have received increasing attention in public health, leading to increased understanding of how social factors —individual and contextual—shape the health of the mother and infant. However, racial differences in birth outcomes persist, with incomplete explanation for the widening disparity. Here, we highlight the social determinants of preterm birth, with special attention to the social experiences among African American women, which are likely attributed to structural racism and discrimination throughout life. (Source: Clinics in Perinatology)
Source: Clinics in Perinatology - March 13, 2024 Category: Perinatology & Neonatology Authors: Nana Matoba, Christina Kim, Tonia Branche, James W. Collins Source Type: research
Ambient Environment and the Epidemiology of Preterm Birth
We describe environmental factors that may influence PTB risks. We focus on exposures associated with an individual ’s ambient environment, such as air pollutants, water contaminants, extreme heat, and proximities to point sources (oil/gas development or waste sites) and greenspace. These exposures may further vary by other PTB risk factors such as social constructs and stress. Future examinations of risks asso ciated with ambient environment exposures would benefit from consideration toward multiple exposures – the exposome – and factors that modify risk including variations associated with the structural genome, ep...
Source: Clinics in Perinatology - March 13, 2024 Category: Perinatology & Neonatology Authors: Gary M. Shaw, David.J.X. Gonzalez, Dana E. Goin, Kari A. Weber, Amy M. Padula Source Type: research
Predicting Preterm Birth Using Cell-Free Ribonucleic Acid
Spontaneous preterm birth (sPTB) is a complex and clinically heterogeneous condition that remains incompletely understood, leading to insufficient interventions to effectively prevent it from occurring. Cell-free ribonucleic acid signatures in the maternal circulation have the potential to identify biologically relevant subtypes of sPTB. These could one day be used to predict and prevent sPTB in asymptomatic individuals, and to aid in prognosis and management for individuals presenting with threatened preterm labor and preterm prelabor rupture of membranes. (Source: Clinics in Perinatology)
Source: Clinics in Perinatology - March 13, 2024 Category: Perinatology & Neonatology Authors: Alison D. Cowan, Morten Rasmussen, Maneesh Jain, Rachel M. Tribe Source Type: research
