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A Blood Test to Predict Women at Risk for Giving Preterm Birth

(SALT LAKE CITY) -- Though more than one in 10 American babies are born prematurely, there have been few clues to predict whether a particular baby is going to arrive too early. But a new study led by researchers from the University of Utah, Brigham Young University (BYU), and Intermountain Healthcare suggests that more than 80 percent of pre-term births can be spotted in advance with a blood test taken during the second trimester of a pregnancy.

The paper introduces three new peptide biomarkers that, in combination with other proteins, can signal high risk of pre-term birth. The test works by looking at just a drop of blood from a mother who is 24 weeks pregnant. The researchers tested their method on blood samples from 80 women who went full-term and 80 whose babies came prematurely. The study will appear in the May print issue of the Journal of Obstetrics & Gynecology and already has appeared online.

“With pre-term birth, if we could even prolong a pregnancy by one or two weeks, we could make a very big impact on the number of babies that survive and make sure that those that survive are healthy,” said M. Sean Esplin, M.D., lead author on the study, associate professor of obstetrics and gynecology (maternal-fetal medicine) at the University of Utah, and an obstetrician for Intermountain Healthcare. “With just one intervention, we could have a really huge impact.”

Knowing she is at high risk for pre-term birth is a big advantage for the mother when it comes to decisions about travel and activity level. Esplin also notes that a new hormone treatment can help a baby stay in the womb a little longer.
Esplin and Steven Graves, who directs the chemistry portion of the research at BYU, began searching for molecular clues to pregnancy complications in 2002.

“What’s been missing is a way of assessing risk,” Graves said. “Our approach has been to look at the naturally occurring molecules that are present in women’s blood to see if we can identify the peptides and small proteins that are at quantitatively different levels in women who go on to have these complications.”

Antonio E. Frias, M.D., a professor of maternal-fetal medicine at Oregon Health & Science University who was not part of the research, said, “This test may dramatically improve our ability to identify moms at risk for spontaneous preterm birth, which we currently cannot do adequately. Because it identifies these patients in this way, it allows us in the future to design interventional trials. Right now we are almost blind in that standpoint.”

The method for predicting pre-term birth is patented by BYU and the University of Utah and has been licensed to a company called Sera Prognostics. The company hopes to have a diagnostic test on the market in the first half of 2012. If follow-up studies also show positive results, Graves is hopeful that the diagnostic test will earn the support of medical care providers, the FDA, and insurers.

“I’m optimistic,” Graves said. “My students think it’s great to be involved with something that’s practical and beneficial to the world around them, as well as being good science.”

Other institution that took part in the study are: The University of Alabama, Birmingham; George Washington University Biostatistics Center, Washington, D.C.; Ohio State University; University of Tennessee; Eunice Kennedy Shriver National Institute of Child Health and Human Development, Bethesda, Md.; University of Cincinnati; University of Pittsburgh; Medical University of South Carolina, Charleston; Wayne State University.