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Protein analysis of amniotic fluid reveals clues about preterm birth

"Right now, drug therapies, compared to placebo, can at best delay delivery by 48 to 72 hours. And, as we've shown, cerclage, or sewing the cervix closed, won't help women with the biomarkers for either inflammation or decidual hemorrhage. This research takes us a giant step forward into mapping out the mechanisms of preterm birth and perhaps finding new ways to attack the problem."

Dr. Weiner notes that for the women whose amniotic fluid did not contain the protein biomarkers, cerclage helped them carry their pregnancies further to term or near term. However, about 50 percent of them still went on to deliver prematurely.

"This shows that there are other causes, besides inflammation and decidual hemorrhage, that lead to preterm birth, suggesting additional biomarkers will be found," explains Dr. Weiner.

Because preterm birth may result from a range of problems, researchers suspect that successful treatment will require combination therapy. "There probably isn't a single, magic bullet that will prevent preterm birth. We need to expand our horizons. Right now, it appears a combination of treatments will prove the key to success," says Dr. Weiner.

Another important component of this protein analysis is that it can be performed quickly. Recent laboratory advances will allow doctors to get test results in about one hour. Dr. Weiner and his colleagues worked with proteomic chip technology from Ciphergen Inc. to develop this new method of protein analysis called MR scoring.

In the United States, about 11 percent of women deliver preterm, and about three percent deliver before 32 weeks, resulting in high infant mortality rates. Normal gestation for pregnancy is about 40 weeks.

Dr. Weiner's co-investigators for the study were Keun-Young Lee, M.D., Department of Obstetrics and Gynecology, Kangnam Sacred Heart Hospital, Hallym University, Seoul, Korea; Catalin S. Buhimschi, M.D., and Irina A. Buhimschi, M.D., Department of Obstetrics, G
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Contact: Sharon Boston
sboston@umm.edu
410-328-8919
University of Maryland Medical Center
1-Mar-2005


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