CHICAGO (AP) – Scientists have taken a big step toward developing an earlier, safer and simple test that could help prevent perhaps 175,000 premature births in the United States each year.
Researchers say they have identified certain proteins in the blood that can indicate whether a pregnant woman has a uterine infection that can lead to premature birth. They hope the discovery will lead to development of a diagnostic blood test that would allow doctors to treat infected women with antibiotics earlier, in time to prevent premature delivery.
“This is potentially very important,” said Dr. Robert Goldenberg, an obstetrics/gynecology professor at the University of Alabama at Birmingham who was not involved in the study.
Other doctors noted that the study involved only 33 women, and said further research is needed to confirm that the proteins are, in fact, a universal indicator of the infections.
Uterine infections typically arise from overgrowth of bacteria that normally live in the vagina.
They frequently cause no symptoms in the mother until she goes into labor prematurely.
An invasive and sometimes risky test called amniocentesis – which involves inserting a long needle through the abdominal wall to draw out fluid – can confirm the infection during labor, but treatment with antibiotics at that point is typically too late to prevent premature delivery.
Scientists said they hope further study will show whether earlier antibiotics can, in fact, help prevent premature labor.
“It would be a great thing if that’s the case, because preterm labor is such a difficult thing to deal with right now,” said Dr. Glenn Markenson, a maternal-fetal medicine specialist at Baystate Medical Center in Springfield, Mass. He was not involved in the study.
The study appears in Wednesday’s Journal of the American Medical Association.
Uterine infections are believed to cause at least half of the estimated 350,000 U.S. births that occur before around 30 weeks’ gestation each year. Such infants run the risk of serious and sometimes fatal health problems, including blindness and brain disorders.
“My hope is that we have laid the foundation for detecting reliable diagnostic markers of intrauterine infection in blood, without the need for an invasive amniocentesis,” said lead author Dr. Michael Gravett of Oregon Health & Science University.
The study was funded in part by ProteoGenix Inc., a biotechnology company whose founders include the Oregon university and some of the researchers. Gravett and a co-author have a significant financial interest in the company.
The scientists combined monkey and human studies with an evolving science called proteomics, or the study of proteins in living cells. Within 12 hours of injecting pregnant laboratory monkeys with infection-causing germs, the researchers identified specific biological markers signaling infection.
The markers also were found in all 11 pregnant women who were in premature labor with symptomless amniotic-fluid infections and whose babies were born shortly thereafter, prematurely. But the markers were not found in any of 11 other women in premature labor who were not infected and whose babies were born near term.
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On the Net:
JAMA: http://jama.ama-assn.org
AP-ES-07-27-04 1546EDT
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