A new genetic test could help identify women who are going into premature labour.
Premature birth (before 37 weeks) affects around 10% of pregnancies, and is a serious health issue; babies born much too early can face a struggle for survival, which with intensive neonatal care is possible from 22-23 weeks in some cases, but with very high risks of death or severe disability. Even babies born at 30 weeks or later have substantially increased risks of various long-term health problems.
The problem for doctors looking after women with threatened preterm labour is trying to distinguish between the minority who will go on to give birth quickly, and those who will continue their pregnancy to term or near-term. If a woman is thought likely to go into premature labour in the next 48 hours, she may need to receive steroid injections to help mature the baby’s lungs before birth.
New research examining blood gene expression patterns associated with spontaneous premature birth within 48 hours of admission to hospital has identified a pattern based on expression of nine key genes related to inflammatory and immune responses.
In combination with other biomarkers, analysis of these genes could offer a new tool to predict premature birth, as well as helping researchers to understand the biological basis of preterm labour. In a small trial the test showed 71% sensitivity and 76% specificity – not highly accurate, but arguably a step in the direction of a clinically useful test, especially given the lack of indicators to distinguish premature labour signs likely to progress from those likely to subside.