Infection Risk Linked to Premature Delivery

Each year in the United States, more than half a million babies are born prematurely, before 37 completed weeks of pregnancy. Many pre-term births are induced labor or cesarean delivery due to pregnancy complications or health problems in the mother or fetus, the premature rupture of membranes (PROM), or infections such as vaginal or urinary tract. But the trigger of almost half of all preterm births remains unknown. However, researchers suspect that an undiagnosed infection may be the trigger in a significant number of these cases.

To better understand the role infection plays in preterm birth, researchers at Stanford University in California studied samples of amniotic fluid saved from 166 women who went into premature labor at the Hutzel Women's Hospital in Detroit from 1998 to 2002. At the time, doctors used standard tests to check for signs of infection, but doctors David Relman and Dan DiGiulio used more sophisticated molecular testing known as polymerase chain reaction (PCR). They discovered that of the 113 women who delivered prematurely, 25 showed infection-those with the heaviest infection delivering the earliest. "We were surprised with the amount of unexpected bacteria we found in the fluid and the fact we encountered new species of bacteria," said Dr. DiGiulio.

Dr. Robert Goldenberg of the Drexel University College of Medicine in Philadelphia was not surprised by the results and suspects that as scientists continue to study amniotic fluid with improved techniques many more pathogens will be identified, according to ScienceNews. "We only know the names of relatively a few of all the bacteria that exist, and a lot of them are difficult to culture or can't be cultured with our current technology."

The researchers say this is likely their findings are an understatement, considering that the samples were so old the DNA in them had begun degrading. Currently, Dr. Relman and his team are studying fresh, rather than stored, amniotic fluid from 2,000 women who get routine amniocentesis in their second trimester. They hope that by identifying the infections before they induce preterm labor or birth, they "could potentially create a treatment for these infections and prevent a lot or possibly all of premature births."

Premature birth is a serious health problem. Premature babies are at increased risk of developing a wide range of health problems, as well as lasting disabilities, which include cerebral palsy, mental retardation, neurological, lung and gastrointestinal problems, vision and hearing loss, and learning disabilities. Premature babies often require care in a neonatal intensive care unit (NICU), whose specialized staff and equipment can deal with the multiple problems these ‘preemies' face.

The Stanford study was reported in PLoS One, the online journal of the Public Library of Science.

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