Premature birth, though it occurs in only five to 10 per cent of all pregnancies, is the main cause of child-related mortality in the developed world. Preterm birth is associated with 70% of all newborn deaths and up to 75% of newborn disease including cerebral palsy, blindness, deafness, respiratory illness and complications of neonatal intensive care.
Because of the great threat preterm birth poses to babies, researchers at the Lunenfeld-Tanenbaum Research Institute (LTRI) at Sinai Health System, which houses Canada’s largest perinatal research program, have been actively involved in research to help identify women at risk of preterm birth and to find new treatments to prevent preterm labour.
This year, they experienced an exciting breakthrough in their research: The team, along with colleagues at University of Calgary, has developed a blood test that has been shown to predict if a pregnant woman is at risk of delivering her baby prematurely, before a full 37 weeks’ gestation.
The test provides the earliest detection of premature birth - as early as 17 weeks of pregnancy - and is the most accurate one to date with 86 per cent accuracy in determining mothers at risk of early delivery. Best of all, the new test will allow clinicians to screen expectant mothers during routine antenatal care.
Led by Dr. Jan Heng, a former post-doc at the LTRI; Dr. Stephen Lye, Scotiabank Scientist in Child and Adolescent Development Health Research Senior Investigator at the LTRI; and Professor Suzanne Tough at the University of Calgary, the study looked at a subset of women who participated in the All Our Babies study, a community based longitudinal pregnancy cohort in Calgary, Alberta. Researchers collected paired maternal blood from pregnant women at two clinically relevant time points: approximately 17 weeks when fetal ultrasound is conducted and at approximately 27 weeks of gestation when gestational diabetes screening is performed. The team then used gene expression profiling and bioinformatics to develop gene sets, coupled with a patient’s clinical information such as history of preterm birth, history of abortion or anaemia, to predict whether or not a woman will deliver prematurely.
The new blood test represents a great step forward in the diagnosis and treatment of preterm birth. “The earlier we can identify risk of a premature birth the better for the women and baby as it buys time for clinicians to develop and implement personalized measures to prevent preterm delivery,” says Dr. Heng.
“This blood test could improve identification of women who will benefit from existing therapies," adds Dr. Lye. "Moreover, it may also help drug studies to focus on women who are at highest risk of delivering preterm when evaluating new treatments."