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Genetic mutation increases risk of preterm birth
February 04, 2008Genetic mutations in the Toll-like receptor 4 (TLR4) gene appear to have significant association with inflammatory injury to the placenta and developing baby, researchers from the University of Pittsburgh's department of obstetrics, gynecology and reproductive sciences report at the 28th annual meeting of the Society for Maternal-Fetal Medicine. Scientific sessions continue through Saturday, Feb. 2, at the Dallas Hyatt Regency at Reunion.
"This indicates a possible genetic predisposition to a kind of misfire in immune system response that could contribute to placental inflammation and spontaneous preterm birth," said Hyagriv Simhan, M.D., assistant professor of obstetrics, gynecology and reproductive sciences at the University of Pittsburgh School of Medicine, who is presenting the work. "These injuries are important because they are more common in preterm babies and associated with major health consequences like cerebral palsy."
TLR4 enables the body to recognize pathogens and activate the immune system. This gene is expressed most abundantly in the placenta and in white blood cells.
For the study, researchers analyzed DNA from placental tissue samples and cord blood from 111 women and their babies, finding that one maternal single nucleotide polymorphism (SNP) in TLR4 (rs1079932) and one fetal SNP (rs1554973) demonstrated "highly significant association with chorionic plate inflammation," irrespective of adjustment for maternal race, smoking and lower genital tract infection, all of which can contribute to genetic mutation. Women with TLR4 mutation were 5.2 times more likely to exhibit inflammatory injury to placental tissue than those without the mutation, Dr. Simhan noted. Babies with TLR4 mutation were nearly five times more likely to exhibit inflammatory placental injury than those without the mutation.
"Being aware of these genetic mutations may lead to better screening efforts," Dr. Simhan said.
Defined as any birth prior to 37 weeks gestation, preterm birth affects some 12 percent of pregnancies in the United States. Costs have been estimated at $26 billion, or $52,000 per infant, in medical care and lost productivity as of 2005, according to the Institute of Medicine. A recent study from the U.S. Centers for Disease Control and Prevention found that preterm birth contributed to more than a third of infant deaths - twice as many as previously thought and making it the leading cause of infant deaths - yet the underlying causes of premature birth remain poorly understood.
More than 500,000 babies are born too soon each year nationwide, and the preterm birth rate has increased more than 30 percent since 1981. Babies who do survive face risks of lifelong challenges related to cerebral palsy, mental retardation, chronic lung disease, and vision and hearing loss, as well as other developmental problems.
University of Pittsburgh Schools of the Health Sciences
For the study, researchers analyzed DNA from placental tissue samples and cord blood from 111 women and their babies, finding that one maternal single nucleotide polymorphism (SNP) in TLR4 (rs1079932) and one fetal SNP (rs1554973) demonstrated "highly significant association with chorionic plate inflammation," irrespective of adjustment for maternal race, smoking and lower genital tract infection, all of which can contribute to genetic mutation. Women with TLR4 mutation were 5.2 times more likely to exhibit inflammatory injury to placental tissue than those without the mutation, Dr. Simhan noted. Babies with TLR4 mutation were nearly five times more likely to exhibit inflammatory placental injury than those without the mutation.
"Being aware of these genetic mutations may lead to better screening efforts," Dr. Simhan said.
Defined as any birth prior to 37 weeks gestation, preterm birth affects some 12 percent of pregnancies in the United States. Costs have been estimated at $26 billion, or $52,000 per infant, in medical care and lost productivity as of 2005, according to the Institute of Medicine. A recent study from the U.S. Centers for Disease Control and Prevention found that preterm birth contributed to more than a third of infant deaths - twice as many as previously thought and making it the leading cause of infant deaths - yet the underlying causes of premature birth remain poorly understood.
More than 500,000 babies are born too soon each year nationwide, and the preterm birth rate has increased more than 30 percent since 1981. Babies who do survive face risks of lifelong challenges related to cerebral palsy, mental retardation, chronic lung disease, and vision and hearing loss, as well as other developmental problems.
University of Pittsburgh Schools of the Health Sciences
Obstetrics Gynecology Current Events and Obstetrics Gynecology News RSSPregnancy complications are a stress test for future maternal health and pregnancies
Predicting whether pregnancy complications affect long-term maternal health as well as future pregnancies is at the heart of two studies conducted by researchers in the Department of Obstetrics, Gynecology and Reproductive Sciences at Yale School of Medicine.
Debate on administration of magnesium sulfate to pregnant women to prevent cerebral palsy in preterm infants
Cerebral palsy (CP) is the most prevalent chronic childhood motor disability with an estimated lifetime cost of nearly $1 million per individual.
Obstetrical unit at Yale-New Haven Hospital achieves dramatic improvement in patient safety
Maternal and newborn outcomes were greatly improved when doctors implemented a series of simple clinical interventions at Yale-New Haven Hospital's obstetrical unit.
Moms who breastfeed less likely to develop heart attacks or strokes
The longer women breastfeed, the lower their risk of heart attacks, strokes and cardiovascular disease, report University of Pittsburgh researchers in a study published in the May issue of Obstetrics & Gynecology.
New ultrasound-guided biopsy method allows improved diagnosis of endometrial disease
A procedure used in conjunction with a vaginal ultrasound might make it easier to visualize and diagnose diseases in the lining of the uterus, researchers at UT Southwestern Medical Center have found.
Pregnancy disorder signals need to screen for heart disease, study shows
High blood pressure experienced during pregnancy could be a woman's earliest warning that she is at risk of developing heart disease - the number one killer of Canadian women - says Queen's University professor of Obstetrics and Gynecology, Graeme Smith.
'Superbug' breast infections controllable in nursing mothers, researchers find
Many nursing mothers who have been hospitalized for breast abscesses are afflicted with the "superbug" methicillin-resistant Staphylococcus aureus, or MRSA, but according to new research by UT Southwestern Medical Center physicians, conservative treatment can deal with the problem.
Bacterial infections in premature babies more common than previously realized
Premature babies are subject to a host of threats that can result in fetal/neonatal disease. In a study published in the January 2008 issue of the American Journal of Obstetrics & Gynecology, researchers from the University of Alabama-Birmingham Medical School and the Drexel University College of Medicine found that genital mycoplasmas are a frequent cause of congenital fetal infection. 23% of neonates born between 23 and 32 weeks of gestation have positive umbilical blood cultures for two genital mycoplasmas (bacteria lacking cell walls): Ureaplasma urealyticum and Mycoplasma hominis.
Common drug for stopping preterm labor may be harmful for babies
A drug commonly used to halt premature labor may be associated with brain damage and intestinal issues in premature babies, according to a new analysis of studies on the issue published today in American Journal of Obstetrics and Gynecology.
Malpractice concerns may deter Florida medical students from entering obstetrics and gynecology
The medical malpractice climate in Florida is discouraging medical students from pursuing careers in obstetrics and gynecology - a trend that could further reduce patients' access to obstetric care, a survey by the University of South Florida College of Medicine found.
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