A new “digital twin” framework shows that 2 out of 9 FDA-approved drugs have the potential to treat preterm labor. The twin model virtually replicated how human immune cells that contribute to labor onset react to each therapy. The work spotlights a form of folic acid and a combination of aspirin plus the acid reflux treatment lansoprazole as the best candidates to postpone birth. Clinical trials to address pregnancy complications, such as preterm labor, must overcome ethical quagmires and underfunding. These difficulties have led to a paucity of prenatal interventions. In a related Focus, Adrienne Scott adds: “The therapeutic gap in treating pregnancy complications reflects not only scientific challenges but also restrictive regulations and a history of tragic failures in treating pregnant people.” Digital twin models offer a safe way to repair this gap. Now, Jakob Einhaus and colleagues present a framework called Simulated Immunome Modeling of Clinical Outcomes (SIMCO), applying it to evaluate the potential of 9 FDA-approved, low-risk drugs as interventions for preterm labor. The drugs were chlorthalidone, maprotiline, metformin, lansoprazole, pravastatin, rifabutin, salicylic acid (aspirin), salicylic acid with lansoprazole, and 5-methyltetrahydrofolate (folic acid). Einhaus et al . first established the drugs’ impact on in vitro cells from blood samples from pregnant and non-pregnant people. Then, they used another set of untreated cell samples from 11 pregnant people to connect gestational age at delivery with molecular immune activity (8 non-pregnant people served as controls). By integrating the data from both experiments, SIMCO’s digital twins could replicate how each drug altered labor-related immune cell activity. Tetrahydrofolate and salicylic acid, alongside lansoprazole, showed the most potential to delay the beginning of labor. The 7 other drugs were counterproductive at first, speeding up labor onset before slowing it.
Science Advances
Single-cell-level digital twins for preterm birth prevention strategies
21-Oct-2026