Simple Way to Predict Preterm Births

Test of cervical mucus may reveal pregnant women’s risk of going into labor too early.

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An estimate suggests almost 18% babies born prematurely before completing 37 weeks of gestation. And 1 million of them do not survive whereas who survive, face developmental problems.

Currently, doctors can not predict preterm births i.e., whether a woman with a normal pregnancy will go into labor before 37 weeks. But, MIT scientists have an approach to identify this risk by analyzing the properties of cervical mucus.

Scientists identified those premature babies that delivered before 37 weeks was very different from that of women who delivered late.

Katharina Ribbeck, an associate professor of biological engineering at MIT said, “Our prediction is that we might be able to predict preterm births ahead of time, before labor sets in. Diagnostic tools for this are missing.”

According to scientists, the analysis could provide a better way to calculate the risk of early labor. It would allow doctors to try to predict earlier to prevent preterm births.

Scientists identified the distinctive chemical and mechanical properties of mucus. They also identified how those properties help it to perform many critical roles as part of the body’s first line of defense against infection.

Mucus generally formed from polymers known as mucins. The composition and arrangement of these mucins determine how porous the gel is.

Simple Way to Predict Preterm Births
“Our prediction is that we might be able to identify risk for preterm birth ahead of time, before labor sets in,” says Katharina Ribbeck, an associate professor of biological engineering at MIT and the senior author of the study. “Diagnostic tools for this are missing.”
Photo: Bryce Vickmark

Scientists classified participants into two groups: low-risk group, high-risk group. The low-risk group involves pregnant women who came into their doctors’ offices for routine visits around 30 weeks and ended up giving birth after 37 weeks. On the other hand, high-risk group involves women who went into labor early, between 24 and 34 weeks.

By collecting samples from both groups, scientists tested the ability of negatively charged spheres about 1 micron in diameter to travel through the mucus. They found a little measurable immaterial difference in porosity between the high and generally safe specimens.

They then did the same test with charged peptide probes. Peptide probes are small enough to avoid getting stuck in the mucus network but are sensitive to the biochemical modifications of the mucus. Scientists found significant differences in mucus permeability and adhesiveness. In this case, peptides were able to pass through samples from high-risk women much more easily.

Ribbeck said, “Means, cervical mucus from women at high risk for early labor, may be more susceptible to invasion. It might due to potentially harmful bacteria and microbes. Means, those women will experience an infection that leads to preterm birth. The altered mucus may be less able to retain helpful immune system components such as antibodies or antimicrobial peptides, which would normally help to combat infection.”

“Mucins display all sorts of immunologically active factors that you may also lose when the adhesive properties change.”

She noted, “this cervical mucus testing could be done early in pregnancy, as part of a routine screen that would reveal whether a woman was at high risk of preterm birth.”

Errol Norwitz at Tufts Medical Center said, “This new study is an innovative approach to combating a problem that has so far proven intractable. Identifying women at high risk, and potentially giving their babies the chance to remain in utero for even a few extra days, could make a big difference.”

“Preterm birth is one of the biggest issues we face in child and baby health care around the world. It’s an enormous burden to individuals and families. We sorely need a way to identify risk because all of the tools that we have now don’t work very well.”

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