Doctors develop simple test to determine preterm labor risk

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SALT LAKE CITY -- Melissa Layton carried her first baby full term and delivered her second at 37 weeks gestation. Had it been any earlier than that, the baby would have been considered a preemie.

Pregnant with her third child she became particularly anxious about the possibility of going into labor too early, as doctors couldn't give her a straight answer as to whether or not that was likely.

"It was just scary waiting in the unknown," she said.

Luckily for Layton, her babies were born without any birth defects and have gone on to be perfectly healthy children.

Preterm birth: a lifetime of costs
Aside from serious health concerns of preemies, the annual public health care costs of caring for preterm infants in the U.S. is over $26 billion, according to a study by the March of Dimes. Additional lifetime costs for children with preterm birth-related medical complications is approximately $500,000 per child.

This is not always the case for mothers and their tiny newborns. Many premature babies end up battling medical complications throughout their lives, which is a major risk associated with preterm labor.

Nationally, one in eight babies, or 12 percent, are born prematurely. It is the leading cause of illness and death associated with newborns, according to researchers with locally based Sera Prognostics, which is working to develop a simple blood test that could help to predict preterm births.

The new test is under patent by the company, scientifically founded in 2008 by Brigham Young University chemistry professor Dr. Steven Graves and Dr. Sean Esplin, associate professor at the University of Utah School of Medicine and a high-risk obstetrician for Intermountain Healthcare.

To date, the test has successfully identified women who experience preterm labor 80 to 90 percent of the time, Graves said.

"What's been missing is a way of assessing risk," he said. Graves is part of a team of researchers who have identified naturally occurring proteins, or bio-markers, within a pregnant woman's blood that can signal a propensity for spontaneous preterm birth. Those small proteins would be assessed along with a regularly scheduled blood draw, accompanying normal pregnancy checkups.

"Doctors currently rely on a range of varied risk factors for predicting preterm birth. However, in most cases, no risk factors are present," Esplin said, adding that Sera's blood test method aims to help physicians identify the problem early and guide treatments to manage and extend at-risk pregnancies.

"With preterm birth, if we could even prolong a pregnancy by one or two weeks, we could make a very big impact on the number of babies that survive and make sure that those that survive are healthy," he said.

Graves said he expects the test to be available for trial at the end of this year and widely available by 2012.

The FDA recently approved the use of an injectable drug, hydroxyprogesterone caproate, in women slated for preterm labor, but Graves said obstetricians, who are generally quite conservative in treatment, don't like to use drugs unless it is necessary.

"Doctors are reluctant to put every woman on it," he said.

The test, detailed in the May issue of the American Journal of Obstetrics and Gynecology, will help to identify women who would benefit from the use of progesterone, and remove the risks for those who would not. Blood would be taken at about 24 weeks into the pregnancy, which is four to eight weeks prior to the existence of any clinical complications, allowing doctors to provide real help to mothers who might be able to carry a baby even a week longer than expected without the test.

Layton said she'd be open to anything that would help her deliver a baby to full term.

"Without it, there's really nothing I can do," she said. "You don't want to have babies too early. It makes it hard on everyone, including them."



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