Now, a team of researchers led by scientists from Stanford University created an cheap blood test that does not just accurately predict gestational age, but also predicts whether a pregnancy may end up in spontaneous preterm birth. The method, described today (June 7) in Science, also enabled the researchers to predict, in most cases, which of the high-risk pregnancies would end prematurely.
"We found that some genes are very good predictors of what women are at risk of giving birth prematurely". Specifically, the team targeted the RNA in the mother's blood. Obstetricians now use ultrasound scans from the first trimester of pregnancy to estimate a woman's due date, but ultrasound gives less reliable information as pregnancy progresses, making it less useful for women who don't get early prenatal care. So far, the ultrasound is still the main method of predicting gestational age, but it can be rather expensive and it still can't predict spontaneous preterm births, which is the leading cause of infant death in the United States.
These women each gave a blood sample during the second or third trimester of their pregnancies.
"I've spent a lot of time over the years working to understand preterm delivery".
Another top researcher was Stephen Quake, professor of bioengineering and of applied physics at Stanford University, who led a team that created a blood test for Down syndrome in 2008 - now used in more than three million pregnant women per year. The genetic activity reveals physiological changes in the tissues and organs of both the mother and the baby - and clues of distress that can precede premature delivery. Doctors now rely on ultrasound imaging or the mother's estimate of her last menstrual period to predict the gestational age of a fetus.
"This gives a super-high resolution view of pregnancy and human development that no one's ever seen before", Stanford postdoctoral scholar Thuy Ngo added.
A similar analysis of RNA was carried out on eight women who delivered prematurely and researchers were able to classify six of the pregnancies as preterm.
"RNA corresponding to placental genes may provide an accurate estimate of fetal development and gestational age throughout pregnancy", the report found.
The results are preliminary and the researchers still have to validate the new tests with larger groups of pregnant women before they're ready for use, but damn is this exciting. They're also keen to explore whether the genes signaling prematurity hold clues about the triggers for early arrivals, and they hope to discover targets for drugs that could delay premature birth.
Scientists from the Statens Serum Institute in Copenhagen, the University of Pennsylvania School of Medicine and the University of Alabama-Birmingham also contributed to the study.
The Chan Zuckerberg Biohub has submitted a patent application for the new technology.
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