Predicting Preterm Birth Still Nearly Impossible.

2002 FEB 14 - (NewsRx.com & NewsRx.net) -- Hopes of finding a reliable way to predict a woman's risk of having a premature baby were dashed by the findings of a randomized clinical trial published in the New England Journal of Medicine (Iams J.D., et al., Frequency of uterine contractions and the risk of spontaneous preterm delivery, January 2002;346).

In the study, women used a home monitor to measure their uterine contractions. The testing failed to distinguish between those women who eventually had a preterm birth (before 37 weeks of gestation) and those who had a full-term delivery. The authors also noted that other current tests, such as ultrasound and fetal fibronectin, also have low predictive value.

"Once again, we see that it's nearly impossible with the technology we have today to accurately predict who is going to give birth to a premature baby," said Nancy S. Green, MD, acting medical director of the March of Dimes. "And the problem is only getting worse, because prematurity in America is on the rise - the rate of premature birth has increased by 23% since the 1980s."

Green pointed out that a separate study published in a previous issue of the New England Journal of Medicine showed that many babies born prematurely or at low birth weight (less than 5 1/2 pounds) had lower IQs, more serious problems with learning, and more chronic health problems that persisted into young adulthood (see below). Prematurity and low birth weight account for more than 90% of all newborn deaths in the United States.

"If we truly want to help more babies be born healthy and lead healthy lives, we need more research aimed at preventing prematurity from occurring in the first place," Green said.

Since 1998, the March of Dimes has awarded nearly $8 million in grants to investigate biological and environmental factors that may contribute to the more than 450,000 preterm or low-birth-weight births each year in the United States. As part of this research program, the organization has selected six of the foremost research teams in the world in the area of preterm birth to receive March of Dimes Perinatal Epidemiological Research Initiative (PERI) grants. Among these is a team led by Charles J. Lockwood, MD, chairman of the department of obstetrics and gynecology at New York University School of Medicine and author of an accompanying editorial in the NEJM, "Predicting Premature Delivery - No Easy Task."

"Although several biomarkers are associated ...