Prevention and cause

Recent news reports stories have reported on both the causes and prevention of prematurity.

Firstly, the causes. The causes of prematurity are not well understood with multiple factors thought responsible. For example this paper suggested infection, vascular disease, maternal BMI, cervical length and previous history of premature births could all be risk factors. Equally, another paper recently reported no evidence for the efficacy of antibiotics as preventatives for premature birth. As reported by the BBC news, and a host of other news sources, however, recent work has strengthened the case for infection playing a vital role in prematurity. Following on from research undertaken by Imperial College London last year which found a link between a protein that causes inflammation in response to infection and prematurity, a group at the National Institute of Health in the US has now linked a particular gene to the story too. After studying the genes of woman and babies in Chile, the researchers have identified genes that are found in proportionately higher numbers in women and babies experiencing premature birth. The genes are linked to inflammation as a result of infection and from a evolutionary point of view are thought to be involved in life preservation (particularly from the point of view of the mother) when infection is present. The next step is to now develop tests to identify the presence of the gene (or protein) in order to pre-empt the inset of premature birth. Further down the line, perhaps even intervention to prevent the inflammatory response could lead to reduction in the likelihood of premature birth.

Closer to coming to fruition as a preventative approach, maybe, researchers at Yale have also recently reported that the use of progesterone can reduce the likelihood of premature birth.Working on the hypothesis that many premature births are a result of premature rupture of the foetal membranes, the researchers have determined that progestrone is able to reduce the rupture and thus potentially could reduce premature birth. Whilst still being explored in the lab, this is nevertheless an interesting piece of research.

Another recent report on work also funded by the NIH reported that Vitamin D could help to reduce the occurence of premature births. The study investigated the rate of early births between a high vitamin D dose group and a control group taking more like the current recommended dose of vitamin D. Premature births in the high vitamin D group were less than half that of the control group.

Please note: This blog does not suggest all expectant mothers should rush out and consume large quantities of vitamin D - please see your doctor!