Premature birth, when a baby arrives before 37 weeks gestation, occurs in 11% of all births in the United States, and 15 million babies are born preterm worldwide. Prematurity is associated with significant and sometimes long term complications for these babies including health problems, developmental delays, learning disorders and even autism. Three new research studies offer new perspectives on the causes of premature birth and impacts of premature birth on the overall health outcomes for babies born before 37 weeks.
Role of Vitamin A in Outcomes for Babies
Researchers looking to evaluate whether the use of Vitamin A had a significant impact on the overall health of premature babies made a surprise discovery about another factor which can significantly impact the rates of lung disease and death in very low birth weight babies. Vitamin A was a common supplement for premature infants for nearly a decade until a shortage in 2010 reduced its availability. Data from 6,200 premature infants was evaluated and showed that use of Vitamin A did not reduce rates of lung disease or death in very low birth weight babies. This research likely means that although the Vitamin A shortage has ended, its use won’t likely increase dramatically saving premature infants the 12 injection series required for one Vitamin A dose.
While evaluating the data further, the study found that the location of birth had a direct link to overall outcomes. Lead researcher Veeral Tolia, MD said, “If you’re a premature baby, who your doctors are is probably more important than what medications they have available to treat you.” Dr. Toilia went on to say, “Independent of these drugs, I think we’re getting better at caring for these infants in a non-pharmacologic way.”
Sources: http://www.irvingweekly.com/s/1894/Baylor-Research-Findings-Could-Eliminate-Need-for-12-Injections-in-Preemies.php and http://www.ncbi.nlm.nih.gov/pubmed/25222512
Role of Genetics in Preterm Labor
In evaluating cause of preterm labor, new research has found that the baby’s genes, not the mother’s, may be behind some preterm births. While we know that some maternal conditions, such as high blood pressure, substance abuse and infection, can contribute to preterm birth, award-winning research from the University of Alabama-Birmingham indicates that the infant’s genetics may also be a factor, at least in some cases. For this study, researchers obtained blood and saliva samples from hundreds of mother-baby pairs to evaluate certain segments of their DNA. The study found that in babies who had duplicates of any four genes or if any seven genes were deleted, the likelihood of preterm birth was significantly higher. Researchers noted that it isn’t clear exactly what about these genetic elements is triggering early birth. It could be that these genes make a baby more sensitive to environmental factors or infection which then causes preterm labor, for example. This groundbreaking research does help explain why current maternal treatments for preterm birth, such as progesterone, may not be effective in all cases. Learn more at: http://www.uab.edu/news/innovation/item/5697-new-research-finds-baby-s-genes-not-mom-s-may-trigger-some-preterm-births
Protection from Infection-Induced Preterm Birth
While a number of factors can influence preterm birth, maternal infection is the leading known cause of prematurity. A study published in December in the Journal of Clinical Investigation, found that hyaluronan, a naturally occurring substance in the cervix and other tissues, may help protect against premature birth caused by infection. Since infection causes 25 – 40% of preterm births, information on factors which offer protective benefits could be very important in reducing the number of premature infants. Hyaluronan has long been thought to have a role in the ripening of the cervix in anticipation of labor and birth. In a study of mice, researchers found that depleted levels of hyaluronan increased susceptibility to infection-induced preterm birth. Read the full study at: http://www.jci.org/articles/view/78765
Statistics on premature birth and the associated risk factors:
Maternal causes of preterm birth: