Premature birth research and issues

[waltky]

Gene for premature birth found...

Premature birth gene 'discovered'
14 April 2011 - Premature birth can be dangerous for the baby

A gene linked to premature births has been discovered, scientists in the US and Finland have said. The researchers hope their study, published in PLoS Genetics, could eventually lead to a test for women at risk of a pre-term birth. In the UK, one in 10 babies is born before the 37th week of pregnancy, with potential problems for their health.

The Royal College of Obstetricians and Gynaecologists said it would help to identify a percentage of those at risk. The international team of researchers looked to human evolution in their hunt for genes linked to premature births. In comparison to other primates and mammals, humans have relatively large heads and narrow birth canals.

Acceleration

The researchers, at Vanderbilt University, Washington University and the University of Helsinki, believed there must have been an evolutionary pressure to "adapt and shift the time of birth" to produce a smaller baby. They looked for DNA which showed evidence of "accelerated evolution" - genes which have mutated more in humans than in other primates. They identified 150 genes.

The next step was to look for an association with premature births, so the researchers compared those 150 genes in 328 Finnish mothers, some of whom had premature births. A strong association to pre-term births was found in variants of the FSHR - or follicle stimulating hormone receptor - gene. Follicle stimulating hormone acts on receptors in the ovaries to encourage follicle (a sphere of cells containing an egg) development and production of the hormone oestrogen.

'Greatest risk'

 

[waltky]

Premies at risk of health problems...

Infancy health risk linked to early birth by research
1 March 2012 - Babies born just a few weeks early have a slightly higher risk of health problems in infancy, research suggests.

Doctors said their work challenged widely held views that babies born after 37 weeks had similar long-term outcomes to those born at full term. The study in the British Medical Journal looked at 14,000 children, born 10 years ago, up to the age of five. It looked at health outcomes including admissions to hospital and having illnesses such as asthma.

Child wheezing

Previous work has focused on babies born very prematurely, before 32 weeks. But this study suggests that the higher number of babies born later may also need extra attention. It found that babies born before 39 weeks have a slightly higher risk of health problems up to the age of five. The earlier the baby arrived, the bigger the risk. For example, 15% of babies born full term experienced asthma or wheezing as young children but the figure increased to 17% for those born just a few weeks early.

They were also slightly more likely to go into hospital. About a fifth of babies - some 100,000 a year - are born early at 37-38 weeks. The authors of the study were at pains to stress that parents should not worry about what was a modest chance of extra illness. But the work should instead be used to question the level of healthcare support and monitoring given to these families, they added.

'Gradient of risk'

 

[waltky]

The causes of premature birth are poorly understood...

Immunity clue to premature labour
5 March 2013 - Calming the immune system will be a vital part of preventing premature labour, say UK academics.

They have shown that inflammation, part of the immune response, overrides drugs which might halt labour in its tracks. Their study, published in the Journal of Biological Chemistry, showed inflammation in the uterus turns off genes which hold labour back. Other experts said the study unravelled some of the complexities in early labour. In the UK about one in every 13 babies is born too soon. The earlier they are born, the greater the risk they will not survival their first few days and the higher the chances of developing disability. However, the reasons why labour starts, early or otherwise, are poorly understood. Some drugs can briefly slow the process down.

Labour off

Researchers at the University of Sheffield were testing how inflammation affected experimental drugs, called histone deacetylase inhibitors, which can turn genes on. In tissue samples they showed the drugs activated genes which relaxed the womb and stopped contractions. However, the chemicals produced during inflammation then turned the relaxing genes back off.

One of the researchers, Dr Neil Chapman, said such drugs would probably fail unless inflammation was targeted as well. He told the BBC: "We really don't know what causes a woman to go into labour, essentially after her womb has had nine months gestation, how does it know 'Game over, time to start contracting'? "The process of human labour is such a big process that it is likely many cell functions must be controlled simultaneously: all the genes saying 'relax' being turned off and everything saying 'contract' being turned on. "If inflammation is part of that process then drugs will need to target that as well. "Due to the complexity of the whole process, however, it's not going to be like a light switch that we can just turn on or off."

Prof Siobhan Quenby, a spokesperson for the Royal College Obstetricians and Gynaecologists, said: "This study is really clever, it unravels the complexities and explains why current treatments are ineffective and that gives us hope." She also said research into the process of labour may be used to devise therapies for people who struggle to go into labour as well.

BBC News - Immunity clue to premature labour

 

[jimanderson]

The reason for premature birth is not well known but such babies need utter care and they tend to grow up quite different than other babies.

 

[waltky]

Music therapy seems to help pre-mature babies...

Tiny preemies get a boost from live music therapy
16 May`13 — As the guitarist strums and softly sings a lullaby in Spanish, tiny Augustin Morales stops squirming in his hospital crib and closes his eyes.

This is therapy in a newborn intensive care unit, and research suggests that music may help those born way too soon adapt to life outside the womb. Some tiny preemies are too small and fragile to be held and comforted by human touch, and many are often fussy and show other signs of stress. Other common complications include immature lungs, eye disease, problems with sucking, and sleeping and alertness difficulties. Recent studies and anecdotal reports suggest the vibrations and soothing rhythms of music, especially performed live in the hospital, might benefit preemies and other sick babies.

Music therapist Elizabeth Klinger, right, quietly plays guitar and sings for Augustin as he grips the hand of his mother, Lucy Morales, in the newborn intensive care unit at Ann & Robert H. Lurie Children's Hospital in Chicago on Monday, May 6, 2013. Research suggests that music may help those born way too soon adapt to life outside the womb. Recent studies and anecdotal reports suggest the vibrations and soothing rhythms of music, especially performed live in the hospital, might benefit preemies and other sick babies.

Many insurers won't pay for music therapy because of doubts that it results in any lasting medical improvement. Some doctors say the music works best at relieving babies' stress and helping parents bond with infants too sick to go home. But amid beeping monitors, IV poles and plastic breathing tubes in infants' rooms at Chicago's Ann & Robert H. Lurie Children's Hospital, music therapist Elizabeth Klinger provides a soothing contrast that even the tiniest babies seem to notice "What music therapy can uniquely provide is that passive listening experience that just encourages relaxation for the patient, encourages participation by the family," Klinger said after a recent session in Augustin's hospital room.

The baby's parents, Lucy Morales and Alejandro Moran, stood at the crib and whispered lovingly to their son as Klinger played traditional lullabies, singing in Spanish and English. "The music relaxes him, it makes him feel more calm" and helps him sleep better too, Lucy Morales said. "Sometimes it makes us cry." Some families request rock music or other high-tempo songs, but Klinger always slows the beat to make it easier on tender ears. "A lot of times families become afraid of interacting with their children because they are so sick and so frail, and music provides them something that they can still do," Klinger said, who works full time as a music therapist but her services are provided for free.

Music therapists say live performances in hospitals are better than recorded music because patients can feel the music vibrations and also benefit from seeing the musicians. More than two dozen U.S. hospitals offer music therapy in their newborn intensive care units and its popularity is growing, said Joanne Loewy, a music therapist who directs a music and medicine program at Beth Israel Medical Center in New York. Preemies' music therapy was even featured on a recent episode of the hit TV show "American Idol," when show finalist Kree Harrison watched a therapist working with a tiny baby at Children's Hospital Los Angeles.

More Tiny preemies get a boost from live music therapy

 

[waltky]

An end to premature births?...

New Genetic Discovery May Eventually End Premature Birth
September 08, 2017 | WASHINGTON — Researchers have found genetic mutations that affect whether a woman is likely to have her baby early or carry it to full term.

Even late preterm babies, those born between 34 and 36 weeks of gestation, are more likely to die or experience problems, even if they are the size and weight of some full-term infants born after 37 to 41 weeks in the womb. Preterm birth is the leading cause of death among children younger than 5 worldwide. These babies have higher death rates even into adolescence and beyond.

Several studies show health problems related to preterm birth persist through adult life, problems such as chronic lung disease, developmental handicaps, vision and hearing losses. The World Health Organization reports that every year, an estimated 15 million babies are born early, and this number is rising. Until now, little was known about the causes, but these findings could help solve the mystery.

Beginning of a journey

Dr. Louis Muglia coordinated the study of the DNA of more than 50,000 pregnant women. The study identified six gene regions, which influence the length of pregnancy and the timing of birth. While the study doesn’t provide information about how to prevent prematurity, Muglia says it could eventually do that. “It’s just the beginning of the journey, but at least we know now, what the foundation is,” he says.

Muglia is co-director of the Perinatal Institute, which focuses on preterm babies, at Cincinnati Children’s Hospital Medical Center. He’s also the principal investigator of one of the March of Dimes’ five prematurity research centers. The March of Dimes helped pay for the study along with the National Institutes of Health, the Bill and Melinda Gates Foundation and other medical research institutes.

Muglia said scientists have known for a long time that preterm birth is a combination of genetic and environmental factors. This study showed the genes involved were from the mother. “For the first time, we have an idea of what tissue in the mom is the one that is likely driving the one for preterm birth,” Muglia says.

Selenium

One of the genes identified is involved in how the body uses selenium, a common mineral provided in food or supplements, but not currently included in vitamins women commonly take while pregnant. Selenium supplements are low-cost, and if the results are confirmed, this supplement could save millions of lives. Supplements including folic acid have been shown to greatly reduce birth defects, so much so that food in many countries is fortified with this particular B vitamin. Another gene indicated that cells that line the uterus play a larger-than-expected role in the length of pregnancy.

The researchers were from the U.S. and from Norway, Denmark, Finland and Sweden. They only tested women of European descent, so more work needs to be done involving women of other races and ethnic origins. But their study does open up areas for researching potential diagnostic tests, new medications, improved dietary supplements or other changes that could help more women have full-term pregnancies, all areas which will require several more years of study. The study was published in the New England Journal of Medicine.

New Genetic Discovery May Eventually End Premature Birth