07 September 2017

Can doctors predict if you will have a prem baby?

Early births are one of the biggest causes of deaths among newborns in South Africa.

An early birth can be a traumatic event for the mother as well as the baby. According to statistics published in the South African Medical Journal, premature birth accounts for 40% of all newborn deaths worldwide. Parent24 previously reported that approximately 14% of all babies born in private care in South Africa are premature, with as much as 23% of babies born premature in the public sector. 

But it seems that there could be a way to establish whether a mother is prone to a premature birth. 

By learning more about the immune system changes that occur during pregnancy, scientists hope they can someday predict if babies will be born prematurely.

Immune system changes

"Pregnancy is a unique immunological state. We found that the timing of immune system changes follows a precise and predictable pattern in normal pregnancy," said study senior author Dr Brice Gaudilliere. He's an assistant professor of anaesthesiology, perioperative and pain medicine at Stanford University School of Medicine in California.

If scientists can identify immune-system changes predicting premature birth, they say they might eventually develop a blood test to detect it.

"Ultimately, we want to be able to ask, 'Does your immune clock of pregnancy run too slow or too fast?'" Gaudilliere said in a university news release.

According to a report on South African births, 35% of newborn deaths are because of complications of premature births. Currently, doctors have no reliable way to predict which babies will be born prematurely.

Immunity 'algorithm' could predict birth

For the study, which was published in Science Immunology, the researchers collected blood samples from 18 women who had full-term pregnancies. The women gave one sample during each trimester and another six weeks after childbirth. The researchers used samples from another group of 10 women who also had full-term pregnancies to verify the findings.

Using a technique called mass cytometry, the researchers simultaneously measured up to 50 properties of each immune cell in the blood samples. The investigators counted the types of immune cells, determined which signalling pathways were most active in each cell, and assessed how the cells reacted when exposed to compounds that mimic bacterial or viral infection.

The research team then used advanced statistical modelling to document the immune system changes occurring throughout pregnancy. (These adjustments keep the mother's body from rejecting the unborn baby.)

"This algorithm is telling us how specific immune cell types are experiencing pregnancy," Gaudilliere said.

The study confirmed that natural killer cells and certain white blood cells have enhanced action during pregnancy. The researchers also found that a signaling pathway among helper T-cells increases on a precise schedule.

Exciting outcome

"It's really exciting that an immunological clock of pregnancy exists," said study lead author Nima Aghaeepour, an instructor in anaesthesiology, perioperative and pain medicine.

"Now that we have a reference for normal development of the immune system throughout pregnancy, we can use that as a baseline for future studies to understand when someone's immune system is not adapting to pregnancy the way we would expect," Aghaeepour added.

Image credit: iStock


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