Blood markers can help predict delivery time

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(Reuters Health) – Scientists have identified markers in the blood that may indicate that childbirth is approaching, according to a new study.

Using an analysis of blood samples collected during the second and third trimesters from 53 women, the researchers identified a combination of factors that predicted the focus on childbirth over a two-week period, according to the report published in Science Translational Medicine. .

“Right now, it’s hard for an obstetrician to give a precise time when a woman will give birth,” said co-author Dr. Brice Gaudilliere of Stanford University. “This can be a problem for both pregnancies that turn out to be premature and those that are complicated by being postpartum.”

“By measuring various factors that represent many physiological systems that are important in maintaining pregnancy, particularly the immune system, we are able to predict when childbirth will occur without relying on an estimate of gestational age,” said Gaudilliere.

Dr. Gaudilliere and colleagues analyzed blood samples from 53 women who gave birth spontaneously, including five who gave birth prematurely.

Blood was collected two or three times from women during the last 100 days of pregnancy, analyzing each sample to detect 7,142 metabolic, protein, and immunocellular traits. Data were plotted based on the number of days before delivery each sample was collected, and by mathematical modeling, the researchers identified which blood characteristics best predicted the onset of labor.

Once they isolated the factors that seemed to foreshadow the onset of childbirth over a two-week period, Dr. Gaudilliere and his team tested their results on the pregnancy of 10 more women, which confirmed that researchers were going on the right track.

Overall, the researchers found that an increase in the metabolites of steroid hormones and the interleukin 1 receptor type 4 preceded childbirth, coinciding with the change in immune activation to the regulation of inflammatory responses.

Dr. Gaudilliere and his team hope the results of the study will produce a test that obstetricians can use to predict childbirth in the next two to three years.

The new research is “interesting and intriguing,” said Drs. Hyagriv Simhan, executive vice president of obstetrics in the gynecology department at UPMC’s Magee Womens Hospital. “The approach is what’s appealing. But it’s a way to be prepared for prime time.”

Beyond that, Dr. Simhan was not convinced that the method would work to predict premature deliveries. “Previous deliveries differ in several ways,” he said. “And the markers can be different. Previous work is not just normal physiological work that starts earlier. Sometimes it’s fundamentally pathological. So it’s not as likely that we can predict it.”

If a test is finally developed, it can help obstetricians advise women who arrive late, especially those who are not comfortable with induction, Dr. Simhan said.

SOURCE: https://bit.ly/33DdCZv Science Translational Medicine, online May 5, 2021.





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