Approximations of gestational age are typically based on ultrasound imaging and/or the patient's estimate of her last menstrual period, but neither method is necessarily ideal. Provisional data for 2017 from the National Center for Health Statistics show that the preterm birth rate in the US has reached 9.93%, up from 9.86% in 2016, the third consecutive annual increase after steady declines over the previous seven years.
Until now, doctors have lacked a reliable way to predict whether pregnancies will end prematurely, and have struggled to accurately predict delivery dates for all types of pregnancies, especially in low-resource settings.
David K. Stevenson, M.D., the principal investigator of the March of Dimes Prematurity Research Center at Stanford University, described the noninvasive blood test approach as a way of "eavesdropping on a conversation" between the mother, the fetus and the placenta, without disturbing the pregnancy.
Preterm births is the largest cause of infant mortality in the United States.
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By searching for evidence of genetic activity in the mother's blood, it could be possible to not only pin down a delivery date, but determine whether the baby is at risk of being born before it's ready. The technique can also be used to estimate a foetus's gestational age - or the mother's due date - as reliably and less expensively than ultrasound.
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Another top researcher was Stephen Quake, professor of bioengineering and of applied physics at Stanford University, who led a team that created a blood test for Down syndrome in 2008 - now used in more than three million pregnant women per year.
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The scientists used blood samples from 21 of them to build a statistical model, which identified nine cell-free RNAs produced by the placenta that predict gestational age, and validated the model using samples from the remaining 10 women.
In the second test, researchers studied blood samples from 38 pregnant women who were already at risk of preterm labor because of early contractions or a previous preterm delivery. From seven cfRNA biomarkers, six out of eight preterm cases were correctly identified.
There is now no reliable way to predict when a pregnancy will result in premature birth, one of the world's primary causes of fetal sickness and death, Dr. Kecia Gaither, director of Perinatal Services at NYC Health+Hospitals in Bronx, New York, said in an email. They collected their blood samples and looked into the genetic RNA particles circulating in the blood stream of each woman.
The researchers noted, however, that both tests will require validation in larger, blinded clinical trials. The gestational age blood test did not do a great job of predicting which women would deliver prematurely, suggesting those particular genes "may not account for the various outlier physiological events that may lead to preterm birth", the study said.
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