Wednesday, August 27, 2008

Mystery of Premature Births Solved?

Researchers at the Stanford University School of Medicine have found one answer to why some women have premature births, while others go full term. Previously unrecognized and unidentified infections of amniotic fluid may be the single most significant cause of premature birth.

A press release from Stanford describes this analysis of amniotic fluid from women in preterm labor. It found that a full 15 percent of the fluid samples harbored bacteria or fungi, which represents an increase of 50 percent over previous estimates.

This is a concern for many doctors because the heavier the burden of infection, the more likely it is that the woman will deliver a younger, sicker infant.

“If we could prevent these infections in the first place, or detect them sooner, we might one day be able to prevent some of these premature births,” said researcher Dan DiGiulio, MD, who conducted the study in the laboratory of David Relman, MD. About 12 percent of all births in this country are premature and the frequency of premature birth is increasing. This issue of increasing amounts of bacteria and fungi is one reason behind the increase.

The study is published in the Aug. 26 issue of PLoS-ONE.

For this study, DiGiulio used a highly sensitive technique called polymerase chain reaction, or PCR, to track down micro-organisms in amniotic fluid samples collected from 166 women in preterm labor at the Detroit Medical Center between October 1998 and December 2002. Of these, 113 women went on to deliver their infants prematurely. Although not all these women were infected, such microbial invasion is thought to contribute significantly to the overall number of preterm births.

Researchers cast a wide net and got the results to show for it. They used both PCR and laboratory cultures to determine that 25 of the 166 samples were infected with either bacteria or fungi. Seventeen bacterial and one fungal species were identified in the positive samples.

Infection of the amniotic fluid likely contributes to preterm delivery by causing an inflammatory response in the pregnant woman. It occurs most commonly either by microbes from the vagina that infiltrate the amniotic sac, or by microbes that travel through the mother’s bloodstream from other parts of her body, such as the mouth. In fact, both gum disease and bacterial vaginosis have been shown to increase a woman’s risk of delivering her baby prematurely.

Speaking personally, I would think (check with your doctor) that a good regimen of probiotics would be helpful. "Good" bacteria have the effect of minimizing the bad ones.


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