Preventing Preterm Births | Cincinnati Children's

After being born weeks ahead of schedule, Frankeigh Fletcher is slowly building up her strength in the Newborn Intensive Care Unit at Cincinnati Children’s.

“We’ve been in the NICU for 108 days,” said Bailey Fletcher, Frankeigh’s mom.

On average, 1 in 10 babies is born premature in the United States. Preterm birth, meaning any birth before 37 weeks, is also the leading cause of death among children under the age of 5 worldwide. Doctors have been searching for reasons for decades. Now a landmark study published in The New England Journal of Medicine may lead to new ways to prevent preterm birth.

”For the first time we have the clues that are going to lead us to rational ways of understanding a woman’s risk for preterm birth and we have the capacity to potentially to develop new interventions based on understanding those pathways,” said Lou Muglia, MD, PhD, co-director of the Perinatal Institute at Cincinnati Children’s and principal investigator of the March of Dimes Prematurity Research Center-Ohio Collaborative.

The study is the result of a massive DNA analysis of more than 44,000 pregnant women from around the world. Researchers, led by Drs. Lou Muglia and Ge Zhang of Cincinnati Children’s, identified six gene regions that influence the length of pregnancy and the timing of birth.

“In our studies, we were able to specifically show that the gene associations we identified were from the moms’ genes,” said Dr. Muglia. “So these are genes that acting in the mom but even more important than that is for the first time we have an idea of what tissue in the mom is the one likely driving the risk for preterm birth.”

Doctors stress more research on the six gene areas needs to be done but they serve as an important starting point. One of the gene areas identified suggests that cells within the lining of the uterus play a larger-than-expected role in the length of pregnancy, which in turn provides a new target for medications to help prevent pre-term birth. Another newly identified gene area raises important questions about how a lack of selenium, a common dietary mineral found in certain vegetables and meats, might affect preterm birth risk.

“I think it leads to an exciting horizon where we can really make a difference in human pregnancy. It’s just the beginning of the journey but at least we know now what the foundation is,” said Dr. Muglia “Before we were kind of wondering where to place our confidence in terms of pathways. Now I think we have unbiased and really strong evidence that these pathways are important ones and we will get somewhere by further understanding them.”

The findings are based heavily on data from more than 44 thousand women who provided saliva samples to a genetic testing company called 23andME.

Researchers from Norway, Denmark and Finland also assisted in this international collaboration. They used data from more than 8,000 Nordic women to further verify their findings.

Vital funding was provided by the National Institutes of Health, the Bill and Melinda Gates Foundation and the March of Dimes.

“We think this is an important breakthrough in finding solutions to end premature birth which is the leading cause of death for children between the ages of 0 and 5 and the leading cause of disabilities for babies,” said Stacey Stewart, president of the March of Dimes.

For NICU parents like Bailey Fletcher, she wants the study and her daughter’s journey to help future families.

“My hope for Frankeigh is that she turns out to be something big, to tell her story, her NICU life so others can understand what she went through and they all can have hope from a story like hers,” said Fletcher.