Seven scientists aim to make strides in predicting and preventing preterm birth

With the help of funding from the March of Dimes, researchers from five states and Canada are seeking answers to questions such as how cellular-level processes that control uterine muscles may affect preterm labor, the causes of preeclampsia, and how air pollution may affect pregnancy and preterm birth - all with the goal of preventing preterm birth so more babies will get a healthy start in life.

These topics are among the work of seven researchers that will be supported for the next three years by new March of Dimes Prematurity Research Initiative (PRI) grants. The nearly $3 million in grants will support scientific efforts to learn to identify which women are at risk for preterm birth and how to prevent it. These 2012 grants bring the eight-year-old program's total to more than $22 million.

Following three decades of increases, in 2010 the United States saw the first four-year decline in the preterm birth rate, to 11.99 percent. Despite the improvement, however, nearly half a million babies are born too soon each year, the March of Dimes notes.

The March of Dimes has set a goal of lowering the nation's preterm birth rate to 9.6 percent by 2020. The goal was set by estimating the maximum achievable benefits of applying known strategies to prevent preterm birth, such as smoking cessation programs, progesterone treatments for medically eligible women, and others, but recognized that continued research is needed to yield new medical advances.

Sarah K. England, PhD, professor, Department of Obstetrics and Gynecology, Division of Basic Science Research, at Washington University in St. Louis, MO, has been among the PRI grantees since the program began in 2005. Dr. England is researching how mutations to a gene that regulates tiny openings in cell membranes thatallow potassium to flow out of uterine muscle cells affect preterm labor. When potassium exits the cells, the uterus relaxes, allowing the pregnancy to continue. Dr. England is investigating whether a genetic mutation may cause the cell membranes to close early, preventing the potassium from leaving the uterus, triggering labor. If this proves correct, it could lead to the development of drugs that open the channels and prevent or halt preterm labor.

Other grant recipients include:

• Jennifer Catherine Condon, PhD, assistant professor, Department of Obstetrics, Gynecology and Reproductive Sciences, University of Pittsburgh, Pittsburgh, PA, who is investigating the role of endoplasmic reticulum in regulating an enzyme called caspase-3. Low levels of caspase-3 may trigger preterm labor. If so, it may be possible to develop drugs to regulate enzyme levels and prevent preterm labor.

• Nihar Ranjan Nayak, DVM, PhD, assistant professor, Department of Obstetrics and Gynecology, Stanford University School of Medicine, who is studying the interaction of two genes in the placenta and how that may cause preeclampsia, a pregnancy-related form of high blood pressure that can be fatal for both the mother and baby and is responsible for about 15 percent of premature births in the United States. The cause of preeclampsia is not known, and the only effective treatment is induction of early delivery.

• Tippi C. MacKenzie, MD, assistant professor, Department of Surgery, Division of Pediatric Surgery and Fetal Treatment Center, the University of California, San Francisco, who is investigating how the mother's immune system may trigger preterm labor after an infection.
• Judith T. Zelikoff, PhD, professor, Department of Environmental Medicine, NYU School of Medicine, who is investigating if there is a cause and effect relationship between air pollution and the risk of preterm delivery.

• Sudhansu K. Dey, PhD, professor and LovaRiekert Chair, Department of Reproductive Sciences, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, whois investigating chemicals that regulate inflammation after a uterine infection to understand how they may contribute to preterm labor.

• Sylvain Chemtob, MD, PhD, professor, departments of Pediatricsand Pharmacology, CHU Sainte-Justine Research Center, Montreal, who is investigating how proteins in the uterine wall may contribute to preterm labor.