Expectant mothers may have a new option for early detection of preterm delivery

Research at the UT Health San Antonio School of Nursing is advancing the science of biomarkers detected in saliva and finding new ways to detect the risk of preterm birth. Findings from this research, led by Elizabeth Brownell, PhD, MA, BA, perinatal epidemiologist and associate professor, could minimize adverse maternal and infant outcomes and improve caregiving and societal outcomes to premature newborns and their families.

In the U.S., approximately 10% of all infants are born premature (less than 37 weeks of gestation), and the rate of preterm births increased from 2015-2019. Among preterm births, one-third are medically indicated, while the remaining two-thirds are spontaneous. Spontaneous preterm deliveries leave expectant women, their families and their providers without advanced warning to take appropriate precautions and for prenatal/perinatal planning.

Currently, the method for preterm delivery detection is sonographic assessment of the cervical length that can be measured during the second trimester. But with the majority of preterm deliveries being spontaneous, providers and patients are not able to plan accordingly, implement interventions or customize care in advance of the delivery.

While there are many known risk factors for preterm delivery, biomarkers identifying increased risk for preterm birth prior to or early in gestation might allow interventions to delay or prevent preterm delivery. Research is advancing toward applying a non-invasive diagnostic test using saliva samples. The purpose of Dr. Brownell’s study was to determine whether maternal H-antigen is a potential biomarker for preterm delivery. The study found that if the saliva sample did not contain the H-antigen, then the woman’s likelihood of preterm delivery was 350% higher relative to women who did secrete the H-antigen. Moreover, maternal production versus non-production of H-antigen (secretor status) is independent of pregnancy and can be measured at any time.

Dr. Brownell recommends conducting more studies among mothers who do and do not secrete the H-antigen to assess its relationship to other clinical risk factors of preterm birth such as: preeclampsia, preterm labor, premature rupture of membranes and infection during pregnancy.

“Further funded research we are pursuing will include maternal/infant clinical, environmental and genetic interactions as a predictor of preterm birth,” Dr. Brownell said. “This research is a major step in the right direction to provide early detection to expectant mothers and their providers to improve the health outcomes related to premature births. Earlier detection would also provide mothers and families the time to review and select options, such as the use of donor milk, to help their premature newborn thrive.”

The salivary science behind this diagnostic is also able to predict the risk of preterm births before a woman becomes pregnant, expanding the potential family planning benefits from early detection to preconception.

Dr. Brownell’s study was published in the Journal of Perinatology.

To read the full study visit Journal of Perinatology, “Maternal H-antigen secretor status is an early biomarker for potential preterm delivery”; Jennifer Caldwell; Adam Matson; Maua Mosha; James I. Hagadorn; James Moore; Elizabeth Brownell.

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Article Categories: Research