The Quest for the Ideal Tests to Predict Preterm Births
Feb. 8, 2000 (Miami) -- Preterm delivery has been one of the biggest dilemmas in obstetrics, resulting in illness or death of many infants. One problem is being able to predict which women will go into labor and deliver before term, or before 37 completed weeks of pregnancy. Another problem is being able to effectively treat the women with medications or other therapy. Recent studies are showing that simple, safe, and noninvasive tests can often be used to predict preterm births, but they are often only a first step. In order to be really valuable, the tests need to be combined with methods to prevent premature births, which is still the next, most important, step.
Research into simple, safe, and noninvasive tests to predict preterm birth was the topic of two presentations given here last week at a meeting of maternal/fetal medicine specialists. A co-author of one of the studies says the information already serves a purpose, though, by helping physicians better understand the warning signs for preterm births.
Inflammation is an important part of disease in pregnancy, explains Roberto Romero, MD. "All of these presentations are saying that an inflammatory reaction can be detected locally in vaginal/cervical secretions or in maternal blood," Romero tells WebMD. Romero is chief of the perinatology research branch of the National Institute of Child Health and Human Development (NICHD) and a professor or obstetrics and gynecology at Wayne State University in Detroit.
"We are [attempting] prediction, and we hope that prediction will [ultimately] help us with prevention," says Romero. He says the next step is to confirm these observations, determine the best time for screening, and then use that information to see if a way can be found to halt the process of premature deliveries.
One presenter, Robert L. Goldenberg, MD, agrees, saying the tests are useful for further study, but he'd wait before putting them into practice. "[Our] data clearly show that it's possible to use a group of tests to better predict preterm birth than any single test," he tells WebMD. "I think the most important thing is to develop interventions using the tests," he says.