Role of Genetics, Nutrition, and Race in Preterm Birth Probed

11/28/2006

Filed under Research Innovationsand Hyagriv Simhan

A recent study from the U.S. Centers for Disease Control and Prevention found that preterm birth contributed to more than a third of infant deaths - twice as many as previously thought, making it the leading cause of infant deaths - yet the underlying causes of premature birth are not well understood. A new investigation at Magee-Womens Research Institute & Foundation (MWRIF) is the first to address the interactions of genetic and environmental factors such as nutrition and inflammation that may figure in the racial disparity in preterm birth, or birth prior to 37 weeks' gestation.

"Preterm birth is a complex condition, and this in-depth study of nutritional status and genetics is unique," says Hyagriv Simhan, MD, MSCR, assistant professor and MWRI assistant investigator. "Nutrition is something that lends itself to interventions to improve health. For example, we now know that women who take folic acid before conception and during pregnancy can reduce the risk of spina bifida and other neural tube defects by as much as 70 percent."

The five-year, nearly $2.8 million study, funded by the National Institute of Child Health and Human Development, will enroll 1,200 participants early in pregnancy to discern the interrelationship of dietary factors, genetics, and infection-related inflammatory changes in the lower genital tract that are known to predispose women to preterm birth.

The study aims to determine whether poor nutrition before conception and during pregnancy is associated with an increased risk for preterm birth, how nutritional status affects the risk of genital tract inflammation, and the roles of genetic mutations and race, which may predispose women to infection.

"We know, for instance, that African-American women are much more likely than white women to have genetic mutations that are associated with infection-related preterm birth," said Dr. Simhan, who also is director of the Prematurity Center at Magee-Womens Hospital of UPMC.

Study participants will be asked to provide investigators with information about their diet, body-mass indices, and weight gains during pregnancy. In addition, blood and nail samples will be analyzed for an objective reflection of nutritional status.

"Understanding the influence of environment and gene-environment interactions on inflammation is critical to understanding the racial disparity in preterm birth," says Dr. Simhan.

The U.S. infant mortality rate has declined since 1995 except between 2001 and 2002, when the rate increased for the first time since 1958. In 2002, the National Center for Health Statistics listed short gestation or low birth weight as the cause of 17 percent of infant deaths. However, two-thirds of the infants who died in 2002 were born prematurely.

More than 500,000 babies are born too soon each year, and the preterm birth rate has increased more than 30 percent since 1981. Babies who do survive face risks of lifelong challenges related to cerebral palsy, mental retardation, chronic lung disease, and vision and hearing loss, as well as other developmental problems.

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