Researchers said the new test, which still needs more testing and improvement, may be a simpler, cheaper and perhaps more reliable method than ultrasounds in the future. Recently released provisional data for 2017 from the National Center for Health Statistics show that the preterm birth rate in the USA has reached 9.93 percent, up from 9.86 in 2016, the third consecutive annual increase after steady declines over the previous seven years.
They next studied two separate cohorts of pregnant women who were known to be at risk of premature birth either because of previous preterm deliveries or because they had experienced premature contractions.
The innovation could "alert us to which women are at risk so they can be appropriately cared for", Stanford professor of bioengineering Stephen Quake, a senior author on the paper, said in a statement. "To date, no test on the market can reliably predict which pregnant moms will go on to preterm labor", comments Stacey D. Stewart, president of March of Dimes. "By measuring cfRNA in the circulation of the mother, we can observe changing patterns of gene activity that happen normally during pregnancy and identify disruptions in the patterns that may signal to doctors that unhealthy circumstances like preterm labor and birth are likely to occur", he says. It's also similarly precise with the new blood test predicting the gestational age within two weeks 45 percent of the time compared to ultrasound's 48 percent accuracy. Specifically, the team targeted the RNA in the mother's blood. The latest research evaluated whether the same method could be developed into blood tests for estimating both gestational age and the risk of preterm birth.
He added that the findings affirm the existence of a "transcriptomic clock of pregnancy" that could serve as a new way to assess the gestational age of a foetus.
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The test detected the variations in RNA in a pregnant woman's blood and estimated due dates within two weeks in almost half the cases.
The research team conducted a pilot study on 31 healthy pregnant women, using 21 of them to create a statistical model based on nine transcripts of RNA from the mother's immune system, the infant's liver, and the placenta.
A similar analysis of RNA was carried out on eight women who delivered prematurely and researchers were able to classify six of the pregnancies as preterm. However, the test did not predict preterm births as all of the women had full-term pregnancies. The team used blood samples collected during pregnancy to identify which genes gave reliable signals about gestational age and prematurity risk. These women each gave one blood sample during the second or third trimester of their pregnancies. The women in the preterm birth analysis were African American, and they represented only two of many potential risk categories for premature delivery, which can also be caused by infection, inflammation, maternal stress and other factors, she said.
Next up will be larger-scale, blinded clinical trials, March of Dimes says, to validate the results.