Sur­pris­ing study finds pos­si­ble cul­prit in preterm births

Kuwait Times - - HEALTH -

WASH­ING­TON: Re­searchers have un­cov­ered a sur­pris­ing pos­si­ble trig­ger for some preterm births: cal­cium buildup in the womb, sim­i­lar to the kind that stiff­ens older peo­ple’s ar­ter­ies or causes kid­ney stones.

Ohio re­searchers study­ing more than 100 preg­nant women found that when a momto-be’s wa­ter breaks too early, the cul­prit seems to be ab­nor­mal cal­cium de­posits that make the nor­mally elas­tic am­ni­otic sac prone to rup­ture.

It’s a small study and more re­search is needed to prove if cal­ci­fi­ca­tion re­ally is be­hind this baf­fling kind of pre­ma­tu­rity and if so, what to do about it. But the re­search, re­ported Wed­nes­day in Science Trans­la­tional Medicine, raises the pos­si­bil­ity of in­ves­ti­gat­ing in­ter­ven­tions. “To have a new po­ten­tial mech­a­nism for one sig­nif­i­cant form of preterm birth is quite ex­cit­ing,” said Dr. Edward McCabe, chief med­i­cal of­fi­cer of the March of Dimes, who wasn’t in­volved in the study. Pre­ma­ture birth - be­ing born be­fore 37 weeks of preg­nancy - can cause life­long health prob­lems, and ba­bies who are very pre­ma­ture can die. Some­times there’s an ob­vi­ous cause for pre­ma­tu­rity, such as an in­fec­tion. Yet most of the time, doc­tors can’t ex­plain what trig­gers preterm birth in an oth­er­wise healthy preg­nant woman.

Dr. Irina Buhim­schi of Na­tion­wide Chil­dren’s Hos­pi­tal took a closer look at a cu­rios­ity: Cal­ci­fied plaques have of­ten been spot­ted in pla­cen­tas af­ter birth - both preterm and full term - and no one knows why. But ab­nor­mal cal­ci­fi­ca­tion is well­known to play a role in a num­ber of dis­or­ders. Clus­ters of min­er­als, known as cal­cipro­tein par­ti­cles, that float in the blood may be de­posited in soft tis­sue in­stead of the skele­ton, lead­ing to such prob­lems as artery-stiff­en­ing atheroscle­ro­sis or kid­ney stones.

Could that process go awry in preterm birth, too? Buhim­schi’s team found higher con­cen­tra­tions of the cal­cium-con­tain­ing de­posits in the am­ni­otic sac when a mom’s wa­ter broke pre­ma­turely than with full-term births or other types of preterm births.

Am­ni­otic fluid can pro­duce cal­cipro­tein par­ti­cles, the team found - and with pre­emies, that fluid also con­tains lower lev­els of a pro­tein named fe­tuin-A that’s sup­posed to keep those de­posits from be­ing dumped in the wrong place, like the am­ni­otic sac. Lab experiments found those de­posits led to less flex­i­ble fe­tal mem­branes. “We’ve shown that for­ma­tion of these par­ti­cles in am­ni­otic fluid is un­healthy, and we need to keep it in check,” Buhim­schi said.

Im­por­tantly, test­ing mom’s blood didn’t un­cover any sig­nal that a problem was brew­ing. Buhim­schi said the problem may be re­stricted just to the am­ni­otic fluid - if the fe­tus’ own or­gans sim­ply don’t pro­duce enough fe­tuin-A to pro­tect it­self. But that would pose a bar­rier to un­cov­er­ing at-risk preg­nan­cies, be­cause test­ing am­ni­otic fluid is risky.

It’s a plau­si­ble the­ory, said Dr. Cather­ine Spong, a ma­ter­nal-fe­tal spe­cial­ist at the Na­tional In­sti­tute of Child Health and Hu­man De­vel­op­ment. But “the clin­i­cal rel­e­vance of this find­ing re­mains to be ex­plored,” Spong cau­tioned. “Prefer­ably non­in­va­sive meth­ods for de­tec­tion might al­low for the de­vel­op­ment of in­ter­ven­tions or the op­por­tu­nity for pre­ven­tion.”—AP

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