Pre-term Births and Biofilm Infections

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        I read an interesting and sad article on the Scientific American blog (how bacteria in the vagina change during pregnancy) and it reminded me again of the role of pathogenic biofilms – chronic infections – and how they are imposing such a terrible burden on our human health. There are a few things in the article that may get updated this year (e.g., “Just to clarify, bacteria do not actually live in the womb…”).

        In February, in Pittsburgh, I watched a very interesting (and upsetting) presentation by one of the authors of the article below. Dr. Romero is the Chief, Perinatology Research Branch and Heads the Program for Perinatal Research and Obstetrics at NICHD, NIH. He is a remarkable scientist who has been directing perinatal research for many years. One of the sub-fields he is studying involve the role of neo-natal biofilm infections in pre-term births.

        His group has been using sophisticated biofilm diagnostics to “inventory” and assess the bacterial biofilm infections associated with the pre-term births mentioned below. For reference, chorioamnionitis is an inflammation of the fetal membranes due to some type of bacterial infection.

        Paediatr Perinat Epidemiol. 2012 May;26(3):250-63. doi: 10.1111/j.1365-3016.2011.01252.x. Epub 2012 Jan 31.

        California Very Preterm Birth Study: design and characteristics of the population- and biospecimen bank-based nested case-control study.

        Kharrazi M, Pearl M, Yang J, DeLorenze GN, Bean CJ, Callaghan WM, Grant A, Lackritz E, Romero R, Satten GA, Simhan H, Torres AR, Westover JB, Yolken R, Williamson DM.


        Genetic Disease Screening Program, California Department of Public Health, 850 Marina Bay Parkway, Richmond, CA 94804, USA. marty.kharrazi (at)


        Very preterm birth (VPTB) is a leading cause of infant mortality, morbidity and racial disparity in the US. The underlying causes of VPTB are multiple and poorly understood. The California Very Preterm Birth Study was conducted to discover maternal and infant genetic and environmental factors associated with VPTB. This paper describes the study design, population, data and specimen collection, laboratory methods and characteristics of the study population.

        Using a large, population-based cohort created through record linkage of livebirths delivered from 2000 to 2007 in five counties of southern California, and existing data and banked specimens from statewide prenatal and newborn screening, 1100 VPTB cases and 796 control mother-infant pairs were selected for study (385/200 White, 385/253 Hispanic and 330/343 Black cases/controls, respectively).

        Medical record abstraction of cases was conducted at over 50 hospitals to identify spontaneous VPTB, improve accuracy of gestational age, obtain relevant clinical data and exclude cases that did not meet eligibility criteria. VPTB was defined as birth at <32 weeks in Whites and Hispanics and <34 weeks in Blacks. Approximately 55% of all VPTBs were spontaneous and 45% had medical indications or other exclusions. Of the spontaneous VPTBs,

        While the current focus of the California Very Preterm Birth Study is to assess the role of candidate genetic markers on spontaneous VPTB, its design enables the pursuit of other research opportunities to identify social, clinical and biological determinants of different types of VPTB with the ultimate aim of reducing infant mortality, morbidity and racial disparities in these health outcomes in the US and elsewhere.

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