CellulaR Injury and Preterm Birth
CellulaR Injury and Preterm Birth
The goal of this study is to examine how cellular dysfunction can lead to preterm birth.
 Women with singleton pregnancies with spontaneous preterm labor, preterm premature rupture of
 membranes, and cervical insufficiency (20 to 36-6/7 weeks gestation), and term deliveries
 (greater than 38 weeks) will be enrolled. Medical/obstetric history and pregnancy outcomes
 will be recorded. Maternal blood, urine and cervical cells (enrollment); cord blood and
 placental biopsy (delivery) will be collected.
Despite improvements in prenatal care, preterm birth (PTB) remains a leading contributor to
 perinatal morbidity and mortality. Several genetic and environmental factors have been
 associated with spontaneous preterm birth, but the pathways by which these factors induce
 preterm delivery have not been defined. The March of Dimes CPR at the University of
 Pennsylvania was created to help elucidate the pathogenesis of preterm birth by bringing
 together a diverse team of investigators with expertise in preterm birth, cellular
 metabolism, genetics, mitochondrial functional analyses, genome, epigenome, and transcriptome
 profiling, integrated bioinformatics analyses, and microbiome research. The center will focus
 on addressing the interactions between bioenergetics, genetics, microbiome, abnormal cervical
 remodeling and placental dysfunction. Each one of these factors will be studied independently
 and in relation to the other factors. In order to study metabolic processes in relation to
 spontaneous PTB, a prospective case-control study will be performed. This study will involve
 women with singleton pregnancies with spontaneous preterm labor (PTL), preterm premature
 rupture of membranes (PPROM), and cervical insufficiency, between 20-0/7 and 36-6/7 weeks
 gestational age (cases), and women with term deliveries (38 to 41 weeks gestation, controls).
 The investigators will obtain information regarding the patients' pertinent past medical and
 obstetric histories, and the following specimens will be collected: maternal blood, maternal
 urine, and cervical epithelial cells at enrollment; and umbilical cord blood and placental
 biopsies at delivery. We will follow and record each of these patients' pregnancy outcomes.
Cases:

 Inclusion Criteria:

 -  18-45 years of age

 -  Singleton pregnancy between 20 0/7 and 36 6/7 weeks gestational age who is admitted
 with preterm labor or cervical insufficiency (greater than 2 cm dilation) or Preterm
 Premature Rupture of Membranes

 Exclusion Criteria:

 -  Multiple gestation

 -  Fetal chromosomal abnormality

 -  Major fetal anomaly

 -  Intra-uterine fetal demise

 -  Gestational hypertension/preeclampsia

 Controls:

 Inclusion Criteria:

 -  18-45 years of age

 -  Singleton pregnancy that delivers at term (38 to 41 weeks gestational age)

 -  Admitted to the hospital with spontaneous labor (regular contractions, cervical
 dilation) or spontaneous rupture of membranes

 Exclusion Criteria:

 -  Multiple gestation

 -  Fetal chromosomal abnormality

 -  Major fetal anomaly

 -  Intra-uterine fetal demise

 -  Intra-uterine growth restriction

 -  Gestational hypertension/preeclampsia

 -  Clinical chorioaminionitis

 -  Induction of labor

 -  Elective c-section