Recently, scientists at the Massachusetts Institute of Technology (MIT) have found a new way to predict the risk of preterm birth. They found subtle differences in cervical mucus in preterm low-risk pregnant women and confirmed that the risk of preterm birth can be predicted by analyzing cervical mucus in pregnant women. This latest study is expected to provide doctors with effective information to intervene early and avoid premature birth.
More than 18% of babies worldwide are premature (born less than 37 weeks of gestation), many of whom died during the neonatal period, and many face obstacles including vision, hearing loss, heart or lung defects. Disability. At present, there is no reliable method for predicting preterm birth in medicine.
Now, scientists at the Massachusetts Institute of Technology (MIT) have found a new way to break the gap. They found subtle differences in cervical mucus in preterm low-risk pregnant women and confirmed that the risk of preterm birth can be predicted by analyzing cervical mucus in pregnant women. This latest study is expected to provide doctors with effective information to intervene early and avoid premature birth.
Katharina Ribbeck, associate professor of bioengineering at MIT, collaborated with Michael House, an associate professor at Tufts University School of Medicine, to complete the study. The results of the study were published in the journal Scientific Reports on September 4.
Cervical mucus
Cervical mucus is secreted by the cervical mucosal gland cells and is a glycoprotein gel. The composition and arrangement of the main constituent molecules, glycoprotein, determine the porosity of the gel. The state of mucus is affected by various ovarian hormones.
As early as 2013, Ribbeck and the team have found that pregnant women with high risk of preterm birth have weaker defensive and less elastic cervix than normal pregnant women. 25-40% of preterm births are thought to be associated with infection of microorganisms through the cervix into the uterus, and the occurrence of this infection is related to mucus, which is normally responsible for preventing pathogens from entering the uterus.
Now, she and the team decided to delve into the molecular and functional properties of mucus. They recruited two groups of pregnant women—low-risk groups (people who received routine examinations and delivered after 37 weeks) and high-risk groups (pregnant women who gave birth in 24-34 weeks) and collected their cervical mucus as a sample.
First, they used a 1 micron diameter, negatively charged particle as the test material. By analyzing the ability of these particles to pass through the mucus, it was found that there were subtle significant differences in porosity between the two mucus samples. Subsequently, they performed the same test with a charged probe that was small enough to avoid being trapped in the mucus but sensitive to the biochemical modification of the mucus. Through these probes, the researchers found that there is a significant difference in permeability and adhesion between mucus. For mucus samples from high-risk women, the probe can be easily penetrated.
This suggests that cervical mucus in women at high risk of preterm birth is more susceptible to invasion by harmful microorganisms, which are more likely to cause preterm birth, for reasons that are still unclear. In addition, changes in cervical mucus tend to lose beneficial immune components, such as antibodies or antimicrobial peptides (these compounds help fight infection).
Ribbeck speculates that the decrease in viscosity is due to changes in the molecular structure of glycoproteins, particularly the number and type of sugar molecules.
Predicting preterm birth
Currently, the most common method for predicting the risk of preterm birth is to measure the length of the cervix, but although shortened cervix is ​​associated with a higher risk of preterm birth, in most cases, shortening of the cervix does not lead to preterm birth. Another routine test measures the level of fetal fibronectin (fFN, a matrix component outside the uterine chorion) in cervicovaginal secretions. However, this protein is not a very reliable test standard. Moreover, even if the length of the cervix and fetal fibronectin levels are normal, there are still premature births in pregnant women.
We don't have a universal detection technology for premature delivery. The pathophysiological mechanisms of preterm birth are extremely complex and often have individual differences. Ribbeck predicts that cervical mucus can be used early in pregnancy as part of regular screening to predict the risk of preterm birth in pregnant women (predicting risk based on microbial infections, unpredictable for other causes of preterm birth).
Errol Norwitz, president of the Department of Obstetrics and Gynecology at Tufts Medical Center, commented on the study and said that this innovative technology is important for solving the problem of premature birth prediction. Premature birth is one of the biggest problems facing children and infants in the world. We urgently need a way to predict risk and intervene in advance.
By studying changes in mucus composition and structure, Ribbeck hopes to find ways to restore the normal function of mucus. “If uterine mucus becomes thinner and less elastic, we can consider adding the necessary ingredients to improve its barrier properties,†explains Ribbeck.
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