Abstract
BackgroundPreterm birth is the leading cause of perinatal morbidity and mortality. Risk factors for preterm birth include a personal or familial history of preterm delivery, ethnicity and low socioeconomic status yet the ability to predict preterm delivery before the onset of preterm labour evades clinical practice. Evidence suggests that genetics may play a role in the multi-factorial pathophysiology of preterm birth. The All Our Babies Study is an on-going community based longitudinal cohort study that was designed to establish a cohort of women to investigate how a women's genetics and environment contribute to the pathophysiology of preterm birth. Specifically this study will examine the predictive potential of maternal leukocytes for predicting preterm birth in non-labouring women through the examination of gene expression profiles and gene-environment interactions.Methods/DesignCollaborations have been established between clinical lab services, the provincial health service provider and researchers to create an interdisciplinary study design for the All Our Babies Study. A birth cohort of 2000 women has been established to address this research question. Women provide informed consent for blood sample collection, linkage to medical records and complete questionnaires related to prenatal health, service utilization, social support, emotional and physical health, demographics, and breast and infant feeding. Maternal blood samples are collected in PAXgene™ RNA tubes between 18-22 and 28-32 weeks gestation for transcriptomic analyses.DiscussionThe All Our Babies Study is an example of how investment in clinical-academic-community partnerships can improve research efficiency and accelerate the recruitment and data collection phases of a study. Establishing these partnerships during the study design phase and maintaining these relationships through the duration of the study provides the unique opportunity to investigate the multi-causal factors of preterm birth. The overall All Our Babies Study results can potentially lead to healthier pregnancies, mothers, infants and children.
Highlights
Preterm birth is the leading cause of perinatal morbidity and mortality
Preterm birth is often categorized as (1) iatrogenic when delivery is a consequence of medical intervention (3035%); (2) spontaneous when it occurs after spontaneous labour with intact membranes (40-45%); or (3) the result of preterm premature rupture of the membranes (PPROM) (25-30%) [3]
Preeclampsia and intrauterine growth restriction have all been associated with iatrogenic preterm birth, the underlying causes of spontaneous preterm birth are less clear
Summary
Preterm birth is the leading cause of perinatal morbidity and mortality. Risk factors for preterm birth include a personal or familial history of preterm delivery, ethnicity and low socioeconomic status yet the ability to predict preterm delivery before the onset of preterm labour evades clinical practice. Evidence suggests that genetics may play a role in the multi-factorial pathophysiology of preterm birth. Reported risk factors are widespread and diverse, supporting the hypothesis of gene-gene and gene-environment interactions in the pathophysiology of spontaneous preterm birth. Associated risk factors include a previous preterm birth or a relative with preterm birth [10] or a black racial background [11], suggesting genetic causes. Other demographic factors such as low socioeconomic status [12] and maternal stress [13] have shown an association, indicating that the environment contributes to the etiology of spontaneous preterm birth
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