Identifying women who are at a higher risk of premature birth allows medical professionals to adopt measures to prevent it during prenatal care. This could include, for example, administering medications, such as corticosteroids, to improve the maturity of the fetus’ lung, hormones, such as progesterone, and the insertion of the pessary, a silicone ring designed to decrease the possibility of a premature birth by closing the cervix. The information would also provide reassurance to low-risk, pregnant women, in addition to reducing public health expenses associated with prematurity.
Cecatti’s team was part of an international consortium called SCOPE (Screening of Pregnancy Endpoints) to understand common pregnancy complications, including spontaneous prematurity. The Brazilian study was based on an international study that tested the blood samples of almost 6,000 pregnant women taken at the 15th and 20th weeks of gestation for women from Auckland, New Zealand, and Cork, Ireland. The analysis used metabolomics techniques — the study of metabolites, substances and biological markers — to elucidate the mechanisms involved in spontaneous premature delivery. For example, researchers identified alkanes (compounds derived from paraffin) as associated with premature birth.
Using the same technology and methodology as in the international study, the research also collected blood and hair samples from 1,180 Brazilian pregnant women from Campinas, Botucatu, Porto Alegre, Recife and Fortaleza during the 20th week of pregnancy. Hair was collected because it may contain information (metabolites) that correspond to the woman’s metabolism and biological status, ranging from the period when they were collected to months prior, at the beginning of pregnancy or possibly even before. In addition, the hair strands do not need to be refrigerated and they do not require major requirements for conservation, which eliminates costs.
This collection had two objectives: to create a large biobank and to validate the results observed in international samples, identifying specific metabolites and substances present in pregnant Brazilian women, since some of them are related to the environment in which the women live. Now that they are collected, these substances could also be used in other studies involving the development of biomarkers for several other conditions identified during pregnancy.
The researchers followed each of these women to assess not only the occurrence of premature birth, but also the development of syndromes related to high blood pressure (pre-eclampsia), restrictions to fetal growth and gestational diabetes mellitus. Thus, it will be possible to investigate the factors related to the so-called “Great Obstetric Syndromes” in the Brazilian population.
