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QUS Technology for Identifying At-Risk Women for Spontaneous Preterm Birth

用于识别有自然早产风险的女性的 QUS 技术

基本信息

批准号：
10199613
负责人：
BARBARA L MCFARLIN
金额：
$ 25.34万
依托单位：
UNIVERSITY OF ILLINOIS AT CHICAGO
依托单位国家：
美国
项目类别：
财政年份：
2020
资助国家：
美国
起止时间：
2020-08-01 至 2021-07-31
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/10199613
关键词：
37 weeks gestation Address Adult Adverse event African American American College of Obstetricians and Gynecologists Basic Science Beds Birth Blood Pressure Cardiomyopathies Cardiovascular system Caring Cervical Cervix Incompetence Cervix Uteri Cessation of life Cities Clinical Complex Control Groups Data Developed Countries Diabetes Mellitus Diagnosis Early Diagnosis Education Electrocardiogram Etiology Event Family Family member Fatigue Fetal Monitoring Fetus Goals Guidelines Health Health Personnel Heart Diseases Heart Rate Heart failure Hispanics Home environment Hospitalization Hospitals Hypertension Hypertensive Crisis Incentives Incidence Individual Infant Infection Intervention Length Life Live Birth Maternal Mortality Measures Medical Methods Monitor Morbidity - disease rate Mothers Myocardial Infarction Not Hispanic or Latino Obesity Physiologic Monitoring Physiological Pilot Projects Postpartum Period Postpartum Women Pregnancy Premature Birth Premature Labor Progestins Pulse Oximetry Quality of life Research Research Proposals Respiration Resuscitation Risk Risk Assessment Screening procedure Signal Transduction Signs and Symptoms Sleep Deprivation Societies Stress Survivors Syndrome System Technology Temperature Testing Time Translations Ultrasonography United States Visit Wireless Technology Woman Women&apos s Group attenuation cardiovascular risk factor clinical care clinical practice cost disparity reduction effectiveness validation experience heart rate variability high risk improved innovation intrapartum maternal morbidity mortality multidisciplinary nanomembrane novel postpartum care prevent preventable death programs prospective public health relevance quantitative ultrasound recruit sensor social trend

项目摘要

This proposed research will refine and prospectively validate the effectiveness of quantitative ultrasound (QUS) technology [QUS parameters: cervical ultrasound attenuation coefficient (ATTEN), cervical ultrasound backscatter coefficient (BSC)], when compared to ultrasound (US)-estimated cervical length (CL), to identify women at risk for spontaneous preterm birth (sPTB). Preterm birth (PTB) is defined as birth before 37 completed weeks' gestation (wks GA). Annually in the U.S., more than 440,000 infants are born preterm, and over 80,000 are born very preterm (prior to 32 wks). Consequences of PTB for survivors are severe, can be life-long and cost society $30 billion annually, a cost that far exceeds that of any major adult diagnosis. Predicting women at risk for sPTB has been medically challenging due to: 1) lack of signs and symptoms of preterm labor until intervention is too late, and 2) lack of sufficiently sensitive screening tools to signal sPTB risk early enough when an intervention would likely be effective. Spontaneous preterm labor is a syndrome associated with multiple etiologies of which only a portion may be associated with cervical insufficiency; however, regardless of the etiology of PTB, the cervix must remodel for passage of the fetus. Novel QUS technology has been developed by our multidisciplinary investigative team and shows promise for becoming a widely available and useful method for early detection of sPTB. QUS technology is a feature that can readily be added to current clinical ultrasound systems, thereby reducing the time from basic science innovation translation to improve clinical care of women. Our pilot studies show that women who experienced sPTB have a significantly lower ATTEN at 20 wks GA (relative to full-term women at 20 wks), and ATTEN at 20 wks more accurately predicts sPTB than CL at 24 wks. When both ATTEN and CL measures are combined, sPTB prediction is improved. Our goals are to identify: 1) women at risk for sPTB earlier and with better accuracy than with CL alone, and 2) differences between women who do/do not respond to progestogen therapy. To achieve these goals, we propose to quantify ATTEN, BSC & CL at two time points (20±2 & 24±2 wks GA; each exam separated by 4 wks) to identify individuals at greatest risk of sPTB. Our pilot data identified 20±2 wks to be sensitive to ATTEN differences and 24±2 wks to be sensitive to CL differences. Three groups of women will be recruited: 1) prior sPTB, 2) short CL at 20 wks, and 3) low-risk control group. Central hypothesis: Cervical ATTEN & BSC (alone or combined) at 20±2 wks are better than CL at 24±2 wks for detecting risk of sPTB; further, ATTEN, BSC & CL at 20±2 & 24±2 wks, when combined, are even better for detecting risk of sPTB.

本研究将完善并前瞻性地验证定量的有效性