Prevention of Preterm Birth in high Risk Nulliparous Patients

描述：哥伦比亚大学的母胎医学部有一个积极和成功的临床研究基础设施。与这一基础设施相结合的是庞大的产科人口。他们为多个多中心临床试验小组做出了重大贡献，包括孕产妇胎儿医学网络。他们现在沿着与Christiana Care Health Systems，Inc.一起申请。参与无产网络的机会罗纳德Wapner，MD具有上级临床研究参与记录，将担任本申请的PI。该中心不仅提供成为成功参与者所需的临床属性，还为网络带来了公共卫生，流行病学，遗传学和表观遗传学，胎盘病理学和超声方面的卓越专业知识。提供了一个概念提案，描述了一种算法的发展，以量化未经产患者的早产风险。本研究专门评估了母体和胎儿炎症/感染途径对早产的影响，并研究了基因型、种族、细胞因子水平、环境暴露和人口统计学因素之间的相对作用和相互作用，这些因素可能会增加早产。 公共卫生相关性：早产一直被认为是现代产科最紧迫的挑战，早产率（PTB）持续上升，导致胎儿死亡和长期发病的单一最大原因。在美国，大多数PTB都是以前没有生育或以前分娩的妇女。因此，从公共卫生的角度来看，只有针对第一次分娩的妇女中的风险因素，才能降低PTB的总体发病率。

DESCRIPTION: Columbia University's Division of Maternal Fetal Medicine has an active and successful clinical research infrastructure. Coupled with this infrastructure is a large obstetrical population. They have made major contributions to multiple multicentered clinical trial groups including the Maternal Fetal Medicine Network. They are now applying along with Christiana Care Health Systems, Inc. for participation in the Nulliparous Network. Ronald Wapner, MD has a superior record of clinical research participation and will be the PI of this application. This center offers not only the clinical attributes required to be a successful participant but also brings the Network exceptional expertise in public health, epidemiology, genetics and epigenetics, placental pathology, and ultrasound. A concept proposal describing the development of an algorhithim to quantify preterm birth risk in nulliparous patients is provided. This study specifically evaluates the impact of the maternal and fetal inflammatory/infectious pathway on preterm birth and investigates the relative role and interactions between genotype, ethnic, cytokine levels, environmental exposures, and demographic factors suggested to increase preterm birth. PUBLIC HEALTH RELEVANCE: Prematurity has long been acknowledged as the most pressing challenge in modern obstetrics, and the rate of preterm birth (PTB) continues to rise resulting in the single largest cause of fetal mortality and long term morbidity. The majority of PTB in the US are to women with no prior birth or previous term births. Thus, from a public health perspective, the overall rate of PTB can only be lowered by targeting risk factors among women delivering their first babv.