Prevention of Preterm Birth in high Risk Nulliparous Patients

描述：哥伦比亚大学母胎医学部拥有活跃和成功的临床研究基础设施。与这些基础设施相结合的是大量的产科人口。他们为包括母胎医学网络在内的多个多中心临床试验组做出了重大贡献。他们现在正在与克里斯蒂安娜保健健康系统公司一起申请加入无生育网络。Ronald Wapner，医学博士在临床研究参与方面有着卓越的记录，并将担任该申请的PI。该中心不仅提供成为成功参与者所需的临床特征，而且还为网络带来了公共卫生，流行病学，遗传学和表观遗传学，胎盘病理学和超声波方面的卓越专业知识。一个概念提案描述了一种算法的发展，以量化早产风险的产妇提供。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，并调查了基因型、种族、细胞因子水平、环境暴露和可能增加早产的人口统计学因素之间的相对作用和相互作用。

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.