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。伴随着这个基础设施的是一个庞大的产科人口。他们为包括母胎医学网络在内的多个多中心临床试验小组作出了重大贡献。他们现在与Christian Care Health Systems，Inc.一起申请加入绝产网络。罗纳德·瓦普纳医学博士在参与临床研究方面有着卓越的记录，并将成为这一应用的PI。该中心不仅提供成为一名成功参与者所需的临床属性，还为该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非凡专业知识。一个概念提案描述了一种算法的发展，以量化早产患者的早产风险提供。这项研究特别评估了母婴炎症/感染途径对早产的影响，并调查了基因、种族、细胞因子水平、环境暴露和人口因素之间的相对作用和相互作用，建议增加早产。 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(PTB)的比率持续上升，成为导致胎儿死亡和长期发病率的最大原因。在美国，大多数肺结核患者是没有早产或早产的妇女。因此，从公共卫生的角度来看，只有针对分娩第一个婴儿的妇女的风险因素，才能降低肺结核的总体发病率。

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.