In 2008, the March of Dimes invested $26.8 million in research to prevent birth defects, premature birth and infant mortality. Areas of investigation included basic biological processes of development, genetics and prevention of premature birth.
What triggers uterine contractions to begin at term or preterm remains poorly understood. Sarah K. England, PhD, a March of Dimes Prematurity Research Initiative (PRI) grantee at the University of Iowa, believes the key may lie in tiny “holes-in-the-wall” of cell membranes (called SK3 channels) that allow potassium to flow out of uterine muscle cells. When potassium exits the cells, the uterus relaxes, allowing the pregnancy to continue to term. At term, channels may close, prompting labor to begin. Dr. England aims to learn “how these holes-in-the-wall can get the uterus to relax when a woman has preterm labor,” in order to develop a drug to open the channels and prevent or treat preterm labor.
Does heredity contribute to premature birth? Yes for the mother, and no for the father, according to a study by March of Dimes PRI grantee Louis Muglia, MD, PhD, of Vanderbilt University in Nashville. Dr. Muglia’s study found that a mother’s genes contribute as much as a third of the variation in timing of delivery. But which genes are involved? Another PRI grantee, Siladitya Bhattacharya of the University of Aberdeen in Scotland, is studying birth timing in grandmothers, mothers and daughters, to see if going back through the generations may help identify a genetic basis for premature birth. The goal is to develop tests that identify high-risk women, allowing treatment to prevent premature delivery.
Babies born just a few weeks too soon are more than three times as likely to have cerebral palsy than full-term infants, according to a March of Dimes study. These results are surprising because, until recently, any problems seen in late preterm babies (born between 34 and 36 weeks of pregnancy) were considered mild and temporary. Late preterm babies account for more than 70 percent of all premature births. Because the last few weeks of pregnancy are critical to a child’s health and development, it’s best for a pregnant woman to stay pregnant for at least 39 weeks, unless there are medical reasons for early delivery.
March of Dimes grantee Rodney E. Kellems, PhD, Yang Xia, MD, PhD, and colleagues at the University of Texas-Houston Medical School reported in Nature Medicine that they had discovered a treatment to prevent preeclampsia in mice. This pregnancy-related form of high blood pressure affects about 5 percent of pregnant women, sometimes resulting in serious complications for mom and baby. The cause is unknown, and the only cure is to deliver the baby — often prematurely. The investigators found that certain immune system substances can trigger preeclampsia in mice, and drug treatment can prevent it. What’s next? An effective treatment for pregnant women that also can prevent premature births.
In 2008, the March of Dimes invested $26.8 million in research to prevent birth defects, premature birth and infant mortality. Areas of investigation included basic biological processes of development, genetics and prevention of premature birth. 
What Triggers Labor?
