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Dysregulated biomarkers induce distinct pathways in preterm birth
L Brou1, L M Almli, B D Pearce
1Department of Epidemiology, Rollins School of Public Health, Atlanta, Georgia, USA.
BJOG : an International Journal of Obstetrics and Gynaecology
|February 14, 2012
Summary
Racial disparities exist in biomarkers linked to spontaneous preterm birth (PTB). Fetal plasma biomarkers are key in European Americans, while maternal plasma biomarkers are crucial in African Americans, highlighting distinct PTB pathways.
Area of Science:
- Reproductive biology and perinatal medicine
- Biomarker discovery and analysis
- Racial health disparities
Background:
- Spontaneous preterm birth (PTB) is a leading cause of neonatal morbidity and mortality.
- Understanding the underlying pathophysiological mechanisms of PTB is crucial for developing targeted interventions.
- Racial disparities in PTB rates and outcomes are well-documented, suggesting potential differences in biological pathways.
Purpose of the Study:
- To investigate racial differences in biomarker concentrations in maternal plasma, fetal plasma, and amniotic fluid between African American and European American women experiencing spontaneous preterm birth (PTB) and normal term birth.
- To identify distinct pathophysiological pathways of PTB associated with these biomarker differences in each racial group.
Main Methods:
- A nested case-control study was conducted.
- Maternal and fetal plasma and amniotic fluid samples were collected from 105 PTB cases and 86 controls.
- Thirty-six biomarkers were analyzed using a protein microarray approach, with Ingenuity Pathway Analysis (IPA) used to determine dysregulated pathways.
Main Results:
- Significant racial disparities in biomarker concentrations were observed across all compartments (maternal plasma, fetal plasma, amniotic fluid).
- Specific biomarkers differed between cases and controls within each race and compartment; for example, fetal plasma biomarkers were more implicated in PTB for European Americans, while maternal plasma biomarkers were more relevant for African Americans.
- Inflammation and hematological functions were associated with PTB in European Americans, while maternal pro-inflammatory changes were dominant in African Americans.
Conclusions:
- Biomarker concentrations differ significantly between PTB cases and controls, with notable racial disparities in these profiles.
- Distinct pathophysiological pathways, involving different compartments and biomarker profiles, contribute to PTB in African American and European American women.
- These findings underscore the importance of considering race in understanding PTB and developing personalized prevention and treatment strategies.
