In February 2006, the March of Dimes awarded six new grants as part of its Prematurity Research Initiative (PRI). The body of work represented by these grants builds on previous basic research, some of it funded by the March of Dimes. For example, a gene-suppression strategy used in one of these projects derives from a startling discovery made in the late 1990s by a March of Dimes-supported scientist studying how genes work. Basic research can yield major breakthroughs in understanding preterm birth and other adverse birth outcomes, and makes possible the type of inquiry described below.
 

• Martin Kharrazi, MPH, PhD, a researcher with the Genetic Disease Branch of the California Department of Health Services. It has long been suspected that fetuses and/or placentas play a part, perhaps even a major part, in determining when birth occurs. Dr. Kharrazi is working to identify maternal and infant variations in genes that control inflammatory responses to infections. These variations may help to account for disparities in very preterm births (at less than 32 weeks of pregnancy) among Mexican Hispanics, non-Hispanic whites and African Americans. Such variations could be the basis for future predictive and preventive strategies.
  
• Charles J. Lockwood, MD, professor and chairman of the Obstetrics, Gynecology and Reproductive Sciences Department, Yale University School of Medicine. Placental abruption is a condition in which the placenta separates from the wall of the uterus, partially or completely, before delivery. If this happens, the baby can be deprived of oxygen and nutrients, and the mother can experience life-threatening bleeding. Dr. Lockwood is exploring the concept that placental abruption might lead to preterm delivery by changing how the uterus responds to the hormone progesterone and other factors. The ultimate goal is to devise hormonal treatment to prevent the 40% of preterm deliveries that are associated with abruption and uterine bleeding.
  
• Errol R. Norwitz, MD, PhD, associate professor in the Obstetrics, Gynecology and Reproductive Sciences Department, Yale University School of Medicine. Dr. Norwitz is working to identify genetic mechanisms and variations in how the uterus responds to progesterone. These factors could predispose some women to spontaneous preterm labor and delivery. This research could lead to better ways of prediction and prevention. 
  
• Johnny R. Porter, PhD, professor of physiology, medicine, and pharmacology in the Physiology Department at Louisiana State University Health Sciences Center. Maternal gum disease is linked to preterm delivery, but whether and how it actually causes prematurity is unclear, leaving doubt about how best to intervene. Dr. Porter is studying the cellular and molecular inflammatory pathways by which deep tooth and gum infections (periodontitis) may trigger preterm birth. This research could lead to new preventive interventions.
  
• Timothy Mark Frayling, PhD, senior lecturer of biomedical and clinical sciences at Peninsula Medical School, University of Exeter, in the United Kingdom. It has long been suspected that fetuses play a part, perhaps even a major part, in determining time of birth. But researchers have not systematically studied fetal genetics and preterm birth. Dr. Frayling is conducting a wide-ranging scan of maternal and infant genes in a search for gene variations that may predispose to preterm birth. He is using high-volume genetic technology to study a large number of mother-infant pairs. Medicine needs to better understand genetic factors in preterm birth in order to improve prediction and intervention.
  
• Jeffrey Andrew Keelan, PhD, MSc, senior lecturer at the Liggins Institute of the University of Auckland in New Zealand. Dr. Keelan is exploring the effectiveness and safety of two forms of treatment to prevent preterm birth: (1) conventional anti-inflammatory drugs and (2) a dramatically new approach that enables targeted suppression of specific genes, such as those involved in inflammatory processes.
  
  February 2006