January 24, 2014

Probing mysteries of preterm birth

Understanding the relationship between the thinning and rupture of fetal membranes and the presence of bacteria could lead to treatment and prevention strategies for premature birth.


Complications of preterm birth – before 37 weeks of gestation – are complex and costly. Nearly one-third of all preterm births are associated with preterm premature rupture of membranes (PPROM).

To advance the understanding of PPROM, Kimberly Fortner, M.D., assistant professor of Obstetrics and Gynecology, and colleagues examined membrane thinning and the presence of bacteria in membrane samples from women who had just given birth and had PPROM, preterm birth for other reasons or full-term birth. The researchers found that the chorion (the fetal membrane outer layer) was thinner at the site of rupture compared to a distant site in all groups, and that PPROM samples had more pronounced thinning overall. They also detected the presence of bacteria in all samples, with the highest bacterial counts in PPROM, and they demonstrated that thinner chorion is associated with increased bacterial presence.

The findings, published Jan. 8 in PLOS ONE, suggest a relationship between bacterial presence, membrane thinning and membrane rupture. Improved understanding may lead to new treatments and ultimately prevention strategies for preterm birth.

This research was supported by the Charles Hammond Foundation and the M. Krzyzewski Family.

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