“Premature birth is the No. 1 enigma in medicine, and the No. 1 predictor of future illness,” says Prof. Eyal Shiner, though he may have a bias, given his devotion to preventing preterm birth. Now, an empirical study – not based on subjective interviews, but on hard data over three generations – has unexpectedly found that not only does the birth mother’s personal history and that of her mother affect the probability of premature birth; so does the medical history of the birth mother’s aunt.
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“Unfortunately, we don’t know what causes premature birth,” Shiner tells Haaretz. There are myriad possible causes. Premature birth could stem from the mother’s state of health; the state of her uterus and/or cervix (some are incompetent to sustain pregnancy); a problem with the child; inner-city habits such as drugs and smoking; uncontrolled diseases or, for that matter, bad habits; a malformed uterus. The list is endless, but Shiner observes that the “most-known risk factor is multiple births, twins, etc.”
One line of defense, therefore, is to elucidate the probability of premature birth and brace. And now, it turns out, there’s value in obtaining a broader family medical history.
It had been known that women born prematurely themselves are more likely to give birth prematurely.
“If a patient is delivering for the first time, the risk of preterm labor is about 7 percent,” says Shiner. If she had a previous preterm pregnancy, the risk rises to 15 percent, and if she unfortunately delivered preterm twice, the risk jumps to 30 percent.”
Also, the case files showed that if the mother was born prematurely herself, she has a 34 percent higher chance of having a premature birth. And if her aunt gave birth prematurely, her risk is 30 percent higher. That’s an item never noticed before.
The findings do not necessarily mean that the cause of premature birth is genetic: it could still be environmental, shared risk factors, and the like.
The study – a joint endeavor by Soroka Medical Center, Clalit Heath Services and Ben-Gurion University of the Negev – examined case histories of 2,300 women and their mothers at Soroka over a 22-year period.
“Premature” is defined as a birth before the start of the 37th week of pregnancy.
The team conducting the study included Shiner and Dr. Yoni Sherf of Soroka Medical Center, partnered with professors Natalya Bilenko, Ilana Shoham-Vardi and Ruslan Sergienko at Ben-Gurion University.
The conclusion from this thinking outside the box and seeking new correlations is clear: women with these risk factors should undergo close monitoring to try to prevent the early birth, which is a leading cause of infant hospitalization and death. And absent data on the mother and grandmother, data on the aunt will do.