2015
DOI: 10.1016/j.ajog.2015.06.011
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Cluster analysis of spontaneous preterm birth phenotypes identifies potential associations among preterm birth mechanisms

Abstract: Objective We sought to employ an innovative tool based on common biological pathways to identify specific phenotypes among women with spontaneous preterm birth (SPTB), in order to enhance investigators' ability to identify to highlight common mechanisms and underlying genetic factors responsible for SPTB. Study Design A secondary analysis of a prospective case-control multicenter study of SPTB. All cases delivered a preterm singleton at SPTB ≤34.0 weeks gestation. Each woman was assessed for the presence of … Show more

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Cited by 42 publications
(31 citation statements)
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“…The absence of maternal morbidity or any other related conditions in this cluster might indicate that sPTB due to spontaneous onset of labor or pPROM often are present without a background of maternal obstetric conditions, confirming the great challenge in recognizing the mechanisms that lead to preterm labor or pPROM. Esplin et al . performed a cluster analysis of 1028 women with PTB, reporting one cluster with a strong familial history of PTB that might have a genetic contribution based on insulin gene analysis.…”
Section: Discussionmentioning
confidence: 99%
“…The absence of maternal morbidity or any other related conditions in this cluster might indicate that sPTB due to spontaneous onset of labor or pPROM often are present without a background of maternal obstetric conditions, confirming the great challenge in recognizing the mechanisms that lead to preterm labor or pPROM. Esplin et al . performed a cluster analysis of 1028 women with PTB, reporting one cluster with a strong familial history of PTB that might have a genetic contribution based on insulin gene analysis.…”
Section: Discussionmentioning
confidence: 99%
“…Considering that growing evidence characterizes early birth as a syndrome preceded by diverse instigating biological pathways (Esplin et al, 2015; Myatt et al, 2012), we propose that clinical tools be developed to predict and prevent the instigating pathway (e.g., inflammation) as opposed to the shared syndromic features (e.g., cervical dilation, uterine contraction, membrane rupture). By mimicking a potential in vivo response to immune challenge, our measure of ex vivo IL-1β production may have potential to predict future risk for inflammatory early birth among African American women not yet experiencing signs and symptoms of labor.…”
Section: Discussionmentioning
confidence: 99%
“…The variation in the outcomes of clinical trials is a reflection of the heterogeneity of the mechanisms that lead to premature delivery. This heterogeneity was best demonstrated by Esplin et al who performed a cluster analysis of women who had a spontaneous preterm birth before 34 weeks 51 . They identified five major clusters representing different phenotypes of preterm birth that were characterized by maternal stress, premature rupture of membranes, familial factors, maternal comorbidities, and a multifactorial cluster that included infection, decidua hemorrhage and placental dysfunction 51 .…”
Section: -Ohpc In Women With a Short Cervical Lengthmentioning
confidence: 99%
“…This heterogeneity was best demonstrated by Esplin et al who performed a cluster analysis of women who had a spontaneous preterm birth before 34 weeks 51 . They identified five major clusters representing different phenotypes of preterm birth that were characterized by maternal stress, premature rupture of membranes, familial factors, maternal comorbidities, and a multifactorial cluster that included infection, decidua hemorrhage and placental dysfunction 51 . This novel approach has furthered our understanding of common pathways that may lead to preterm birth and can help provide a phenotyping guide for future clinical trial design.…”
Section: -Ohpc In Women With a Short Cervical Lengthmentioning
confidence: 99%