Principal Investigator: Beena Kamath-Rayne, MD, MPH

In the past, fetal maturity testing has relied on amniocentesis, an invasive procedure, and provided information only on the maturity of the fetal lungs. However, the test has been shown to be unreliable because late preterm (34-<37 weeks) and early term (37-<39 weeks) newborns continued to be admitted to neonatal intensive care with other problems of prematurity, including poor feeding, apnea/bradycardia of prematurity, and need for thermoregulation, which were undetected by fetal maturity testing. Therefore, improved methods of fetal maturity testing are needed, especially those that can be performed in a less invasive manner, for example, by blood and urine.

This proposal outlines a research pipeline which will begin by identifying biomarkers of fetal maturity in amniotic fluid, which has a larger proportion of cell-free fetal RNA and DNA for analysis, making it a practical first step for biomarker discovery. Once the biomarkers are identified and correlated with neonatal outcomes (infants that do or do not have the neonatal morbidities), we will translate the identified markers or physiologic pathways in the blood and urine of pregnant women, thus leading to the development of improved tests for fetal maturity that do not require an invasive procedure such as amniocentesis. Our approach could then be applied to the discovery of other biomarkers of organ-related diseases in the fetus, monitoring of organ function in the fetus, prediction of fetal health during high-risk pregnancies, and other preterm birth risk factors.