New Testing Strategy During Pregnancy Cuts Neonatal Mortality Risk

Testing seemingly low-risk pregnant individuals for increased risk of spontaneous preterm birth and treating them based on the results effectively reduces neonatal morbidity and mortality, a new study has found.

Preterm birth, defined as any birth before 37 weeks’ gestation, is the leading cause of illness and death in newborns. Researchers are searching for ways to better prevent preterm birth and improve maternal and infant outcomes as a result — and they may have found one.

That’s according to a new study published in Diagnostics, which found that screening clinically low-risk pregnancies using a validated maternal blood biomarker test for spontaneous preterm birth risk, followed by providing preventive treatments to those screening positive, does in fact improve neonatal outcomes.


The test, provided by Sera prognostics and called the PreTRM® Test, can be used between weeks 18 and 20 of pregnancy by doctors to measure and analyze proteins in the blood that are highly predictive of preterm birth.

To confirm that the test would in fact improve newborn health outcomes, researchers conducted the AVERT PRETERM TRIAL on 1,463 expectant mothers at ChristianaCare Hospital in Delaware.

The participants were screened for preterm birth risk in mid-pregnancy, and those found to be at higher risk were offered interventions including care management, more intensive education, and medications such as vaginal progesterone and low-dose aspirin.

Their results were compared with those from approximately 10,000 patients who had given birth in the two-year period before the trial enrollment began.

The researchers found that those who were screened and treated when necessary saw an 18% reduction in severe neonatal morbidity and mortality, a seven-day reduction in mean neonatal hospital length of stay, and an increased average gestational age at birth before 32 weeks of 2.48 weeks.

The test and treatment method also yielded a 28-day reduction in neonatal length of hospital stay for babies born before 32 weeks’ gestation, reducing time spent in the hospital for those at risk of earliest delivery.

The test and treat strategy was associated with a significant reduction in neonatal morbidity and mortality, and hospital and NICU length of stay in the entire intent-to-treat population.

It was also linked to decreased odds of preterm birth and spontaneous preterm birth at various gestational ages at birth, and an average NICU length-of-stay reduction of 0.6 days per pregnancy across all pregnancies tested.


According to the 2023 March of Dimes Report Card, more than one in 10 infants was born prematurely in the United States consistently for the past five years. Premature birth is associated with a significantly increased risk of major long-term medical complications, including learning disabilities, cerebral palsy, chronic respiratory illness, intellectual disability, seizures, and vision and hearing loss.

The study authors conclude: “Our results suggest that universal screening and treatment to prevent PTB complications amongst women lacking traditional clinical risk factors is an effective strategy.”


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