Researcher’s $1.2 million grant funds efforts to reduce prevalence of preterm birth

A scientist at Case Western Reserve University School of Medicine has been awarded a $1.2 million grant to develop a therapy to reduce the prevalence of premature births, which today affect more than 15 million newborns worldwide each year.

Sam Mesiano, associate professor of reproductive biology, will use the grant to learn more about the mechanisms by which the hormone progesterone sustains pregnancy and blocks labor. He and his team will explore how the natural pro-gestation actions of progesterone can be exploited therapeutically to prevent preterm labor and premature birth.

The ultimate goal of the work is to develop an affordable oral medication that carries a measurable positive effect on this devastating health outcome. In the United States alone, preterm births account for 12 percent of all deliveries, and cause the majority of lung disease, vision and hearing difficulties, and learning disabilities. Hospital care for premature infants costs more than $13 billion per year.

The award is part of the Preventing Preterm Birth initiative, a Grand Challenge in Global Health administered by the Global Alliance to Prevent Prematurity and Stillbirth (GAPPS), an initiative of Seattle Children’s. The initiative seeks to discover biological mechanisms that lead to preterm births and develop novel interventions to prevent them.

“GAPPS is excited to support Dr. Mesiano’s research because it will reveal critical information in the quest to prevent preterm birth,” said Craig E. Rubens, executive director of GAPPS. “Progesterone is already receiving attention as a therapy to prevent preterm birth, and the potential for learning more about how it works and then developing an oral medication means this project could make a significant impact in helping more pregnancies come to term.”

Mesiano’s collaborators include Gregory Tochtrop, associate professor of chemistry at Case Western Reserve, who will play a major role in developing novel progesterone-based compounds.

Preterm birth, defined as a live birth before the start of the 37th week of gestation, is a global socioeconomic problem. The World Health Organization reports that it is the second-leading cause of death for children under age 5, and causes 75 percent of neonatal mortality and morbidity.

Mesiano and his colleagues first will focus on further understanding how progesterone, a natural hormone produced by the placenta, affects the muscle of the uterus to prevent contractions. They hope to develop a treatment that targets progesterone’s natural relaxing qualities to block the contractions of labor.

Progesterone therapy is provided to some women to prevent preterm birth. However, the treatment is effective only in women with an increased risk for preterm birth (based on a previous preterm birth), or if the woman’s cervix is found by ultrasound at mid-gestation to be shorter than normal. Unfortunately, this represents only a small portion of women who experience preterm birth. Nonetheless, Mesiano and colleagues believe that progesterone-based compounds hold great promise to promote uterine relaxation and prevent preterm labor.