Silent infections may play role in preterm birth

Every day, 1,500 babies in the United States are born too early, according to the March of Dimes. Even babies born just a few weeks too soon can face serious health problems and are at risk of lifelong disabilities, such as cerebral palsy, blindness and hearing loss.

“Preterm birth is a major health problem,” says Indira Mysorekar, PhD, assistant professor of obstetrics and gynecology at Washington University School of Medicine in St. Louis. “Little is known about the mechanisms of birth, and even less is known about what causes preterm birth.”


Mysorekar is a recipient of a four-year grant from the Burroughs Wellcome Fund. The grant is one of five nationwide that will explore the biological mechanisms and causes of preterm birth.

Mysorekar and a team of researchers at the School of Medicine are studying asymptomatic infections in the placenta and uterine lining to see if they may play a role in preterm birth.

Specifically, the scientists are looking for new mechanisms by which microorganisms are harbored in these tissues and potentially induce women to deliver babies before 37 weeks.

Mysorekar, who studies recurrent urinary tract infections (UTIs), has determined that bacteria hiding in the bladder lining can cause recurrent UTIs.

She will bring her expertise on the urinary tract to bear on similar issues in the placenta and uterine lining.

“I decided to see if bacteria during pregnancy could act in a related way and trigger preterm birth,” Mysorekar says.

Mysorekar will be working with a team of other experts on this initiative, including George Macones, MD, the Mitchell and Elaine Yanow Professor and chair of the Department of Obstetrics and Gynecology, an expert in the prediction and prevention of preterm birth; D. Michael Nelson, MD, PhD, the Virginia Lang Professor of Obstetrics and Gynecology, who researches how human placental dysfunction contributes to abnormal pregnancy outcomes; Herbert “Skip” Virgin, MD, PhD, the Mallinckrodt Professor and chair of the Department of Pathology and Immunology, who directs a Center for Pathogen Discovery to identify new pathogens.

“Preterm birth is the most pressing issue in perinatal medicine, and we have made little progress over the past 20 years in understanding its etiology,” Macones says. “Indira Mysorekar brings a fresh perspective and brilliant mind to this issue, and I think this research will be a major contribution.”

Others involved in the project include Jenifer Allsworth, PhD, assistant professor in obstetrics and gynecology, who studies the epidemiology of bacterial vaginosis and its association with preterm birth; David Hunstad, PhD, assistant professor of pediatrics and of molecular microbiology, an expert on how some bacteria modulate elements of host immunity using both in vivo and in vitro models of infection; and Jeffrey Henderson, MD, PhD, assistant professor of medicine, of molecular microbiology, who uses mass spectrometry in the Center for Women’s Infectious Disease Research to identify pathogen-associated secondary metabolites in patient samples.