Using RNA to predict preterm birth

Preterm birth, or when a baby is born before 37 weeks of pregnancy, affected one out of every 10 infants born in the United States in 2020, with Black women disproportionately likely to be at risk.  

Preterm birth and low birth weight can lead to health complications, including breathing and feeding difficulties – which makes early detection especially important. Recently, a study in the American Journal of Obstetrics and Gynecology signaled the potential for using RNA messages to predict preterm birth among individuals.  

Dr. Michal Elovitz, chief medical advisor at the Mirvie pregnancy health platform and the Hilarie L. Morgan and Mitchell L. Morgan President’s Distinguished Professor in Women’s Health at the Perelman School of Medicine at the University of Pennsylvania, sat down with Healthcare IT News to discuss the study, what’s next in terms of clinical trials and why being able to predict pregnancy complications is so important.  

Q. Could you tell me a bit about the AJOG study, and what it signifies for Mirvie?  

A. This study shows the Mirvie RNA platform has the potential to transform how we detect, prevent, and treat preterm birth. The results show the platform predicts preterm birth months in advance and identifies distinct pathways driving its development. This breakthrough enables tailoring existing interventions to patients based on their unique biology and allows the development of new interventions directly targeting distinct causes of preterm birth.  

This research shows that the platform can predict 76% of early preterm birth cases (less than 35 weeks) associated with premature cervical remodeling, two months in advance on average. We also identified distinct RNA messages involved with amino acid metabolism and insulin-like growth factor pathways predicted cases of extremely premature birth (less than 25 weeks).   

These results build on a diverse, large, and global collaborative study recently published in Nature that shows the Mirvie RNA platform can predict 75% of preeclampsia cases, another common pregnancy complication, months in advance.  

Q. Given the relatively small sample size of the study, what’s next in terms of research?  

A. Mirvie is currently conducting ongoing clinical research to validate existing peer-reviewed evidence, enhance the Mirvie RNA platform performance, and improve the understanding of other pregnancy complications. Our team consults leading physician-scientists from academia and community providers to advance pregnancy health and bridge long-standing gaps between researchers, providers and patients.  

Q. How does the RNA platform work? How could clinicians best utilize it?  

A. It’s very important that simple blood tests developed using the RNA platform work for all women, regardless of assumed risk. For too long, unreliable and, at times biased, clinical factors such as race, BMI, and maternal age have been used to determine a pregnant person’s risk.  

The Mirvie RNA platform combines revolutionary analysis of tens of thousands of RNA messages from the fetus, the placenta and the mom with machine learning. It identifies patterns in RNA that reveal the underlying biology of pregnancy health. These RNA profiles allow the detection of pregnancy complications well before they occur.   

Q. Why is it so important to be able to predict preterm birth?  

A. Clinicians still rely on generalized risk assessments based on prior obstetrical history or clinical factors such as weight and race to help determine if a pregnant individual will develop a complication. However, these traditional methods fail to identify 80% of complications until symptoms appear.  

This severely limits our ability to address this complex condition and reduce its devastating burden on moms and babies because we cannot tailor existing interventions to patients based on their unique biology or develop new interventions directly targeting the distinct causes of preterm birth.  

Q. What are you excited about with regard to the future of the platform?  

A. For the first time in history, research using this platform can reveal a fundamental understanding of the underlying biology of each unique pregnancy. It opens a new window into pregnancy health for women to act and their doctors to intervene before pregnancy complications like preterm birth or preeclampsia become a crisis. This can enable proactive, preventive, and personalized pregnancy care for the health of millions of moms and babies.  

This interview has been lightly edited and condensed for clarity.

Kat Jercich is senior editor of Healthcare IT News.
Twitter: @kjercich
Email: [email protected]
Healthcare IT News is a HIMSS Media publication.

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