Preterm labor and delivery represent a major health problem in the United States and around the world. Recent statistics indicate that the rate of preterm births has not changed over the past 10 years, in spite of efforts to address this problem. The rate of preterm birth has remained at approximately 8 percent to 10 percent of all deliveries. Although approximately 30 percent of preterm deliveries are associated with maternal infection, the larger fraction of preterm births are idiopathic. Preterm infants account for 70 percent of our neonatal mortality, and the estimated cost for the care of premature infants is approximately billion dollars annually. A number of therapeutic agents have been applied as treatments for preterm labor, and success has limited and associated with potential health consequences to mother and infant. No therapy is effective in allowing pregnancies to reach term. Success is relative, and includes the benefit of delay of delivery for only a few days to initiate appropriate steroid therapy. To a large degree this failure of therapeutics reflects our incomplete understanding of the regulation of human labor. This proposal presents a novel approach to address control of preterm labor based on recent new insights into the human-specific aspects of labor.
