Roberto Romero, MD, Chief

The Perinatology Research Branch (PRB) conducts clinical and laboratory research in maternal and fetal diseases responsible for excessive infant mortality in the United States. The PRB focuses on mechanisms of disease responsible for premature labor and delivery, with particular emphasis on the role of subclinical intrauterine infection and inflammation. Prenatal diagnosis of congenital anomalies is also a major area of interest.

The NICHD awarded a contract and a lease to establish a facility and support the operations of the PRB in Michigan. The facility, housed at Hutzel Women's Hospital of Detroit, was delivered to NICHD in February 2005. It has access to a patient population with a high rate of pregnancy complications and brings to bear the academic resources of three major universities: Wayne State University, the University of Michigan, and Michigan State University. The PRB plans to develop strong collaborative relationships with the universities, which are all part of the Life Science Corridor established by the state of Michigan to attract and support research and development in the biomedical field. The PRB has been and will continue focusing on development of the physical plan, organization, and recruitment of support staff.

Premature birth is the leading cause of perinatal mortality and morbidity worldwide. The PRB has defined preterm labor as a syndrome and determined that at least 25 percent of all preterm infants are born to women with subclinical intrauterine infection. Moreover, the PRB has provided evidence that a substantial number of premature neonates are critically ill before birth. During 2006, research focused on the following: (1) elucidation of the transcriptional profile of the chorioamniotic membranes and uterine cervix in term labor; (2) the expression profile of genes involved in two mechanisms of preterm labor (progesterone suppression and intra-amniotic infection); (3) validation of a bedside rapid test to detect intra-amniotic inflammation; (4) molecular evolution of the mammalian placenta; and (5) investigation of biomarkers to predict and assess disease severity in preeclampsia.

Congenital anomalies are the second leading cause of perinatal mortality in the United States. Advances in imaging techniques have allowed in utero detection of many anatomical defects with ultrasound. The PRB has initiated a series of projects that use three-dimensional ultrasound to improve the detection of congenital anomalies and to assess fetal growth and development. The PRB has invested substantial effort in the development of techniques to improve prenatal diagnosis of congenital heart disease, which is the leading cause of death among fetuses with congenital anomalies. The PRB also explored the diagnostic potential of novel technological developments that allow real-time three-dimensional scanning of the fetus with two-dimensional matrix array transducers.