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A typical pregnancy lasts 40 weeks, but for about 1 in 10 pregnant women labor begins too soon. Premature or preterm birth is the leading cause of newborn deaths worldwide. Yet doctors have struggled to understand why preterm birth occurs—or how to predict which pregnancies are at highest risk.

Now, researchers at UC San Francisco have discovered antibodies that play a role in triggering early labor. The antibodies were present in higher levels and appeared earlier in pregnancy in women who went on to give birth to their babies before 37 weeks' gestation compared to women who delivered their babies at term.

The research was published in Nature Immunology and carried out using a new immune profiling tool built at UCSF. It could lead to both new ways of screening for preterm birth risk and new interventions to stop it.

"We built our tool to find exactly these kinds of hidden immune signals," said Joe DeRisi, the Gordon M. Tomkins professor of biochemistry and biophysics at UCSF and senior author of the new work. "The fact that it's pointing us toward why some pregnancies go wrong is an exciting result."

Every pregnancy presents a puzzle for the human immune system: a fetus is not genetically identical to a mother, yet her body must not reject it. In most cases, the immune system knows not to attack.

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