All babies should have an equal chance in life.  

Preterm birth is a leading cause of infant death in Califormina, accounting for more than a third of all cases. Surviving preterm birth often face lifelong health challenges, including developmental delays, respiratory issues, and other complications.

Preterm birth also disproportionally affects Black women, who experience a rate 47% higher than all other women.

 

The PREMO (Premature Microbiome and Outcomes) initiative investigates how the early-life microbiome influences the development of preterm infants. By understanding why some preterm babies are predisposed to health complications during early development and in later childhood, PREMO aims to uncover opportunities for precision treatments and preventative measures in microbiome medicine to reduce negative outcomes.

Leadership

PREMO investigators are collaborating with the UCSF arm of the PROMPT (Prediction of MatuRity, MOrtality, and Morbidity of PreTerm Newborns) study (prompt.ucsf.edu) and the UCSF California Preterm Birth Initiative (PTBi-CA). PROMPT focuses on identifying clinical and molecular factors that predict maturity, mortality, and morbidity in preterm infants. By uncovering these factors and understanding their role during infancy and childhood development, PMORT aims to deliver actionable insights for personalized clinical care and precision-focused interventions.

This collaboration combines expertise from multiple fields to study preterm infant outcomes, with a focus on the interplay between microbiome health and metabolic disturbances. PREMO leadership includes Drs. Susan Lynch,  Tiffany Scharschmidt, and Joanna Halkias. UCSF PROMPT study leaders include Drs. Elizabeth Rodgers and Laura Jelliffe-Pawlowski.

Objectives

The PROMPT/PREMO partnership leverages ongoing PROMPT activities, including the development of a large, well-documented, and densely sampled cohort of preterm infants, the collection of clinical data, and the evaluation of short- and long-term outcomes. PROMPT also conducts detailed metabolic profiling of participating infants.

Through this collaboration, researchers aim to uncover  functional roles of both the microbiome and metabolism in driving adverse health outcomes during early development. These insights will pave the way for new therapeutic strategies to improve the health of preterm infants. The study also provides a centralized resource for future integrative research efforts at UCSF and creates training opportunities for graduate students and research fellows. 

Study Design

Initially, researchers will collect blood, stool, buccal, and skin samples from 100 mother-infant pairs throughout the neonatal developmental period. Additional studies include maternal vaginal swabs and breast milk samples. 

To gain broader insight, the PROMPT/PREMO study is being conducted in parallel with a related investigation at the University of Iowa. Next-generation technologies available through the Benioff Center for Microbiome Medicine (BCMM) CoLab Incubators support advanced data analysis.

Funding

This collaboration is made possible by funding from the following sources:

  • Marc and Lynne Benioff
  • NIH
  • NSF

 

Results

Enter The Microbiome Preterm Birth DREAM Challenge leveraged over 3,500 vaginal microbiome samples from approximately 1,300 pregnant individuals across multiple studies, including PREMO. This is the largest and most geographically diverse dataset of its kind. Based on key features in the microbiome composition, this dataset enabled machine learning models to predict preterm birth (<37 weeks of gestation) and early preterm birth (<32 weeks of gestation) with great accuracy. 

In recognition of its significance, the dataset was selected by the National Science Foundation (NSF) for inclusion in the National Artificial Intelligence Research Resource (NAIRR) Pilot program, one of the only 10 datasets chosen in a competitive process involving 12 federal agencies. This inclusion will expand access to the resource, fostering AI-driven research and multidisciplinary collaboration. The dataset, along with pregnancy-related omics data, is publicly available through the March of Dimes Prematurity Research Data Repository (https://pretermbirthdb.org).

Interested in this study? Want to participate?

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