PREMO

All babies should have an equal chance in life.

Currently, more than a third of infant deaths in California are related to preterm birth, with surviving preterm babies often facing a lifetime of health complications.

Preterm birth also disproportionally affects Black women, where the rate is 47% higher than that of all other women.

PREMO (Premature Microbiome and Outcomes) investigations aim to develop a greater understanding of the role of the early-life microbiome in preterm infant development. In doing so, we can determine the role of the microbiome in influencing why some preterm babies are predisposed to health complications during early development and in later childhood. We believe this will pave the way for new precision treatments or preventative measures in microbiome medicine that will help to mitigate these outcomes.

Leadership

PREMO investigators are partnering with the UCSF arm of the PROMPT (Prediction of MatuRity, MOrtality, and Morbididty of PreTerm Newborns) study (prompt.ucsf.edu). PROMPT focuses on determining how clinical and molecular factors can be used to predict maturity, mortality, and morbidity in preterm infants and in turn, uncover key drivers of outcomes during infancy and throughout development.

By identifying risk patterns and underlying molecular signaling, the PROMPT study aims to provide key information for anticipatory clinical management of preterm infants, and aims to uncover personalized and precision focused interventions that address key metabolic perturbations.

PROMPT/PREMO study efforts reflect an integrative multi-disciplinary collaborative research effort that will be conducted by the Benioff Center for Microbiome Medicine in partnership with the UCSF PROMPT study investigators and the UCSF California Preterm Birth Initiative (PTBi-CA). PREMO leadership includes Drs. Susan Lynch, Tiffany Scharschmidt, and Joanna Halkias. UCSF PROMPT study PIs include Drs. Elizabeth Rodgers and Laura Jelliffe-Pawlowski.

Objectives

On-going PROMPT activities that the PROMPT/PREMO integrative study effort will be able to take advantage of include the development of a large, well-characterized and densely longitudinally sampled preterm birth cohort, collection of clinical data, and assessment of short- and long-term outcomes. PROMPT also includes robust longitudinal assessment of metabolic profiles on participating infants.

The PROMPT/PREMO partnership enables us to determine functional contributions of both the microbiome and metabolism to adverse health complications encountered during early development, and to develop novel therapeutic strategies that may counteract these activities.

This study will also develop a central resource for current and future PROMPT/PREMO and BCMM/PTBi-CA integrative research efforts across campus and provide training opportunities for graduate students and research fellows.

Study Design

Initially, blood, stool, buccal and skin samples from 100 mother/infant dyads will be collected throughout neonatal developmental. With additional support, further studies will include maternal vaginal and breast milk samples. This study is being conducted in parallel with a related study at the University of Iowa, to gain greater insights into a broader population of preterm neonates.

The expertise and next generation technologies present within the BCMM CoLab Incubators will be leveraged to support PROMPT/PREMO.