Investigation of biochemical changes indicative of abnormal cervical remodeling during preterm birth using in vivo Raman spectroscopy

Abstract

Preterm birth (PTB) is the leading cause of death for children under 5, affecting 1 in 10 children in the United States. Premature infants are at a higher risk for infections and developmental issues. During pregnancy the cervix undergoes a drastic remodeling process allowing it to become pliable for parturition, but abnormal cervical remodeling can cause PTB. Cervical remodeling is required for delivery and early remodeling could serve as an indicator of preterm birth. However, the mechanisms for cervical remodeling are not well understood, making it difficult to distinguish normal remodeling from abnormal remodeling. Raman spectroscopy is an optical method that can observe biochemical changes. This work uses Raman spectroscopy as a method to detect microstructural changes that are imperative to cervical remodeling. The relationship between proteins, lipids, blood, and DNA was studied to determine trends leading to cervical dilation in normal, infection-mediated, and induced preterm birth. The mouse cervix was determined to be heterogenous and proteins associated with collagen structure diminished throughout pregnancy while DNA signal increased. The infection-mediated model displayed a much higher increase in blood content than normal and induced parturition models. In this work, the effectiveness of Raman spectroscopy to detect differences biochemical trends during normal and abnormal cervical remodeling was shown, bringing science one step closer to reducing preterm birth rates.