Measuring Collagen Arrangement and Its Relationship with Preterm Birth using Mueller Matrix Polarimetry

Preterm birth (PTB) is defined as delivery prior to 37 weeks of gestation. It is the leading cause of infant death worldwide, responsible for infant neurological disorders, long-term cognitive impairment, as well as chronic health issues involving the auditory, visual, digestive, and respiratory systems. In expectant mothers, causes for PTB can include infection, inflammation, vascular disease, short intervals between pregnancies, multiple gestations and genetic factors. In the U.S., PTB occurs in over 11% of births and at an elevated 18.1% in Miami-Dade County, FL; while in the developing world the incidence of PB is over 15%. Early identification of at-risk pregnancies is important for the success of medical intervention.Current diagnosis methodologies of PTB include ultrasound imaging of cervical length and fetal fibronectin assay but have low positive predictive power. Compared to the markers targeted by current diagnosis methodologies, collagen content in the cervix changes more drastically throughout the course of gestation due to its link to changes in load bearing capacity that occur during the phases of pregnancy. Mueller matrix polarimetry is capable of characterizing changes in collagen without making contact with patients and may prove to be an improvement to current diagnosis methodologies. A clear difference is seen in collagen orientation between nonpregnant and pregnant patients.The development of a new imaging modality aimed at assessing early changes in collagen arrangement in the cervix may improve risk determination of PTB and reduce the morbidity of the condition. Earlier prediction of PTB could improve outcomes by allowing longer intervention times to prolong gestation time for the infant in the womb. A more reliable quantitative predictor may also lead to development of more treatment options.