What is Preterm Birth?

Preterm birth describes a baby that is born too early. A normal pregnancy that goes full-term lasts 37-40 weeks or about 9 months. A preterm baby is one that is born before 37 weeks. These babies are known as premature (born before maturity) and tend to have more health problems and stay in the hospital longer than babies born full-term. The earlier in pregnancy a baby is born, the greater the chance of serious health problems, both immediate and long-term. According to the World Health Organization (WHO), more than 1 in 10 babies is born prematurely each year.

There are several categories of preterm birth, based on how far along the pregnancy is (gestational age): 

  • moderate to late preterm (32 to 37 weeks)

  • very preterm (28 to 32 weeks)

  • extremely preterm (less than 28 weeks) 


Very Preterm Birth and Extremely Preterm Birth accounts for the most serious and costly health problems, and this is the primary focus for Nixxi. 

What Causes Preterm Birth?

Common causes include multiple pregnancies, infections and chronic conditions such as diabetes and high blood pressure. There could also be shared genetic factors among family members that affect risk. Women who live in poverty, both in low-income countries and more developed nations, have a much higher risk. Often, however, no cause will be identified. Some of the other known risk factors for preterm birth include prior preterm birth, pregnancy with twins or other multiples, a short interval between pregnancies, fertility treatments, and problems with the major organs involved in the pregnancy. Smoking, drug use, inability in maintaining a healthy weight, and stress can all contribute to preterm birth risk as well. Lifestyle choices and decision-making play a critical role in eliminating some of these risk factors and give women a better chance of having a healthy pregnancy and baby.

Nixxi's Unique Approach to Tackling Preterm Birth

The maternal/fetal HPA axis is known to influence the timing of delivery. Nixxi's research and development advances prior literature and allows the early prediction of spontaneous preterm delivery.

Jolivet, 1974 
Leong, 1976
Cortisol associated with onset of spontaneous labor
Campbell, 1987
Goland, 1988
Sasaki, 1989
Placental CRH identified to have an influence on HPA axis
McLean, 1995
Karalis, 1996
Wadhwa, 1998
"Placental clock" theory proposed for CRH and gestational length
McGrath, 2002
Sibai, 2005
Sandman, 2006
Conflicting data  on the utility of CRH as a biomarker for preterm birth
Ruiz, 2016
Papatheodorou, 2013
Wang, 2013
Study of CRH in subpopulations and underlying mechanisms
  • Discovered progesterone metabolism imbalance upstream of CRH   

  • Developed biomarker algorithm predictable of spontaneous PTB <32 weeks

  • Elucidated underlying mechanism leading to uterine contractility and response to therapy


For over 40 years, scientists have been studying the role of the stress hormone cortisol and its associated molecules on the onset of labor. These studies have repeatedly established that biologic markers for stress can be observed in pregnant women who go on to have a preterm delivery. A study in the American Journal of Obstetrics & Gynecology estimated that nearly 60% of preterm births that occur at less than 34 weeks have evidence of maternal stress. The same study found that maternal stress disproportionately affects African-American women, possibly contributing to higher rates of preterm birth.


Nixxi has taken a fresh look at the past 40+ years of research in this area for opportunities to advance the science. By utilizing an advanced targeted steroid metabolomics approach, our team has discovered an imbalance in hormonal pathways that is highly correlated to preterm delivery. The end result is a promising new test that can be used early in pregnancy to identify women at risk for spontaneous preterm delivery less than 32 weeks gestation. 

© 2020 by Nixxi, Inc.


4340 E. Indian School Road, Suite 21-168

Phoenix, AZ 85018