Preterm birth complications are the leading cause of death among children under 5 years of age. Every year, 15 million babies are born prematurely, and sadly the figure is still rising.1
These babies (born before 37 weeks of pregnancy) are often critically ill and suffer lifelong complications. There was exceptionally limited success in reducing rates of preterm birth, largely because current treatment plans are ‘one size fits all’ while preterm delivery often has very different causes. Further, current methods of predicting preterm birth — cervical length measurements via transvaginal ultrasound and fetal fibronectin measurements — have major limitations: They are mainly used late in gestation which may be too late for effective intervention. Furthermore, cervical measurements require specialist equipment and operators which limit their use as a potential screening test for the general population.
Our scientists have made major headway in researching the causes of preterm birth and developing potential solutions and tests. In a recent original study funded by Genesis, which profiled the thousands of small molecules that are present in blood and urine, our scientists were able to identify different reasons for preterm birth from very early in pregnancy. This means that we may now begin to design individualised treatment and prevention plans that are based upon a much better understanding of why an individual woman is at risk, therefore much more likely to be successful with treatment.
Women’s Health focusing on Preterm birth
The short video below explains how our research looks at women’s health focusing on how to stop preterm birth.
Understanding genetic markers for preterm birth
Our researchers have previously identified nine circulating miRNA biomarkers, that can easily be detected in a woman’s blood as early as 12 weeks into her pregnancy, linked with subsequent preterm birth.
Despite this promising potential for testing whether a women is at risk, we have little understanding of how the miRNAs (microRNA regulates gene expression and biological processes) cause preterm birth. We are supporting Dr Kim Sung Hye’s study into the role of two of these microRNA biomarkers in the cells that form the placenta.
The Protective Function of “Good Bacteria”
The female reproductive tract is host to a complex community of bacteria, viruses and other microbes, some of which protect against disease and others which cause it. One type of “good bacteria”, Lactobacillus, protects against infection by producing lactic acid, keeping dangerous microbes at bay. Genesis Research Trust is funding Fabienne Hanton, Researcher at IRDB, Imperial College London, in exploring further protective functions of lactic acid in the reproductive tract, including how it reduces inflammation following an infection. Inflammation is also associated with the onset of labour and so this research may provide valuable insight into preventing infection-caused preterm birth.
30% of cases of preterm labour are preceded by PPROM (Preterm premature rupture of the membranes), which causes the waters to break prematurely. Research funded by Genesis Research Trust has shown that bacteria in the vagina both protect against and increase the risk of PPROM. Current research compares the influence of bacteria present in the vagina, fetus and placenta to cause PPROM. This helps us understand the necessary conditions for PPROM, including infection and inflammation in the uterus. These findings inform antibiotic treatments to prevent PPROM.
Professor Phil Bennett and his world-leading team at Genesis have made crucial contributions to understanding many of the causes of premature birth.
“We have discovered important links between the bacteria in the birth canal and the risk of preterm labour, and have found simple chemicals in the mother’s blood which predict the risk of preterm birth. We have shown that a simple and cheap change in the cervical stitch operation used in many cases to prevent preterm labour can reduce the risk by half and could save over 150,000 preterm births worldwide, every year.”
— Professor Phil Bennett and Dr David MacIntyre
Managing Preterm Labour
Childbirth is initiated by hormonal interactions. But miscommunications can cause preterm labour. Premature birth is the leading cause of child mortality worldwide in infants under five. We have funded Dr Abigail Walker, Development Lead in Panacea Innovation at Imperial College London, in researching how muscles in the uterus and reproductive tracts respond to such hormones. This understanding has helped develop drugs that improve management of preterm labour, including inductions.