A team at University College London are conducting research to develop an antimicrobial therapy to reduce the risk of preterm birth in women who are considered high risk. The therapy will protect the womb from infection, which in turn will reduce the risk of preterm birth.
Some of the proteins produced by the cervix help fight infection: the researchers will investigate antimicrobial therapy for the prevention of infection-associated preterm birth and neonatal morbidity. . The research is jointly funded by charities Action Medical Research and Borne.
Evidence suggests that in some pregnant women, bacteria can pass into the womb, triggering inflammation and increasing the risk of early labour. The cervix acts as a physical barrier to help protect the womb and baby from infection and also produces specialised antimicrobial proteins to help fight infection. Dr Ashley Boyle and Professors Simon Waddington and Donald Peebles of University College London aim to boost the effect of the antimicrobial proteins by developing an innovative antimicrobial therapy to stop the bacteria from entering the womb and reduce the risk of preterm birth.
Commenting on why she is supporting this research, Imogen, mum to 7-year-old Wilfred who was born at 25 week says: “I can still remember how scary it was when Wilfred was born too early. He developed a really dangerous bowel condition called He had a bleed on the brain and necrotising enterocolitis (NEC)and had to have 25cm of his bowel removed and a stoma fitted. We brought him home four months after he was born, and although he is fine apart from mild cerebral palsy, we do not want any other parent to go through what we went through. At one stage we thought that we might lose him.”
Wilfred was one of the 55,000 babies born prematurely each year in the UK.1,2More than 1,000 babies die each year after being born too soon.3 Many others who do survive are at increased risk of lifelong problems including cerebral palsy, blindness, hearing loss and learning difficulties. Although the causes of preterm birth remain poorly understood, an infection may be involved in four out of 10 women who experience an unexpected early labour.4
“Bacteria from the mother’s vagina can sometimes get through the neck of the womb the cervix and enter the womb where the baby is growing. Unfortunately, this can trigger inflammation that may cause premature birth. More treatments are needed as the effectiveness of progesterone which is the current approach recommended for women at high risk of preterm birth, is not well-established,” says Dr Boyle.
The antimicrobial therapy being developed by the researchers can boost the production of one of the proteins in cervical cells, which they hope will help stop bacteria from entering the womb. The researchers will evaluate the anti-inflammatory and anti-bacterial effectiveness of the antimicrobial therapy, with or without progesterone, on cervical and vaginal cells grown in the laboratory. If encouraging, the results could lead to clinical trials.
Dr Caroline Johnston, Senior Research Manager at Action Medical Research, says: “We are working in partnership with Borne to tackle premature birth and have jointly funded eight projects since 2017. Funding this project is part of our commitment to fund vital research to reduce the high rate of premature birth by investigating the causes of early labour and advancing the search for new treatments that could prevent or delay early birth.”
Find out more at www.action.org.uk/premature.
References
[1] Office for National Statistics Vital statistics in the UK: births, deaths and marriages – 2021. Available via: https://www.nice.org.uk/guidance/NG25/documents/preterm-labour-and-birth-final-scope2. [Accessed 06 November 2024]
[2] National Institute for Health and Care Excellence. Preterm labour and birth final scope April 2013. Available at:
http://www.nice.org.uk/guidance/gid-cgwave0660/resources/preterm-labour-and-birth-final-scope2. [Accessed 06 November 2024]
[3] Northern Ireland Statistics and Research Agency: Registrar General Annual Report 2020 Stillbirths and Infant Deaths, Table 4.5: Stillbirths and infant deaths by sex and cause, 2012 to 2020: Registrar General Annual Report 2020 Stillbirths and Infant Deaths | Northern Ireland Statistics and Research Agency (nisra.gov.uk) [website accessed 20 June 2023]
[4] Agrawal V. Hirsch, E. Intrauterine infection and preterm labor. Semin Fetal Neonatal Med. 2012; 17(1):12-9.