Each year, around 55,000 babies are born prematurely in the UK – and sadly, more than 1,000 babies die each year after being born too soon. [1-5] Many others who do survive are at increased risk of lifelong problems. Evidence suggests that bacteria can pass into the womb, triggering inflammation and increasing the risk of early labour. Dr Ashley Boyle and Professors Simon Waddington and Donald Peebles of University College London are developing an innovative antimicrobial therapy that aims to boost the body’s natural defences against infection. If successful, this could ultimately help prevent preterm labour in women at high risk of giving birth too soon – improving survival and quality of life for their babies.
This project is jointly funded by Action Medical Research and Borne.
How are children’s lives affected now?
Around one in every 13 babies in the UK will be born premature, before 37 weeks of pregnancy.1-5 Babies who survive preterm birth may experience lifelong problems such as 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.6
“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,” says Dr Boyle. “Unfortunately, this can trigger inflammation that may cause premature birth.”
Progesterone treatment is the current approach recommended for women at high risk of preterm birth due to a weakened cervix or previous history of early labour.
“Unfortunately, the effectiveness of progesterone is not well-established and new approaches are needed to help prevent these women from giving birth too soon,” says Dr Boyle.
How could this research help?
“Our goal is to develop a new antimicrobial therapy that can help protect the womb from infection and, in turn, reduce the chances of preterm birth in high-risk women,” says Dr Boyle.
As well as providing a physical barrier, the cervix also produces specialised antimicrobial proteins that help fight infection. The researchers are developing an antimicrobial therapy that can boost the production of one of these proteins in cervical cells, which they hope will help stop bacteria from entering the womb. They will evaluate the anti-inflammatory and anti-bacterial effects of the gene therapy, with or without progesterone, on cervical and vaginal cells grown in the laboratory.
“We will then assess the effectiveness of our antimicrobial therapy – alone and in combination with progesterone by carrying out a series of experiments in a laboratory model of preterm birth,” says Dr Boyle.
If our results are encouraging, we hope this will ultimately lead to clinical trials in women at high risk of giving birth too soon.
Research table
Project details
| Location | Department of Maternal and Fetal Medicine, EGA Institute for Women’s Health, University College London |
| Project Team |
Professor Simon N Waddington, BSc MSc PhD
Dr Ashley K Boyle, BSc, MSc, PhD Professor Donald M Peebles, BA MA MBBS MD MRCOG |
| Grant Awarded | |
| Grant Amount | £244,714 |
| Start Date | |
| End Date | |
| Duration | 30 months |
| Grant Code (GN number) | GN2984 |
References
- Office for National Statistics, Vital statistics in the UK: births, deaths and marriages - 2021 https://www.ons.gov.uk/peoplepopulationandcommunity/populationandmigration/populationestimates/datasets/vitalstatisticspopulationandhealthreferencetables [website accessed 20 June 2023]
- National Institute for Health and Care Excellence - Preterm labour and birth final scope April 2013http://www.nice.org.uk/guidance/gid-cgwave0660/resources/preterm-labour-and-birth-final-scope2 [website accessed 20 June 2023]
- Office for National Statistics. Childhood mortality in England and Wales 2021. Table 4. Child mortality (death cohort) tables in England and Wales - Office for National Statistics (ons.gov.uk) 2021 data tables. Release date Mar2023 [website accessed 20 June 2023]
- National Records for Scotland. Vital Events Reference Tables 2021, Table 4.5: Infant Deaths by sex and cause, Scotland 2010 to 2021 List of Data Tables | National Records of Scotland (nrscotland.gov.uk) [website accessed 20 June 2023]
- 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]
- Agrawal V. and Hirsch, E. Intrauterine infection and preterm labor. Semin Fetal Neonatal Med. 2012; 17(1):12-9
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