Developing a new test to identify women at risk of premature birth

In the UK, more than 61,000 babies are born prematurely – before 37 weeks of pregnancy – each year and sadly, more than 1,000 will die.^1-7 Children who survive can experience lifelong disabilities such as cerebral palsy, learning difficulties, blindness and hearing loss. Although the causes of preterm birth are often not understood, one factor may be how a woman’s body deals with mild vaginal infections during pregnancy. Dr Rachel Tribe at King’s College London is aiming to develop a new screening test that can help identify pregnant women who are at increased risk of early delivery. She hopes this will help save children’s lives and reduce the risk of long-term complications from being born too soon.

Action Medical Research and Borne are jointly funding this research.

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.^1-8 And, despite extensive research over recent years, these numbers are not falling.⁹

Being born too soon can have tragic consequences. It is the biggest cause of newborn death, and those who survive can grow up with life-changing conditions – including cerebral palsy, learning difficulties, blindness and hearing loss.¹⁰

There are many different reasons for premature birth, but often the causes are not fully understood. Women who give birth very early – before 34 weeks of pregnancy – often have a mild infection in their vagina, but some women with similar infections still give birth at full term.

“We think how a woman’s body fights these mild vaginal infections during pregnancy might be important,” says Dr Tribe. “Building a better understanding about this could open up new ways to reduce a woman’s risk of premature birth and the heartache it can cause.”

How could this research help?

“Our aim is to develop a new screening test to identify women in early pregnancy who have an increased risk of premature birth,” says Dr Tribe.

The team think that tiny spherical structures called exosomes released by cells lining the vagina are key in defending against mild infections by alerting neighbouring cells to the bacterial invasion.

The researchers will examine this exosome defence system in samples collected from women in early pregnancy – comparing those who have straightforward pregnancies to those who deliver preterm. They are also planning a series of laboratory experiments to improve their understanding of how exosomes work and how they may help protect pregnant women from complications.

“We hope to identify a specific signature in the exosomes of women most likely to have a preterm birth,” says Dr Tribe. “If we can develop this into a new test for women in early pregnancy, identifying those at risk would enable appropriate steps to be taken to protect their baby from being born too soon.”

References

1. Office for National Statistics: https://www.ons.gov.uk/peoplepopulationandcommunity/birthsdeathsandmarriages/livebirths/bulletins/birthsummarytablesenglandandwales/2016 [website accessed 12 December 2017]
2. National Records of Scotland: 2016 Births, Deaths and Other Vital Events - Preliminary Annual Figures: https://www.nrscotland.gov.uk/statistics-and-data/statistics/statistics-by-theme/vital-events/general-publications/births-deaths-and-other-vital-events-preliminary-annual-figures/2016 [website accessed 12 December 2017]
3. Northern Ireland Statistics and Research Agency. Births. Live births 1887-2016. https://www.nisra.gov.uk/publications/monthly-births [website accessed 12 December 2017]
4. National Institute for Clinical Excellence: Preterm labour and birth final scope April 2013 https://www.nice.org.uk/guidance/ng25/documents/preterm-labour-and-birth-final-scope2
5. Office for National Statistics. Childhood mortality in England and Wales 2014. Table 6. http://www.ons.gov.uk/peoplepopulationandcommunity/birthsdeathsandmarriages/deaths/datasets/childmortalitystatisticschildhoodinfantandperinatalchildhoodinfantandperinatalmortalityinenglandandwales  [website accessed 12 December 2017]
6. National Records for Scotland. Section 4: Stillbirths and Infant deaths: http://www.nrscotland.gov.uk/statistics-and-data/statistics/statistics-by-theme/vital-events/general-publications/vital-events-reference-tables/2014/section-4-stillbirths-and-infant-deaths  [website accessed 12 December 2017]
7. Northern Ireland Statistics and Research Agency. Registrar General Annual Report 2015 – Stillbirths and Infant Deaths: https://www.nisra.gov.uk/publications/registrar-general-annual-report-2015-tables-and-full-report [website accessed 12 December 2017]
8. Bliss charity: https://www.bliss.org.uk/prematurity-statistics-in-the-uk [accessed 06 December 2017]
9. House of Commons Library; World Prematurity Day 2015, Debate Pack CDP 2015/104: http://bit.ly/2DAFt0Q
10. Blencowe H et al. Born too soon: the global epidemiology of 15 million preterm birth. Reproductive Health 2013; 10 Suppl 1 S2