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Premature birth: how to stop women from going into labour too soon

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What did the project achieve?

“This laboratory study has increased our understanding of the role of an important protein molecule called Hsp20 in controlling womb contractions – and how its effects could potentially be controlled with drugs to help prevent premature labour,” says Professor Nick Europe-Finner of Newcastle University.

Around 60,000 babies are born prematurely in the UK each year and sadly, more than 1,000 die as a result of being born too soon.1-5 Although the causes of preterm birth are complex, many occur because the mother goes into early labour – but there are currently no effective treatments to prevent this from happening.

Professor Europe-Finner, and his co-investigator Professor Michael Taggart who is based at the same institution, are investigating the biological processes that control whether the womb is relaxed, as during pregnancy – or contracting, as during childbirth.

“We have found out that a chemical modification of a protein molecule called Hsp20 acts like a switch – boosting its ability to stop womb contractions,” says Professor Europe-Finner. “By using drugs that can turn this switch on, we were able to reduce contractions in womb muscle cells in the laboratory.”

The researchers then created a small piece of Hsp20 that was modified so it was permanently switched on – and attached this to another protein molecule called CPP that is good at getting other substances into cells.

“We showed that this combined CPP-Hsp20 molecule could effectively get inside womb muscle cells and reduce contractions – suggesting it could be developed into a new treatment to help prevent premature birth,” says Professor Taggart.

The researchers also carried out sophisticated analyses of womb tissue samples from pregnant women during caesarean sections, uncovering information on more than 2,000 protein molecules that may be involved in controlling womb contractions.

“Analysis of these data is likely to reveal other potential drug targets, which we hope will one day lead to effective new treatments to help reduce the number of babies being born too soon,” says Professor Europe-Finner.

 

References

  1. Vital statistics in the UK: births, deaths and marriages - 2018 update: https://www.ons.gov.uk/peoplepopulationandcommunity/populationandmigration/populationestimates/datasets/vitalstatisticspopulationandhealthreferencetables [website accessed 31 October 2019]
  2. 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
  3. Office for National Statistics. Childhood mortality in England and Wales 2017, Table 6: http://www.ons.gov.uk/peoplepopulationandcommunity/birthsdeathsandmarriages/deaths/datasets/childmortalitystatisticschildhoodinfantandperinatalchildhoodinfantandperinatalmortalityinenglandandwales  [website accessed 31 October 2019]
  4. National Records for Scotland. Section 4: Stillbirths and Infant deaths 2017: https://www.nrscotland.gov.uk/statistics-and-data/statistics/statistics-by-theme/vital-events/general-publications/vital-events-reference-tables/2017/section-4-stillbirths-and-infant-deaths [website accessed 31 October 2019]
  5. Northern Ireland Statistics and Research Agency. Registrar General Annual Report 2017 – Stillbirths and Infant Deaths: https://www.nisra.gov.uk/publications/registrar-general-annual-report-2017-stillbirths-and-infant-deaths [website accessed 31 October 2019]

This research was completed on

Over 60,000 babies are born prematurely every year in the UK.1-4 Tragically, premature birth is the biggest killer of babies in the UK, with nearly 1,400 babies dying each year after being born too soon.5-7 Many others who survive a very early birth develop lifelong disabilities. Despite these dangers, little is known about why some women go into labour too soon or how to stop it. Professors Nick Europe-Finner and Michael Taggart, of Newcastle University, are leading a team of expert researchers who are searching for answers. Their ultimate aim is to prevent premature birth, and save babies from death and disability.

How are babies’ lives affected now?

“Premature birth is a major cause of death and illness in babies in both the UK and worldwide,” explains Professor Europe-Finner.8 “Preterm birth rates are increasing in almost all countries.8 About 15 million babies around the world are born too soon every year – that’s more than one in 10 of all babies.8 Sadly, around one million of these babies die within just a month of being born.”8

All newborn babies are vulnerable, but those born early are particularly so. They can face difficulties with breathing, feeding and fighting infections, and are at increased risk of developing lifelong conditions such as cerebral palsy, blindness, hearing loss, lung disease and learning difficulties. They might also have an increased susceptibility to health problems during adulthood, including high blood pressure and diabetes.

Premature birth kills one baby every 30 seconds.9 More children die as a result of being born too soon than from AIDS, malaria or diarrhoea.9 We must do more to stop this.

How could this research help?

Many premature births happen when women go into labour too soon – often for no apparent reason. The research team aims to boost understanding of why this happens and find a way to stop it.

“The womb behaves very differently during pregnancy and childbirth,” says Professor Taggart. “We are investigating the natural processes that control whether the womb is relaxed, as during pregnancy, or contracting, as during childbirth. We have recently discovered that a protein called heat shock protein 20 – or Hsp20 – may have an important part to play, so we are finding out more about how this works. We are also studying whether substances that mimic Hsp20 could be used as drugs – to prevent contractions and stop babies from being born too soon.”

Premature birth can have a huge impact on the lives of babies and their families – and on society and the health system. It is essential to find ways to stop it.

 

References

1. Office of National Statistics. (24Jan2013) Live births in England and Wales by characteristics of the mother 1, 2011 [Online]. Available from http://www.ons.gov.uk/ons/search/index.html?newquery=Birth+Summary+Table... [Accessed: 25January2013] No. of live births = 723,913.

2. Northern Ireland Statistics and Research Agency Registrar General Annual Report 2011 (Section 3 Births, Table 3) [Online] Available from http://www.nisra.gov.uk/demography/default.asp98.htm [Accessed: 25January2013]. No. of live births = 25,273.

3. General Register Office for Scotland Vital Events Reference Tables 2011 (Section 3 Births; Table 3.1b) [Online]. Available from http://www.gro-scotland.gov.uk/statistics/theme/vital-events/general/ref... [Accessed25January2013]. No. of live births = 58,590.

4. Office of National Statistics News Release 24July 2007. Pre term birth data (2005) - 7.7% live births in England and Wales are born preterm (before 37 weeks gestation). [Online] Available from http://www.ons.gov.uk/ons/publications/re-reference-tables.html?edition=... [Accessed 25 January 2013].

Preterm birth, defined as childbirth occurring at less than 37 completed weeks or 259 days of gestation http://www.who.int/bulletin/volumes/88/1/08-062554/en/

Calculation made by Action Medical Research based on figures in references 1-4 for the total number of live births a year in the UK and the percentage of all preterm live births in England and Wales, respectively. Estimate assumes incidence of premature live birth is the same for the UK overall as it is for England and Wales.

Total no. of live births in UK = 723,913 + 25,273 + 58,590 = 807,776.

Estimated number of premature live births in UK = 807,776 x 7.7% = 62,199.

5. Office of National Statistics Release 10October2012 Childhood Mortality statistics: Childhood, infant and perinatal 2010, Childhood, Infant and Perinatal mortality in England and Wales, Table 6

http://www.ons.gov.uk/ons/publications/re-reference-tables.html?edition=...

‘Immaturity related condition’ deaths = 1338 infant (babies under one year old) deaths in 2010

6. Northern Ireland Registrar. (2011) General Annual Report 2011 (Section 4: Stillbirths and Infant Deaths, Table 4.5 Stillbirths and infant deaths by sex and cause. Disorders related to length of gestation and fetal growth) = 16 infant deaths

Available from http://www.nisra.gov.uk/demography/default.asp76.htm

[Accessed on 31January2013]

7. General Register Office for Scotland. (2011) Vital Events Reference Tables 2011 (Section 4: Stillbirths and Infant Deaths), Table 4.5 Infant deaths by sex and cause. Disorders related to length of gestation and fetal growth = 27 infant deaths

http://www.gro-scotland.gov.uk/statistics/theme/vital-events/general/ref...
Estimated total no. of infant deaths related to prematurity in UK per year = 1338+16+27 = 1381.

8. March of Dimes; The Partnership for Maternal, Newborn and Child Health; Save the Children; World Health Organization. Born too soon. The global action report on preterm birth. 2012. http://www.who.int/pmnch/media/news/2012/preterm_birth_report/en/index.h... Website accessed 9 January 2014.

9. March of Dimes. Infographic: The global problem of premature birth. 2012. http://www.marchofdimes.com/glue/files/modwpd.pdf Website accessed 9 January 2014.

 

Project Leader Professor G Nick Europe-Finner BSc PhD FSB
Project Team Professor Michael J Taggart BSc PhD FSB Dr Magdalena Karolczak-Bayatti MSci PhD Professor S C Robson MD MRCOGDr Achim Treumann Dipl Biochem PhD Dr Arwyn T Jones BSc MSc PhD
Project Location Institute of Cellular Medicine, Newcastle University
Project Location Other Biopharmaceutical Bioprocessing Technology Centre, Newcastle UniversitySchool of Pharmacy and Pharmaceutical Sciences, Cardiff University
Project duration 3 years
Date awarded 15 November 2013
Project start date 22 April 2014
Project end date 21 April 2017
Grant amount £183,040
Grant code GN2217

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