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Premature birth: predicting which women might go into labour too soon

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What did the project achieve?

“We’ve made important steps towards our goal of developing a simple blood test, for use early in pregnancy, to identify women who are at high risk of going into labour prematurely,” says Dr Joanna Cook of Imperial College London. “A test like this would enable women to receive extra monitoring and care designed to protect their babies.”

Latest figures suggest around 61,000 babies are born too soon every year in the UK.1-2 Sadly, premature birth is the biggest killer of babies in the UK, and babies who survive a very early birth are at risk of developing lifelong disabilities.

Lots of premature births happen when women go into labour too soon – often for no apparent reason.

“Researchers do not fully understand the mechanisms that control labour,” says Dr Cook. “We have improved understanding of the role of some naturally occurring substances called microRNAs and found that the level of certain microRNAs in the blood, very early in pregnancy, is abnormal in women who go on to develop a shorter and weaker cervix and in those who deliver their babies too soon. We hope that this exciting finding will enable us to develop a new way to screen pregnant women so doctors can identify, and help, women who are at risk of going into labour too soon.”


1. National Institute for Health and Care Excellence (NICE). Scope Guideline. Preterm labour and birth. April 2013. https://www.nice.org.uk/guidance/ng25/documents/preterm-labour-and-birth-final-scope2 Website accessed 11 September 2017.

2. Office for National Statistics (ONS). Overview of the UK population: July 2017. Figure 5: UK births, deaths and natural change, 1956 to 2016. https://www.ons.gov.uk/peoplepopulationandcommunity/populationandmigration/populationestimates/articles/overviewoftheukpopulation/july2017#toc Website accessed 11 September 2017.

This research was completed on

Research Training Fellowship*: Dr Joanna Cook

Over 60,000 babies are born prematurely every year in the UK.1-3 Tragically, around 1,300 of these babies die4-6 Many others who survive a very early birth develop lifelong disabilities. Despite these dangers, we can’t always tell which women will go into labour too soon. Dr Joanna Cook, of Imperial College London, is looking for a new way to identify expectant mothers who are at risk, so they can receive extra monitoring and care designed to protect their babies.

How are babies’ lives affected now?

Premature birth is a major cause of death and illness in babies worldwide.7 About 15 million babies around the world are born too soon every year – that’s more than one in 10 of all babies.7

Lots of premature births happen when women go into labour too soon – often for no apparent reason. “During my work as a doctor, I have cared for many women who’ve gone into labour early and witnessed the distress, and sometimes tragedy, this can cause,” says Dr Cook.

Sadly, premature birth is the biggest killer of babies in the UK.4 Babies who survive are at increased risk of developing lifelong conditions such as cerebral palsy, blindness and learning difficulties. They are also more vulnerable to high blood pressure and diabetes during adulthood.

“Frustratingly, we don’t fully understand why some women go into labour too early and are therefore often unable to stop this from happening,” says Dr Cook.


How could this research help?

“We hope to develop a simple blood test that could be used very early in pregnancy to identify women who are at high risk of going into labour too soon,” says Dr Cook. “Expectant mothers who are at risk could then be monitored more closely. We could invite these women to visit antenatal clinics more regularly and intervene if appropriate, for example by giving them hormone treatment to try and stop their babies from being born early.”

Dr Cook is investigating the role of naturally occurring substances called microRNAs, which seem to be involved in controlling when a pregnant woman goes into labour.

Preterm birth rates are increasing in almost all countries.4 More children die as a result of being born too soon than from AIDS, malaria or diarrhoea.8 Dr Cook is hoping that one day her work will help stop this.


* Research Training Fellowships:
Each year, Action Medical Research awards these prestigious grants to help the brightest and best doctors and scientists develop their career in medical research.


  1. Office for National Statistics. Release: Preterm births, data. 24 July 2007. http://www.ons.gov.uk/ons/publications/re-reference-tables.html?edition=... [Website accessed 12 June 2014]
  2. Beck S et al. The worldwide incidence of preterm birth: a systematic review of maternal mortality and morbidity. Bulletin of the World Health Organization 2010; 88: 31-38. doi: 10.2471/BLT.08.062554. http://www.who.int/bulletin/volumes/88/1/08-062554/en/ [Website accessed 12 June 2014]
  3. Office for National Statistics. Population Estimates for UK, England and Wales, Scotland and Northern Ireland, Mid-2011 and Mid-2012. http://www.ons.gov.uk/ons/rel/pop-estimate/population-estimates-for-uk--... [Website accessed 12 June 2014]
  4. Office for National Statistics. Child Mortality Statistics: Childhood, Infant and Perinatal, 2012. Table 6 Live births, stillbirths and linked infant deaths: ONS cause groups and birthweight. http://www.ons.gov.uk/ons/publications/re-reference-tables.html?edition=... [Website accessed 12 June 2014]
  5. Northern Ireland Statistics and Research Agency. Registrar General Annual Report 2012 - Section 4 Stillbirths and Infant Deaths (Excel files). Table 4.5 Stillbirths and infant deaths by sex and cause, 2009-2012. http://www.nisra.gov.uk/demography/default.asp99.htm [Website accessed 12 June 2014]
  6. General Register Office for Scotland. Vital Events Reference Tables 2012. Section 4: Stillbirths and Infant Deaths. Table 4.5 Infant deaths, by sex and cause, Scotland, 2002-2012. http://www.gro-scotland.gov.uk/statistics/theme/vital-events/general/ref... [Website accessed 12 June 2014]
  7. The Partnership for Maternal, Newborn and Child Health. Born too soon. The global action report on preterm birth. 2 May 2012. http://www.who.int/pmnch/media/news/2012/preterm_birth_report/en/index.h... [Website accessed 12 June 2014]
  8. March of Dimes. Infographic: Premature birth. 2012. http://www.marchofdimes.com/glue/files/modwpd.pdf [Website accessed 12 June 2014]


Project Leader Dr J R Cook, BSc (hons) MBBS MRCOG
Project Location Parturition Research Group, Institute of Reproductive and Developmental Biology, Imperial College London
Project Location Other Department of Obstetrics and Gynaecology, Queen Charlotte's and Chelsea Hospital, Imperial College Healthcare NHS Trust
Project duration 2 years
Date awarded 6 February 2014
Project start date 1 April 2014
Project end date 30 August 2016
Grant amount £156,036
Grant code GN2248


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