Premature birth: predicting who’s at risk

Premature birth and its complications are the leading cause of death among children under five years of age across the world.¹ Tragically, over 1,000 babies die in the UK each year after being born too soon.^2-4 Babies who survive a very early birth are at risk of developing lifelong problems such as cerebral palsy, blindness and learning difficulties. Professor Nigel Klein, of University College London’s Institute of Child Health, is developing a new way to predict, very early in pregnancy, which women are at risk of premature birth, so they can be monitored more closely and offered extra care in an attempt to prolong their pregnancy and delay their babies’ birth.

How are babies’ lives affected now?

Sadly, over 61,000 babies are born too soon each year in the UK, putting them at risk of death and disability.^5-8 Worldwide, 15 million babies are born prematurely every year – that’s more than one in 10 of all babies – and the likelihood of being born early has been rising in almost all countries with reliable data.^9,10

All newborn babies are vulnerable, but those born very early are particularly so. They can face difficulties with breathing, feeding and fighting infections, and are at increased risk of developing lifelong disabilities. They’re also more susceptible to some health problems during adulthood, such as high blood pressure and diabetes.

Some things are known to increase a woman’s chances of giving birth too soon, but many early births remain unexplained.¹¹ “The reasons why women go into labour early are not fully understood,” says Professor Klein. “Preventing premature birth remains a major challenge to modern medicine.”

How could this research help?

The researchers are developing a new way to identify women who are at high risk of going into labour too soon.

With earlier funding from Action Medical Research and the Henry Smith Charity, the researchers discovered that women who lack white blood cells at the cervix – the opening to the womb – are more likely to give birth prematurely.

(White blood cells help fight infection and infection within the womb has been linked to early births.)

Now the team is developing a new diagnostic test – which detects white blood cells at the cervix – that would be suitable for widespread use early in pregnancy.

“We hope our new test will mean women who are found to be at high risk of giving birth early can be monitored more closely and offered extra treatment, with the aim of prolonging their pregnancy,” says Professor Klein. As better treatments become available, this may reduce the number of babies who are born too soon.

This project is supported by Dangoor Education.

References

1. WHO Preterm birth. Fact sheet No 363. Updated November 2015. Website accessed 03 August 2016.

2. Office for National Statistics. Childhood mortality in England and Wales 2014. Table 6. Website accessed 03 August 2016

3. Northern Ireland Statistics and Research agency. Registrar General Annual Report 2014 – Section 4 Stillbirths and Infant Deaths (Excel files) Table 4.5. Website accessed 03 August 2016.

4. National Records for Scotland. Vital Events Reference Tables 2014. Section 4: Stillbirths and infant deaths. Table 4.5: Infant deaths, by sex and cause, Scotland, 2004 to 2014. Website accessed 03 August 2016

5. National Institute for Health and Care Excellence (NICE). Preterm labour and birth final scope April 2013. Website accessed 15 August 2016

6. Office for National Statistics. Statistical bulletin: Birth Summary Tables, England and Wales: 2015. Live births, stillbirths, and the intensity of childbearing measured by the total fertility rate. Website accessed 15 August 2016.

7. ISD Scotland Data Tables (2015 data). Maternity and Births. Table 5 - Live births (all, singleton and multiple) by birthweight and gestation. Website accessed 15 August 2016.

8. Northern Ireland Statistics and Research Agency. Births. Live births 1887-2014. Website accessed 15 August 2016.

9. Chang HH et al. Preventing preterm births: trends and potential reductions with current interventions in 39 very high human development index countries. Lancet 2013; 381: 223–234.

10. World Health Organization. Born Too Soon. The Global Action Report on Preterm Birth. 2012. Website accessed 20 July 2016.

11. Blencowe H et al. Born Too Soon: The global epidemiology of 15 million preterm births. Reprod Health. 2013; 10(Suppl 1): S2.