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Understanding how labour starts to uncover new ways to prevent spontaneous preterm birth

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Around 55,000 babies are born prematurely in the UK every year – that’s around one in 13.[1],[2] Tragically, more than 1,000 babies die in the UK each year after being born too soon.[3-5] Many others who survive a very early birth develop lifelong problems such as cerebral palsy, blindness, hearing loss and learning difficulties. Dr Victoria Male of Imperial College London is investigating the role of a newly identified type of immune cell in triggering the onset of labour. Her findings will inform future research aiming to prevent spontaneous preterm birth – which could ultimately lead to happier outcomes for many babies and their families.

This project is jointly funded by Action Medical Research and Borne.

How are children’s lives affected now?

Premature birth is the biggest killer of babies in the UK. Babies who survive preterm birth have an increased risk of long-term complications, such as cerebral palsy and learning difficulties.

“Too many lives are being lost because babies are born too soon – and those who do survive often grow up with life-changing disabilities,” says Dr Male.

Despite the dangers, little is known about why some women go into labour too soon. In around one in five of all preterm births, the mother goes into spontaneous labour that starts for no obvious reason.[6]

“We urgently need effective treatments that can help stop premature labour – but a major barrier to this is that we do not yet understand how labour is triggered, even when a pregnancy has reached full-term,” says Dr Male. “But we have recently identified a new kind of immune cell in the lining of the womb – which we suspect plays a key role in this process.”

How could this research help?

“We aim to determine whether or not these immune cells trigger labour,” says Dr Male.

The researchers have found evidence suggesting that these cells can switch on genes that activate an immune response in the surrounding tissues and help the waters to break. They now plan to study these cells isolated from pregnant women at full term – who are either not in labour or have entered the early stages of labour.

“If these cells are involved in initiating labour, we would expect to see an increase in their number and activity before labour is established,” says Dr Male. “We would also expect them to be more numerous and active at the place where the sac surrounding the baby ruptures.”

The team will then use the same approaches to start investigating whether similar mechanisms are involved in starting labour too soon.

By fully understanding how these cells are involved in triggering labour, this could lead to ways to target them, or some of the molecules they produce, to prevent early labour.

Dr Male

Research table

Project details

Project Leader Dr Victoria Male, PhD
Location Department of Metabolism, Digestion and Reproduction, Chelsea and Westminster Hospital Campus, Imperial College London
Grant Awarded
Grant Amount £204,974
Start Date
End Date
Duration 36 months
Grant Code (GN number) GN2971

References

  1. Office for National Statistics, Vital statistics in the UK: births, deaths and marriages - 2020 https://www.ons.gov.uk/peoplepopulationandcommunity/populationandmigration/populationestimates/datasets/vitalstatisticspopulationandhealthreferencetables [website accessed 16 February 2023]
  2. Birth characteristics in England and Wales: 2020 https://www.ons.gov.uk/peoplepopulationandcommunity/birthsdeathsandmarriages/livebirths/bulletins/birthcharacteristicsinenglandandwales/2020
  3. Office for National Statistics. Childhood mortality in England and Wales 2020. Table 17. http://www.ons.gov.uk/peoplepopulationandcommunity/birthsdeathsandmarriages/deaths/datasets/childmortalitystatisticschildhoodinfantandperinatalchildhoodinfantandperinatalmortalityinenglandandwales  [website accessed 16 February 2023]
  4. National Records for Scotland. Section 4: Stillbirths and Infant deaths: https://www.nrscotland.gov.uk/statistics-and-data/statistics/statistics-by-theme/vital-events/general-publications/births-deaths-and-other-vital-events-quarterly-figures/3rd-quarter-2022  [website accessed 16 February 2023]
  5. 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 16 February 2023]
  6. Barros et al. The distribution of clinical phenotypes of preterm birth syndrome: implications for prevention. JAMA Pediatr. 2015 169(3):220-9.

 

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