- Project leader: Dr R M Tribe Phd - Division of Reproductive Health, Endocrinology and Development, Kings College London, St Thomas' Hospital
- Project team: Professor A H Shennan FRCOG, Professor P Bennett MD, PhD, FRCOG
- Other location: Division of Paediatrics, Obstetrics and Gynaecology, Imperial College London, Hammersmith Hospital
- Duration: 3 years
- Grant: £102,364
- Status: Ongoing research
Premature birth: is inflammation to blame?
Premature babies are at enormous risk of death and disability. Yet doctors don't know how to stop women from going into labour too early and can't predict who will be affected. Researchers are studying whether inflammation leads to early labour. They hope this will reveal how to prevent premature birth.
What's the problem and who does it affect?
Premature babies struggle against enormous risks.
Around 50,000 babies are born prematurely in the UK each year. For these tiny babies, the first few weeks of life are fraught with danger.
Sadly, many die soon after birth. In fact, three of every four babies who die within four weeks of birth are premature.
Babies that survive are at high risk of getting developmental problems and severe disabilities, both mental and physical.
Prematurity doesn't affect just the baby, it has a huge impact on their family and on society as a whole. The UK alone spends over £4 billion annually on neonatal intensive care for premature babies.
Dedicated researchers lack adequate funding
As yet, doctors can't predict which women will go into labour prematurely. And they don't know how to prevent or treat premature labour. Unfortunately, research into pregnancy has not been a government priority. It is up to committed researchers, with the help of charities like Action Medical Research, to find solutions to this problem.
What is the project trying to achieve?
Does inflammation cause premature labour?
Researchers need to find out more about how premature labour begins. They already know that the cervix, which forms the neck of the womb, often gets shorter before premature labour starts. They suspect inflammation might cause this shortening.
So the research team will invite women who are thought to be at high risk of premature labour to take part in a study. At least once a fortnight, researchers will assess each woman's cervix using ultrasound scans. They will also take blood samples and vaginal swabs to test for markers of inflammation.
Researchers will try to stop some women from going into premature labour using, for example, the hormone progesterone or a procedure called cervical stitch.
The results will reveal any links between inflammation and changes in the cervix. They will also show whether treatment can limit the effect of inflammation on the cervix.
What are the researchers' credentials?
The project leader, Dr Rachel Tribe, is a scientist and senior lecturer with 10 years' experience of researching pregnancy and premature birth. She has published many peer-reviewed papers in highly regarded journals.
Professor Andrew Shennan has coordinated several large clinical trials into treatments for preterm labour and is a world expert on regulating blood pressure in pregnancy. Professor Phil Bennett is also highly respected worldwide, for work on prostaglandins and labour.
Both Professor Shennan and Professor Bennett run clinics for pregnant women who are at high risk of going into premature labour, so the team should recruit patients quickly to their study.
Who stands to benefit from this research and how?
Towards treatments that stop inflammation
Researchers suspect inflammation can cause premature labour. If they're right, the next step would be to try to prevent premature birth by stopping inflammation.
The study should reveal whether any of the existing treatments are beneficial and how best to design new treatments.
Screening mothers might save babies' lives
The ultimate plan is to screen women for inflammation regularly throughout pregnancy. This would reassure women who do not have inflammation and allow better treatment of women who do.
A large number of women and babies stand to benefit. Doctors think one in ten pregnant women are at high risk of going into labour prematurely - that's 70,000 women at risk each year in the UK.
Unfortunately, one in a hundred women gives birth more than ten weeks early. At this very early stage, the baby's chances improve dramatically for every extra week of pregnancy. So any treatment that prevents, or even just delays, premature birth could save many lives and prevent disability.
Regular screening and subsequent treatment of high-risk women would cost considerably less than looking after babies in neonatal intensive care units and treating any longer term disabilities as they grow up.
