Premature birth: predicting the risk of early labour in first-time mothers
This research was completed on 6 September 2011
Published on 30 July 2012
Premature birth is the biggest killer of babies under one in the UK.1-4,a,b Babies who survive are at risk of developing lifelong disabilities. Dr Rachel Tribe, of King’s College London, is looking for ways to screen first-time mothers to identify who is at risk of giving birth early. Her studies suggest that testing levels of cytokines – natural proteins that help coordinate the immune system – would not be particularly helpful, so she is turning her attention to other lines of research.
What is the problem and who does it affect?
Pregnancy can be a time of great excitement and anticipation. Expectant parents hope for a normal pregnancy and a healthy baby. Sadly, however, things don’t always work out. About 60,000 babies are born prematurely each year in the UK, putting them at risk of death and disability.5,c
Some premature births are planned – doctors decide to deliver the baby early because complications in the pregnancy are putting the health of mother or baby at risk. However, the majority of early births are spontaneous, with the mother going into labour, or her waters breaking, too soon.6,7 Over half of these women are in their first pregnancy.7
Most of the first time mothers who go into labour prematurely do so unexpectedly, without warning, and are totally unprepared for the early arrival of their baby. Sadly, once a woman has gone into labour early, doctors can do little to stop her baby from being born too soon.
What did the project achieve?
Dr Tribe hopes to develop a screening test for routine use during pregnancy to identify first-time mothers who are at risk of giving birth prematurely. No such test is currently available. Women at high risk could then be referred for specialist antenatal care, in an attempt to stop their babies from being born too soon.
“In this project, we studied 115 first-time mothers who gave birth prematurely and 230 who had their babies at full term,” explains Dr Tribe. “We measured the level of 32 different cytokines in vaginal swabs taken when the women were 20 weeks pregnant. Cytokines are proteins that help coordinate the immune response to infection, and evidence suggests there is a link between infection, and therefore levels of cytokines, and premature birth.”
Results show that the level of most of the cytokines did not differ significantly between women who did, and did not, give birth prematurely. “We have come to the conclusion that a screening test that measures the level of these particular cytokines is unlikely to work in terms of predicting preterm birth in first time mothers. We plan to publish our results and are pursuing other approaches.”
What are the researchers’ credentials?
Dr Tribe is an eminent scientist in the field of pregnancy research. She leads a flourishing research group, looking for better ways to prevent premature birth and predict who’s at risk. This research took place at King’s College London, St Thomas’ Hospital, in London, which has state-of-the-art equipment perfectly suited to this project.
|Project Leader||Dr Rachel Tribe BSc Sp Hons PhD|
|Location||Maternal and Fetal Research Unit, Division of Women’s Health, King’s College London|
|Grant awarded||16 August 2010|
|Start date||16 August 2010|
|End date||6 September 2011|
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- Office for National Statistics. (2009) Child Mortality Statistics in England and Wales, 2009 (Table 6) [Online]. Available from http://www.statistics.gov.uk/downloads/theme_health/child-mortality/chil... [Accessed 22 March 2011]
- Office for National Statistics. Infant and perinatal mortality in England and Wales by social and biological factors. Statistical Bulletin. 24 November 2009. http://www.statistics.gov.uk/pdfdir/ipm1109.pdf
- Northern Ireland Registrar. (2009) General Annual Report 2009 (Section 4: Stillbirths and Infant Deaths) [Online]. Available from http://www.nisra.gov.uk/demography/default.asp76.htm [Accessed on 22 March 2011]
- General Register Office for Scotland. (2009) Vital Events Reference Tables 2009 (Section 4: Stillbirths and Infant Deaths) [Online]. Available from http://www.gro-scotland.gov.uk/statistics/theme/vital-events/general/ref... [Accessed on 22 March 2011]
http://www.ic.nhs.uk/statistics-and-data-collections/hospital-care/mater... and http://www.statistics.gov.uk/downloads/theme_health/HSQ43.pdf
Number of births for England and Wales is 708,711 see http://www.statistics.gov.uk/downloads/theme_population/FM1-37/FM1_37_20... Number of births for Northern Ireland is 29,410 births see http://www.nisra.gov.uk/archive/demography/publications/annual_reports/2...
Number of births for Wales is 60,041, see table 3.8 http://www.gro-scotland.gov.uk/statistics/theme/vital-events/general/ref... TOTAL= just under 800,000 live births for the UK
Gestation length for England see http://www.hesonline.nhs.uk/Ease/servlet/ContentServer?siteID=1937&categ...
- Iams JD, Romero R, Culhane JF, Goldenberg RL. Preterm Birth 2. Primary, secondary, and tertiary interventions to reduce the morbidity and mortality of preterm birth. Lancet 2008; 371:164-75
Langhoff-Roos J, Kesmodel U, Jacobsson B, Rasmussen S, Vogel I. Spontaneous preterm delivery in primiparous women at low risk in Denmark: population basedstudy. BMJ 2006; 332:937-9. Epub 2006 Feb
a. For England and Wales, deaths listed as due to “immaturity related conditions”
b. For Scotland and Northern Ireland, deaths listed as due to “disorders related to length of gestation and fetal growth”
c. Calculation made by Action Medical Research based on figures for the number of births a year in the UK and the number of preterm deliveries in England, respectively. Estimate assumes incidence of premature birth is the same for the UK overall as it is for England.