Preventing the onset of preterm labour
This research was completed on 28 February 2011
Published on 6 October 2007
Premature birth is the biggest single cause of death in infants.1,2,3,6,7 Yet attempts to stop women from going into labour early have been largely unsuccessful. Researchers are studying the physiological processes that trigger labour, on a molecular level. They hope to identify potential drugs that might be able to help stop babies from being born too soon.
What's the problem and who does it affect?
Born too soon
Around 700,000 babies are born each year in the UK.4 Some 50,000 are born prematurely.4,5,8 Sadly, about 1,500 of these premature babies die.1,2,3,6,7 Many others, particularly those who are born very early, are at risk of developing serious problems, such as cerebral palsy, blindness, deafness and developmental delay.
For many women, preterm labour is shocking, scary and unexpected. All of a sudden, they have a tiny baby, who may need to spend months in hospital. This can be an anxious time, full of uncertainty about whether the baby is going to pull through. It can also be difficult to cope with other responsibilities, such as other young children.
Premature babies who go on to develop serious disabilities, such as cerebral palsy, can need lifelong care. When older, they may not be able to complete their education or have a normal job. This can completely change the lives of the baby’s family. Attempts to prevent the onset of preterm labour with drugs have been largely unsuccessful. We desperately need to improve the situation.
What is the project trying to achieve?
What causes preterm labour?
We don’t fully understand the physiological processes that control when a pregnant woman goes into labour, whether at term or preterm. The researchers working on this project suspect that interactions between two proteins, called NFkappaB and C/EBP, may play a key role in triggering labour. Both of these proteins control the production of other proteins that play important roles in ripening the cervix and causing the uterine contractions that occur with labour.
The project team’s preliminary studies show that, when working together, NFkappaB and C/EBP seem to have a much more dramatic affect on proteins that ripen the cervix and cause contractions than when working independently. The researchers are investigating how NFkappaB and C/EBP interact with each other in cells grown in a laboratory, and which genes or proteins they influence, to help establish how and whether they play a role in the onset of labour. The team has also identified several drugs that may inhibit the interaction between NFkappaB and C/EBP. They are investigating whether these drugs have the potential to prevent preterm labour.
What are the researchers' credentials?
|Project Leader||Professor P Bennett BSc PhD MD FRCOG|
|Location||Parturition Research Group, Institute for Reproductive and Developmental Biology, Imperial College London in conjunction with the Department of Obstetrics and Gynaecology, Chelsea and Westminster Hospital, London and Warwick Medical School, University of Warwick, Coventry|
|Grant awarded||6 July 2007|
|Start date||1 March 2008|
|End date||28 February 2011|
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Professor Bennett and his team have been researching both the scientific and clinical aspects of preterm labour for nearly 20 years. The team was the first to show the importance of an enzyme that makes prostaglandin, a locally acting hormone, in the onset of labour and later showed that this, and other proteins that cause cervical ripening and contractions, are in turn controlled by the protein NFkappaB.
Professors Bennett, Johnson and Thornton are all internationally recognised for their work on prematurity.
The team works in laboratories in the Institute for Reproductive and Developmental Biology at Imperial College, which is the country’s largest basic science institution working on diseases of women and newborn babies, containing state-of-the-art equipment for studies on cells and protein regulation. The group is especially well placed to do these studies because the laboratories are located right next door to Queen Charlottes Hospital, one of the busiest maternity hospitals in the UK.
Who stands to benefit from this research and how?
Working towards new drugs
If we are to stop so many babies from being born too soon, we need to develop ways to prevent, or delay, the onset of labour. The researchers have identified several potential drugs that might, in theory, have the ability to do just that.
Their work will reveal whether the drugs show promise in cultured cells. It will also boost our understanding of the physiological processes that regulate the onset of labour. If the candidate drugs do show promise, then the researchers plan further studies to establish the proof of principle that’s needed to begin clinical trials in pregnant women.
They have the expertise and facilities needed to run such trials. Identifying ways to stop women from going into labour prematurely would bring many benefits. It would cut costs to society by, for example, reducing the number of babies who need intensive care at birth and the number who go on to need lifelong help. The benefits to babies and their families, of avoiding death and serious disabilities such as cerebral palsy, are too numerous to mention.
- Office for National Statistics: Health Statistics Quarterly 28 (Winter 2005), 32 (Winter 2006), 36 (Winter 2007).
- General Register Office for Scotland, Vital Events Reference Tables 2006.
- Northern Ireland Statistics and Research Agency. Registrar General Annual Report 2006.
- Office for National Statistics. Health Statistics Quarterly 35 (Autumn 2007), Table 2.1: http://www.statistics.gov.uk/downloads/theme_health/HSQ35.pdf
- The Information Centre, Community Health Statistics. NHS Maternity Statistics, England: 2003-04, 2004-05, 2005-06.
- For England and Wales, deaths listed as due to “immaturity related conditions”.
- For Scotland and Northern Ireland, deaths listed as due to “disorders related to length of gestation and fetal growth”.
- Calculation made by Action Medical Research based on figures in references 4 and 5 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.