Research projects

Tommy's funds a wide range of research projects across the UK, all of which aim to help us give every baby the best start in life. These projects are either based in our research centres at St Thomas' Hospital, London and St Mary's Hospital, Manchester or at hospitals and universities in other locations across the UK.

Have a look below to see some of the Tommy's research projects that are currently ongoing.

Assessment of the long-term clinical and economic costs of premature birth

Dr Petrou, Dr Henderson, National Perinatal Epidemiology Unit, Oxford

The high rates of morbidity and mortality arising from preterm birth impose a considerable burden on health care resources, which are well known to be limited.  Babies born prematurely are at an increased risk of a range of complications both in the short and long term.  Short-term complications include chronic lung disease, brain injury, eye problems, sepsis.  Long-term complications include an increased risk of learning difficulties or behavioural problems, and motor and sensory impairments.

Although the health outcomes for babies born prematurely are well known, relatively little is known about the economic consequences. The objective of this study is to estimate both the clinical and economic consequences of premature birth for the health service, for other sectors of the economy and for society as a whole up to age 18 years.

The model will initially be broken down into gestational age categories of before 28 weeks, 28 to 32 weeks, 33 to 36 weeks, and 37 completed weeks.  The model will have a neonatal phase, and then a phase for each year of life.  Death at any stage will be built in to the model. 

The results will be presented in terms of mean costs in each gestational age category, which will be disseminated widely through the medical, scientific, and economic communities, plus to the UK Government to help inform health policies.

Investigating the management of pre-term labour

Prof P Bennett, Imperial College, London

Preterm labour is known to be associated with infection in the womb.  Labour, whether term or pre-term, is associated with activation of specific genes whose purpose is to ensure that the cervix is ready for labour and to coordinate contractions of the womb.  These genes are triggered by hormone-like substances (such as cytokines and prostaglandins).  Infection can cause these genes to be activated too early, as a result of infection, then this will cause preterm labour.  The research team will investigate whether a specific type of prostaglandin could be used to “switch-off” the genes that are associated with triggering labour, thereby stopping preterm labour and leading to delayed delivery of the baby and improved neonatal outcome.

Is the grading system for placentas useful in terms of function?

Dr S Ong, Prof T Mayhew, University of Nottingham

During pregnancy the placenta is seen on ultrasound scans, most of the time it has a smooth appearance.  Sometimes it looks irregular and appears to have patches of brightness – this is called a Grade 3 placenta.  Nobody really knows what affect this grade 3 placenta has, although there is a suggestion that it is related to poor pregnancy outcomes.  The research team will try to establish whether there is a link between grade 3 placentas and poor pregnancy outcome, through looking at oxygen supply across the placenta.  They will do this by looking at the structure of cells within the placenta and how close together they are.  The hypothesis is that in a normal placenta it is easy for oxygen to pass across the placenta to the baby whereas in a grade 3 placenta it is more difficult for oxygen to pass across the placenta to the baby and it is this decreased oxygen supply that causes problems in pregnancy.

Investigating the effect of antioxidants on pregnancy and pre-eclampsia

Prof C Redman, Dr I Sargent, Dr E Linton, University of Oxford 

The ongoing VIP trial (funded by Wellcome Trust – see details under Tommy’s London research centre) is currently investigating whether treatment with vitamins C & E during pregnancy can help to prevent pre-eclampsia.  However, researchers are still unsure about how the vitamins might be working.  We still do not know much about pre-eclampsia and how it develops, although we do know that the placenta is the primary cause.  This project will use blood samples taken from the same women recruited to the VIP trial in Oxford, to examine how treatment with the vitamins alters markers of inflammation the mother’s blood stream as inflammation is known to affect the function of the placenta.  Dependent on whether these markers are increased or decreased and the relative levels, the team will be able to determine whether the vitamins are affecting inflammation in the blood stream or whether more investigation needs to be made into how the vitamins reduce the risk of pre-eclampsia.

Investigating the causes of raised blood pressure in pre-eclampsia

Professor G Mann et al, Kings College London

It is known that cells lining blood vessels (endothelial cells) are damaged during pre-eclampsia.  This research aimed to show that the cells were damaged, in order that we might learn how it may be prevented.  The project showed that pre-eclampsia alters the ability of fetal endothelial cells to handle ions, such as calcium.  These alterations in the cell's ability to handle calcium result in the production of relaxing substances within the cell.  These relaxing substances (nitric oxide and PGI2) act on smooth muscle in the blood vessel, causing relaxation and increased blood flow, and therefore ultimately increasing blood pressure.  Although suspected, this is the first time that this has been shown through direct research evidence.

Following on from this project, work will look at specific ion channels (known as TRP proteins) which alter the way calcium ions enter cells.  Changes in production of TRP proteins in pre-eclampsia may occur as a result of the changed handling of calcium ions seen in endothelial cells in pre-eclampsia.

[This project was fully funded by The Big Lottery Fund following an application prepared by Tommy’s.]