Tommy’s scientists continue vital pregnancy research work

Through the summer, scientists at Tommy’s Research Centres all over the UK have still been hard at work, supporting families through high-risk pregnancies at our pioneering clinics and sharing their latest ground-breaking studies into miscarriage, stillbirth and premature birth.

August 2020

Understanding what baby movements can mean

Pregnant women are encouraged to get to know their baby’s normal movements to make sure they notice if something changes; when a baby is unwell, they may conserve energy by slowing down their movements, which can be a sign they’re at risk of stillbirth. 3 recent studies found that a single period of significantly increased movement may send the same warning, so our Manchester Research Centre’s stillbirth specialists launched the INVEST project to find out more.

The other research into this was done by looking back after babies were born, which isn’t the most reliable evidence – but we had a unique opportunity to study pregnancies in real time. 64 pregnant women who came to our clinics at St Mary’s Hospital with concerns about their baby moving more than normal agreed to take part in our research, so the Tommy’s team monitored them throughout pregnancy to see if this was linked to any problems for the baby.

Happily, the research showed that babies suddenly moving more than normal was not linked to stillbirth. Our scientists also looked for any problems with how the placenta was working, or other signs of babies struggling, and again found no links to increased baby movements. This reassuring news for parents-to-be was recently published in Acta Obstetricia et Gynecologica Scandinavica.

While researchers continue to decode the important messages these kicks and flutters can send, we’ve developed a guide to baby movements in partnership with NHS England, to help expectant parents understand everything we’ve discovered so far. Remember, if you’re worried about your baby’s movements, you should always speak to your midwife or maternity unit.

Working to predict and prevent premature birth

Around 60,000 babies are born prematurely each year in the UK, which can lead to serious life-long health problems. Premature birth is a leading cause of death in new-borns, which is why we’re committed to finding out why it occurs and developing new treatments to stop it from happening. The reasons for premature birth are often unclear, but experts at our London Research Centre are investigating certain proteins and enzymes found in the vagina that seem to play a role.

Researchers studied more than 600 pregnant women at our Preterm Surveillance Clinic, measuring their vaginal fluid in early pregnancy and then following up to see when they went into labour. They found that premature birth was more likely to happen to women with higher levels of an enzyme called human neutrophil elastase (HNE), as well as proteins called elafin and cathelicidin.

Professor Andrew Shennan and his research team just published their latest results in the journal Nature, showing that levels of elafin could be used to predict moderate premature birth (<34 weeks) while cathelicidin and HNE were able to predict late premature birth (<37 weeks). Current tests for premature birth vary in accuracy, so mothers often don’t get the right care in the right place at the right time; we developed the QUIPP app to change that, and this ongoing study aims to discover new data which will make it even more effective.

Turning research breakthroughs into better care

On top of running their innovative clinical studies, our National Centre for Miscarriage Research is working to put their findings into practice so that more people can benefit from their work. Since the success of our PRISM trial, we’ve been calling for progesterone to be prescribed to women who have had a miscarriage before and experience bleeding in early pregnancy – and in the meantime, we’ve developed a document to help if you want to ask your doctor for this treatment.

This month we published the biggest ever study into medical management of missed miscarriage, showing that a combined drug is more effective than the current standard NHS treatment, so now we’re urging the National Institute for Health and Care Excellence (NICE) to update their guidelines to make sure everyone who needs it gets the best possible treatment. (Until then, we’d encourage anyone going through this to ask their doctor about combining mifepristone with misoprostol.)

As the biggest research centre focused on miscarriage in Europe, the work never stops, and we’ll soon be publishing a major new study into all aspects of miscarriage: how often it happens and the huge impact that has, what we know about the underlying causes, why some people go on to have healthy babies while others experience recurrent loss, which tests and treatments are best, and more. We hope this will create a blueprint for how to support people going through miscarriage while we continue to unpick how we can prevent it.