60,000 babies are born prematurely in the UK each year, which can have serious consequences without the right care – but it’s very hard to predict when this will happen, and up to 80% of mothers with signs of premature labour are still pregnant a week later. Being born too soon leaves babies vulnerable, so doctors have to be cautious and treat mothers who might be at risk 'just in case', which often means they go through anxious hospital stays and unnecessary drug treatments only to give birth on time.
Predicting premature birth
Experts from our Edinburgh research centre have developed a more accurate way to predict premature birth, which involves measuring levels of fetal fibronectin (a protein which acts like a glue to fix the amniotic sac to the womb lining). Previous Tommy’s research discovered that when a mother is at risk of giving birth prematurely, this protein is released into the vagina, where it can be picked up with a swab.
Fetal fibronectin testing is already used in our Preterm Birth Clinic at the Royal Infirmary of Edinburgh, and at our first specialist clinic in London, but current NHS guidelines for assessing premature birth risk focus on measuring the cervix so this test is not always offered.
Latest research findings
Our Edinburgh team analysed 5 European studies that measured the fetal fibronectin levels of 1,783 pregnant women with symptoms of premature labour, checking how many of them actually gave birth within a week of that test (139). They compared this with information the NHS would typically consider warning signs for premature birth - such as the mother's age, BMI, ethnicity, smoking status, pregnancy history and cervical length - looking for patterns in the data to suggest these other things were in play when babies arrived early.
Having identified the most significant risk factors, our researchers then spent 2 years studying 2,942 mothers who came to 26 UK hospitals with symptoms of premature labour, so that we could see if this information can be used in real time to help predict which babies will really be premature.
Only 85 mums in the study gave birth within a week of their fetal fibronectin test – but many more would have been considered equally vulnerable based on the other ways of measuring risk, which could have meant they endured additional stress and unnecessary treatment. The new findings in prestigious journal PLOS Medicine show that combining fetal fibronectin tests with other warning signs is a much more accurate way of predicting premature birth.
Improving maternity care
In light of this research adding to already substantial evidence of how fetal fibronectin can help to predict premature birth, we’re calling for this testing to be standard practice across the UK. Our latest research estimates this could save the NHS £840 for every mother identified as potentially vulnerable to premature birth, reducing the economic as well as emotional costs of the current system.
“Most mothers with signs of premature labour are still pregnant a week later, and this study shows the typical NHS tests aren't accurate enough to tell who's really at risk, which can put undue strain on expectant parents and on the NHS. Our latest research clearly demonstrates that fetal fibronectin testing can reduce the economic and emotional toll of this issue, being more cost-effective while reassuring families who may otherwise be very anxious and helping to make pregnancy safer for those who do need special care.” - Tommy’s CEO Jane Brewin
Our specialist pregnancy clinics have already incorporated fetal fibronectin testing into their QUiPP app, which accurately predicts the risk of premature birth, to ensure mothers get the right treatment at the right time – but we believe that every family should have access to the best possible care. We urge the Government to include these tests as standard in national maternity care guidelines, to help focus precious NHS resources on those most in need.