A study of 1,253 women at Tommy’s specialist preterm clinic at Guy’s and St Thomas NHS Trust has shown that the series of tests that the clinic conducts on women who are referred to it are correctly identifying women who are at a high-risk of premature birth. The vast majority (more than 90%) of women who are referred to the clinic will not go on to have a preterm birth and being able to identify which women are at low risk allows the clinic to manage the majority as outpatients, while concentrating treatment on those who are shown to be at much higher risk. Tommy’s is the UK baby charity that funds research into miscarriage, stillbirth and premature birth.
The purpose of the study was to answer whether preterm birth surveillance clinics can identify those who are not at risk of preterm birth. The study, conducted by Professor Andrew Shennan, Professor of Obstetrics at Guy’s and St Thomas NHS Trust, triaged women at high-risk for premature birth, on the basis of history, cervical length and quantitative fetal fibronectin values (point-of-care biomarker test pioneered by this clinic).
Professor Shennan comments, “This study is so important for us and our patients as it proves that our clinic does what it should - provide much needed reassurance to the many, whilst correctly identifying the few that need our help. Women who come to the clinic, many of whom have risk factors for preterm birth, can be managed from home if our tests show that they are not at risk.”
The vast majority of women referred in early pregnancy get a low risk score in the clinic’s tests, and can be managed as outpatients. According to this study, once they get this score, their risk of premature birth is comparable to the normal pregnant population. Only 6% of all women triaged needed to be admitted as these were correctly identified as being at higher risk of preterm birth and neonatal morbidity and mortality, and receive care to improve outcome. This evidence provides a high level of reassurance to women with negative screens, in spite of their risk factors, and reduces unnecessary admissions and intervention.
Whilst the tests used in this study have established predictive accuracy, this is the first evidence that their use in a preterm surveillance clinic translates into direct benefits for patients. 94% of high risk women managed in the clinic have normal outcomes and can be managed as outpatients. This important finding will help motivate and benchmark our continuing efforts to provide the best care for our patients and contribute to national guidelines for preterm birth prevention.
Jane Brewin said: "Tommy's is pleased to fund research which offers parents-to-be better pregnancy care. For the health of our children, we must strive to make preterm birth a thing of the past; identifying those at risk, so we can intervene before it's too late, takes us an important step towards that goal. Parents across the UK will appreciate the reassurance that they will not have their baby early and can enjoy a healthy pregnancy."
For further information, please contact Hannah Blake in the Tommy’s press office
07730 039361 or [email protected]
- Tommy’s is a national medical research charity, dedicated to funding research into miscarriage, premature birth and stillbirth, so that more babies can be given the best chance of being born healthy.
- Tommy’s-funded research is critical. Even though 1 in 4 women experience complications in pregnancy from miscarriage to premature birth and stillbirth, little funding has been made available for pregnancy health research in the UK – Tommy’s therefore relies on the fundraising efforts of the public to carry out its work.
- Tommy’s has four research centres – at St Thomas’ London, St Mary’s Manchester and The Royal Infirmary, Edinburgh and Tommy’s National Centre for Miscarriage Research, a partnership of three universities: The University of Birmingham, The University of Warwick, and Imperial College London, working with their affiliated NHS Trusts.
Sadly, pregnancy complications - such as premature birth, miscarriage and stillbirth - are more common than people think, and 1 in 4 women will lose a baby at pregnancy or birth in the UK.
Further statistics show that each year in the UK:
- 1 in 4 women will have a miscarriage
- 3,500 babies are stillborn
- 60,000 babies are born too soon (which can lead to cerebral palsy, chronic lung disease, disability, blindness, deafness and illness in adulthood).
This unique Preterm Surveillance Clinic – funded by Tommy's as part of our research in St Thomas' Hospital, London, has won an NHS Innovation Challenge Prize, for its success in reducing the number of premature births in South East London.
Tommy’s prematurity research centre in London is based at St Thomas’ Hospital, where the charity first began. Opened in 1995, it is the first Maternal and Fetal Research Unit in the UK.
Around 60,000 babies are born prematurely each year in the UK. These babies are vulnerable – they are born before they have grown to cope with the outside world. Tommy’s is saving lives by researching how we can prevent premature births by finding those at risk early on.
A preterm birth is one that happens before 37 weeks of pregnancy. Globally, more than 1 in 10 pregnancies will end in preterm birth.
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