Finding out who’s at risk: how can we predict preterm labour?

Mr Paul Seed, Dr Jenny Carter, Prof Rachel Tribe, Prof Jane Sandall, Prof Andrew Shennan

Researchers supported by Tommy’s are building a tool for women with symptoms of threatened preterm labour, to work out how likely they are to give birth too soon.

Why do we need this research?

Most women who have symptoms that suggest they’ll give birth prematurely – like contractions or pain in their stomach – actually go on to have their baby at full term. Even so, a lot of women are treated ‘just in case’, as the consequences of not doing anything could be devastating.

We want to make it easier to tell which women who have symptoms of threatened preterm labour (TPTL) are actually at risk. Treating women who are not likely to give birth early can be unnecessarily stressful for parents, and treatments may have their own side effects. If we can avoid this, we can concentrate on giving help to women who really need it.

What’s happening in this project?

Our researchers recruited around 1,200 women with symptoms of TPTL to the PETRA study. The aim of the study was to improve how we predict whether a women is likely to go into premature labour.

From these women, the team collected data on many different risk factors, as well as testing for a substance called fetal fibronectin, which has been linked to preterm birth. Some women also had their cervixes measured using an ultrasound scan – a shorter cervix means a higher likelihood of early labour. Our researchers then analysed all the data together to create a tool to calculate how likely they are to give birth near in the future.

The team found that the tool was very good at predicting how likely it is that a woman will give birth before 30 weeks, or give birth within a week of testing. They have now used these results to update the QUIPP app, a smartphone app to help doctors decide who is at risk of premature birth.

The researchers also conducted interviews with 19 women who were assessed for symptoms of preterm labour. Our researchers wanted to understand the experiences of these women, and how they felt about their initial assessment as well as their treatment by healthcare professionals.

Common themes in their experiences include the uncertainty of their situation, and conflicting information and emotions. The women also said that their care and interaction with healthcare professionals both helped and hindered their ability to cope with this stressful experience.

What difference will this project make?

The findings from this study will help us predict whether or not someone with symptoms of preterm labour is likely to give birth soon. The research also highlighted the experiences of women in this situation, and point to ways that healthcare teams can improve the care and support they give to women. Ultimately this will ensure that women with symptoms of preterm labour get the treatment and support they need.

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