Predicting premature labour using the body’s natural defences

Ms Sogol Salamipour, Dr Natalie Suff, Mr Paul Seed, Prof Rachel Tribe, Prof Andrew Shennan, Dr Natasha Hezelgrave, Dr Amirah Modh Zaki, Dr Alex Ridout, Dr Flavia Flaviani, Dr Holly Jenkins, Ms Jiadai Mi, Dr James Mason, Prof William Wade

Our researchers have found that a natural substance made in the vagina and cervix could help us tell whether a woman will go into early labour. The team hope this could lead to new ways to prevent premature birth.

Project ongoing

Why do we need this research?

Premature birth can lead to health problems for the baby and is the leading cause of death in new‑borns. We need to find new ways to lower the risk of early labour.

What’s happening in this project?

Recently, Tommy’s helped fund a study into how we could use elafin, a natural substance in the body, to tell if a woman is likely to go into premature labour.

During pregnancy, cells in the walls of the vagina and cervix produce substances that help to fight infections. Our researchers tested whether one of these substances, elafin, could be used to tell whether or not early labour will take place.

2,000 women were recruited to the INSIGHT study, some of whom were at high risk of early labour based on their clinical history. To look at how elafin could affect early labour, doctors took samples of vaginal fluid, blood, and cells at different stages during the pregnancy.

Our researchers have found that the amount of elafin changes during pregnancy. Interestingly, they also found that the woman’s ethnicity also influenced the levels of elafin. They discovered that black women have more elafin than white women in early mid-pregnancy, and that this had an effect on the bacteria present in their vagina. They also found the link between elafin and preterm birth varied depending on the woman’s ethnicity. These results suggest that premature birth might have different causes in black and white women, something which the team are now investigating further.

In another part of this study, Tommy’s researchers are developing new ways to better understand the link between elafin, the bacteria present in the vagina, and the cells which line the cervix and vagina. To do this, our researchers are growing vaginal cells in the lab using special equipment which closely replicates the environment of the vagina. They are using this technique to study how different bacteria have different effects on the lining of the vagina, and what effect that might have on the risk of preterm labour.

What difference will this project make?

These projects will help us better understand the body’s natural defences to the bacteria present in the vagina, and how they might be linked to preterm labour. This work could lead to new ways to predict whether a woman is at risk of going into labour early, and maybe find ways to stop this happening. The hope is that this will ensure that fewer babies are born too early.

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