The Preterm Trials Consortium: using long-term trials to answer difficult questions

Tommy’s has helped to set up a platform that is allowing researchers to study premature birth more effectively.
  • Authors list

    Professor Andrew Shennan, Dr Jenny Carter, Professor Rachel Tribe

    Start date: 2016
     

This project took place at our London centre which operated between 1995 and 2021.

Why do we need this research?

Research into premature birth is a tricky task. To get results that you can trust, large numbers of people need to be included and this can mean that trials need to go on for a long time. For example, Tommy’s recently supported the MAVRIC study that showed that the abdominal stitch helped women with a weak cervix carry their babies to full term. But this study took eight years.

In the case of the MAVRIC study, it was hard to recruit women to the trial for two reasons. Firstly, many doctors were strongly either for or against the abdominal stitch and did not want to take part. Secondly, the women that were included had very high-risk pregnancies and were relatively rare.

If a condition is rare, or it is difficult to find people to take part in research, it can be hard to test which treatments work best. To make things harder, research funding is often given for relatively short periods of time; often too short to find meaningful answers or understand long-term effects.

Tommy’s wants this to change.

What’s happening in this project?

To make research into premature birth more achievable, our researchers have been involved in setting up the Preterm Trials Consortium (PTC). The consortium is a collaboration between a large number of research centres – 40 so far, including specialist preterm teams based in the UK, Europe, Australia and New Zealand – that will help researchers carry out lots of different studies in large numbers of women. By setting this up, scientists can begin to address the many unanswered questions surrounding premature birth.

As part of the PTC, a clinical database has been created that stores information about women who take part in clinical trials, attend specialist preterm clinics or have symptoms of threatened preterm labour. This information, relating to the care the women received and the outcomes of their pregnancies, can then be shared with scientists around the world. The PTC database went live in December 2016, and so far over 5,000 women have given permission for their data to be stored on the platform; most of these women have also consented to long-term follow-up of their children’s health. In addition to this, historical records have been collected for nearly 5,000 women. 

What difference will this project make?

The Preterm Trials Consortium will enable high-quality long-term research to take place. This is necessary to answer some of the big questions we still have about premature birth, such as:

  • Whether the cervical stitch can help women who have bulging membranes;
  • When to remove the cervical stitch in women whose waters have broken;
  • The best way to deliver a premature baby that is positioned to come out feet first.

The answers to these questions will enable us to improve the care being given to women who are at risk of premature birth and could help reduce the number of babies being born too soon.

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