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.
One area that is being explored is the way in which parts of the immune system may increase the chances of a woman giving birth early. During pregnancy, cells in the wall of the vagina and cervix produce substances called antimicrobial proteins that are the body’s first defence against infection. In a small pilot study, Tommy’s researchers showed that one of these substances – elafin – was observed in higher amounts in women who gave birth before 37 weeks. Our researchers want to confirm these findings in a larger study and want to understand more about how this works.
What’s happening in this project?
Our researchers have been carrying out the INSIGHT study to find out more about the causes of premature birth. By looking at samples from over 600 women, including more than 460 who were at risk of premature birth, the team noticed that the amount of elafin in vaginal fluid drops during pregnancy. They also found that obese women and women who smoked during their pregnancy had higher levels of elafin in their vaginal fluid.
Our researchers found a moderate link between elafin levels and the risk of premature birth before 34 weeks, but more importantly, they found that it may be possible to predict the chances of premature birth by looking at several different molecules and bacteria in vaginal fluid, rather than just looking at elafin. They also identified a bacteria that may be useful for probiotic treatment. This will need to be tested as it has the potential to reduce the chances of premature birth.
In another part of this project, Tommy’s researchers are carrying out work in the lab to better understand the link between the types of bacteria present in the vagina and the levels of antimicrobial proteins, and how this is related to premature birth. In particular, they are beginning to understand that different bacteria have different effects on the lining of the vagina, and that this relates to the risk of premature birth.
What difference will this project make?
This project will tell us more about how the body naturally responds to bacteria present in the vagina, and how this might be linked to preterm labour. This work could lead to new ways of predicting whether a woman is at risk of going into labour early and may help us find ways to stop this happening. The hope is that this will ensure that fewer babies are born too early.
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