New bacteria test could half premature birth rate

Tommy's news, 11/06/2018

Researchers, including Professor Phillip Bennett, from Tommy’s National Centre for Miscarriage Research, have discovered a new test which has the potential to prevent up to halve of premature births. The simple bacteria test could be used to identify the risk at routine check-ups, helping ensure early intervention. 

Around 60,000 babies are born prematurely each year in the UK. Globally, more than 1 in 10 pregnancies end in premature birth – around 15 million babies every year. 

The new swab test can be used to confirm if women are carrying potentially harmful bacteria in their reproductive tract. Research suggests that such conditions, which produce no symptoms, can cause up to half of premature births. 

Scientists from Genesis Research Trust are now testing treatment options to prevent such cases, by giving women supplements which replace the dangerous microbes with “good bacteria”.

These trials are an attempt to limit the use of nonessential drugs in pregnancy, amid concern that the indiscriminate use of antibiotics in women whose waters break early in pregnancy kills “good” bacteria and allows growth of harmful bacteria in some women.

Doctor David MacIntyre, who lead this research, noted the potential of this simple test:

“The possibility of reducing the number of babies born prematurely is a major breakthrough.

Professor Phillip Bennett, Head of the Tommy's Miscarriage Centre team, at Imperial College explains:

'What we have shown is that that the risk of preterm birth, in some cases, is related to the type of bacteria which are present in the vagina in early pregnancy. 

Using antibiotics in pregnancy will often kill the ‘good bacteria’ which allows the ‘bad bacteria’ to grow in their place. We have also shown that having the ‘bad bacteria’ in the vagina at the time of preterm birth relates to an increased risk of infection for the preterm baby immediately after birth which increases the risk of longer term bad outcomes for that baby. So one important message is that we have to be very careful in giving antibiotics to pregnancy women, and we should not give antibiotics just because we think that a women is at higher than usual risk of preterm birth.

A challenge in looking at the bacteria in any individual women is that the current techniques don’t produce results quickly enough for us to test the type of bacteria in the vagina in the clinical setting or to be able decide who should, and who should not have antibiotics.

So Dr David MacIntyre and Professor Zoltan Takats have developed a technique using a machine very similar to the machines used in airports security to detect tract amounts of explosives, which tell us about the bacteria present in the vagina in a matter of minutes.

This test works very well, and we plan to role it out into clinical care in the very near future'. 

Being able to accurately predict which women are at risk of pre-term labour allows us to give them the care they need sooner, and as we develop and improve preventative treatments, we hope to we can avoid the worst case scenario of a very premature delivery for many more women.

What is preterm birth?

A preterm birth is one that happens before 37 completed weeks of pregnancy.

The World Health Organisation gives the following definitions for the different stages of preterm birth:

• Extremely preterm: before 28 weeks
• Very preterm: from 28 to 32 weeks
• Moderate to late preterm: from 32 to 37 weeks.

Tommy's Premature birth research

Tommy’s funds pioneering research into the causes, prevention and treatment of premature birth.  

Research is vital so that we can understand which women are likely to go into labour early, and help them carry their baby for as long as possible.Tommy’s support cutting-edge work on the causes and prevention of premature birth through our centres in both London and Edinburgh. Clinics at both centres care for mums at risk of preterm birth.

Recent research highlights

• Researchers have found that levels of a protein called elafin could be used to tell which women are most at risk of going into early labour.
• We are helping women around the world have healthy pregnancies by trialling a cheap, easy-to-use saliva test that can tell how likely a woman is to give birth prematurely.
• The SUPPORT trial is the first ever clinical study comparing the effectiveness of three different treatments in preventing premature birth in women with a shortened cervix.
• Scientists have found that drugs normally used to prevent heart disease may delay preterm birth.