The Power of Research
Delivering the step-change needed
Last month, we launched our new National Centre for Preterm Birth Research, because we believe more needs to be done to prevent babies being born too soon. 6 babies are born prematurely every hour, and the government is not on track to reduce the rate of premature birth to 6% by 2025.
Our new centre is dedicated to delivering the step-change we need to reduce the number of babies born too soon and give a new generation a better start in life. The research will focus on answering the key questions that families affected by premature birth have:
- What is my risk of premature birth and how can it be reduced?
- Why did I give birth prematurely and can it be prevented in the future?
- How can outcomes for my premature baby be improved?
- How does having a premature birth impact the future health of my family?
Identifying the best treatments for each person at risk
Measuring the length of the cervix is the most comment method for assessing someone’s risk of premature birth. While interventions like the cervical stitch and progesterone are treatment options, they don’t work for everyone. This means there must be other causes of cervical shortening that are leading to premature birth.
This study, which will be carried out across the whole centre, aims to find out the causes of cervical shortening and assess how factors like the bacteria in the vagina and how well the placenta is working impact whether someone will respond to treatment like a stitch or progesterone.
This study will mean we’re able to predict which women and birthing people who have a short cervix will benefit from the different treatments available. It will also help us better understand how to monitor women and birthing people at risk.
Exploring emerging research fields to better understand premature birth
Another innovative area our team will be focusing on is how changes in the womb lead to labour starting. The ways in which the womb and the cervix prepare for and bring about birth are not well understood.
Our researchers think the ability of the womb to sense changes in force – stretch and pressure – is important to make sure a pregnancy continues to full term. They also think when these processes go wrong, this could lead to premature birth.
Our team at the University of Leeds and Queen Mary University of London are looking at a protein in the womb that detects force – Piezo1 – to find out how it might be involved in triggering birth at full term, and how these processes might be going wrong in premature birth. By understanding how proteins like Piezo1 are involved in premature birth, we can start to develop new ways of preventing it in the future.
Helping parents be more involved in decision making
We know from stories from our community that having a premature baby is a hugely anxious time for families. Most premature births are unexpected, meaning parents aren’t prepared for some of the decisions they need to make under very stressful circumstances.
When a woman or birthing person goes into labour prematurely, midwives and obstetric doctors are usually the first clinicians to explain what is happening, and many different healthcare professionals may be involved. It’s crucial all messages given to families are consistent and that they’re involved in decisions about their baby’s care.
After experiencing sharp pains in her stomach, tightening and some bleeding, Sheyma was she was admitted to hospital. Sheyma delivered her baby, Younes, at 25 weeks:
As I was examined I could tell by the nurse and doctor’s faces that something wasn’t right. Then the doctor gently held my hand and said: "Love, I need you not to panic but your baby is coming earlier than expected. I am about to push the emergency buzzer so you'll see lots of people in here that will do their best to help you and your baby."
In that moment, everything felt surreal and I lost it. All I could think was that he was only 25 weeks.
Lots of people rushed into the room and as the nurses tried to put a cannula in my hand, I asked another to call my husband who was waiting in the car park because of Covid. I remember seeing his face as I was rolled to the delivery ward, he looked terrified and I just kept apologising to him as I felt guilty that my body was failing to keep our baby safe inside.
Our scientists have previously analysed patterns and styles of communication between doctors and parents on the neonatal unit. The next step is to understand more about how neonatal and obstetric doctors involved parents in the decisions that need to be made.
In this project, our researchers will ask for consent to record conversations between doctors and parents during premature birth to find out which communication approaches are most effective at allowing parents to make the decisions that are right for them and their family.
By improving communication between doctors and parents, we can reduce the regret that parents sometimes feel about the decisions made at such a stressful time.
Kath Abrahams, Chief Executive at Tommy’s said:
Here at Tommy’s, we believe more needs to be done to give parents the answers they need after having a baby too soon. Through collaborative research at our new centre, we are aiming to find new next tests and treatments to reduce the numbers of babies born prematurely and help all women and birthing people get the right care at the right time.
Together, we will save babies’ lives. This is the power of research.