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Premature birth could be predicted sooner with test for bacteria

Mothers at risk of premature birth could be identified sooner in pregnancy than is currently possible by looking for specific bacteria and chemicals in their cervicovaginal fluid, a study has found.

The study was led by researchers at King’s College London and was jointly funded by charities Tommy’s and the Rosetree Trust, as well as the National Institute for Health Research (NIHR) through a doctoral fellowship to Dr Natasha Hezelgrave, and the Wellcome Trust providing strategic support to another member of the team.

Babies born prematurely often have lifelong health problems and it is the leading cause of death in newborns. It can be hard to predict and prevent premature birth and the reasons can often be unclear.

Researchers analysed cervicovaginal samples from 346 mothers taken at 10-15 weeks pregnant, and again at 16-23 weeks, then grouped women by their typical communities of bacteria and biochemicals. They checked this against cervical length measurements (the current standard NHS assessment for premature birth risk) and followed up to see who gave birth early.

For the first time this study found that a specific bacterium limits the risk of early premature birth, which the researchers hope will lead to new preventative therapies. A combination of metabolites and bacteria were linked to birth at or before 34 weeks, while seven different metabolites were associated with birth at or before 37 weeks.

These links were equally significant when mothers were tested in the first and second trimester. This means that those at risk of premature birth could be accurately identified much earlier in pregnancy than current tests allow, and therefore could then benefit from medical or surgical treatments that aren’t possible in late pregnancy.

Tommy’s chief executive Jane Brewin commented: “With 60,000 babies born prematurely each year in the UK, there’s a real and urgent need for better ways to predict and prevent preterm birth. This new study has not only uncovered warning signs that could be used to develop new tests, but also a possible treatment which could make pregnancy safer for the most vulnerable, so this new avenue of research has really exciting potential for clinical practice.”

Dr Natasha Hezelgrave was part of the team carrying out this study, which formed part of Dr Hezelgrave’s NIHR Doctoral Fellowship on Biomarkers for the prediction and management of threatened spontaneous preterm birth. The NIHR Doctoral Fellowship is a career development award to undertake a PhD and increase an individual's research skills.

The study is published in the Journal of Clinical Investigation.