Melbourne researchers developing test to predict premature births

MELBOURNE researchers are developing a swab test to predict the 10 per cent of woman who will give birth prematurely without warning, a prognosis they say will revolutionise the care of 15 million pre-term infants born each year.

MELBOURNE researchers are developing a test to predict the one in 10 women who will give birth prematurely without warning, which they say will revolutionise the care of 15 million pre-term infants born annually.

After 15 years of research, the team has narrowed their scope to 10 biomarkers, or proteins that change as a woman's body prepares for imminent birth.

On the back of the launch of a major study, they are hoping to offer the swab test to women within three years.

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The Royal Women’s Hospital, Mercy Hospital for Women and University of Melbourne team is recruiting 3000 Victorian mums throughout the next year to define at what gestation — ideally between 20 and 24 weeks — the test is most accurate for warning of impending birth.

The Predicting Preterm Labour study, funded through a tie-up with biotech Carmentix, will see women who give birth at the Mercy or The Women’s invited to take part as early as 18 weeks into their pregnancy.

Senior research fellow Harry Georgiou said the strength of the test was that it relied on multiple biomarkers in cervical fluid that reflected changes occurring in the earliest signs of labour.

Pregnant mum Briony Swart, with her six-year-old son Oscar, has had two early miscarriages. She says the swab test would provide some peace of mind. Picture: Jake Nowakowski

This includes activation of the uterus muscles for contractions, inflammation and remodelling of the cervix.

“One of the things that makes a prediction difficult is that some of these biomarkers change very early in pregnancy, some seem to be changing around 20-24 weeks and others change quite close to ­labour,” Dr Georgiou said.

“But we are starting to see consistent changes in patterns, and it has culminated in something that in the next year or so we hope will be clinically ­relevant.”

Pre-eclampsia or fetal growth restriction can trigger a premature birth. Having one premature birth increases the risk for future pregnancies.

But half of women who give birth before 37 weeks have no identifiable risk factors, with 40 per cent first time mothers.

Globally, about 15 million babies are born premature each year and more than a million die as a result.

Melbourne mother Briony Swart, who gave birth on Friday at 36 weeks, had two early miscarriages and twice gave birth to stillborn babies at 21 weeks after her son Oscar, now aged six, was born.

Briony Swart, who is 36 weeks pregnant, with her six-year-old son Oscar, has had two early miscarriages and lost two babies at 21 weeks. Picture: Jake Nowakowski

“This test would provide some peace of mind,” Ms Swart said.

“The unknown or the waiting makes a difficult situation even harder, but information makes it more bearable.”

Clinician-researcher Dr Megan Di Quinzio said knowing that pre-term labour was imminent would allow the mother and baby early access to treatments to delay labour, or boost the chance of the ­infant surviving with the fewest possible complications.

“There is no drug to stop labour, but if we knew it was going to happen we would get the women to a centre with appropriate neonatal facilities,” Dr Di Quinzio said.

“We could more closely monitor them, and there are treatments such as giving the mother corticosteroids to boost lung and brain development in babies, and magnesium sulfate which is a neuroprotective against cerebral palsy.”

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