INSIGHT – a biobank to help predict pregnancy complications

Research into predicting preterm birth has been hampered by a lack of good quality biological samples, donated by a large number of pregnant women.

To address this, the INSIGHT project was started in 2013 by King’s College London. Samples from over 2,300 pregnancies have been collected and stored in the INSIGHT biobank. The aim is to create a resource that would allow scientists to develop ways to spot early signs that a pregnant mother might go into preterm labour.

Borne has been supporting INSIGHT since 2021. The original INSIGHT biobank was focussed on finding early indicators of preterm birth. Since then, the project has expanded into a phase called INSIGHT-2, to also look at other pregnancy complications such as preeclampsia, gestational diabetes, and foetal growth restriction.

The INSIGHT project is recruiting a diverse group of women being looked after in hospitals in Central London. Some of the women donating samples to INSIGHT are known to have a high risk of preterm birth, while others are considered to be at normal risk.

Each woman recruited to the INSIGHT cohort is asked to donate multiple samples during and after their pregnancy. This will mean that scientists can look for changes over time that might predict pregnancy complications. Parents are also asked to agree to their baby donating samples after birth and in their early years. This will allow researchers to look at how any problems with a mother’s pregnancy might affect the health of their child.

The samples and information collected include:

• Blood samples
• Swabs of the cervix and vagina
• Hair samples (to measure levels of a hormone called cortisol, associated with stress)
• Cervical length measurements (an indicator of whether someone is likely to go into labour)
• Saliva from mother and baby
• Foetal fibronectin (a protein that can indicate preterm birth)
• Questionnaires to explore the mother’s physical and mental health

The INSIGHT biobank has already collected more than 150,000 samples, and has contributed to a wide range of research collaborations, including:

• Understanding how the vaginal environment affects risk of preterm birth.
• Impact of pregnancy problems on the baby’s immune system.
• Impact of chronic stress and anxiety on risk of preterm birth.
• Cell free RNA as a predictor of preterm birth.
• Air pollution as a risk factor for preterm birth.
• Refinement of the QUiPP app – a clinical decision-making tool designed for health professionals to calculate individual risk scores of preterm birth.
• Development of a new tool to measure changes to the cervix during pregnancy.
• Understanding how type-1 diabetes in the baby might originate during pregnancy.