2017 - 2018 in review
From trialling a new treatment to prolong labour to starting a new study into the maternal immune system, 2018 brought us closer to our mission: preventing premature birth.
Thank you for making it all possible.
Why does preterm labour happen?
In 2018, we continued to study the processes and mechanisms responsible for the initiation of labour at the cellular level.
Preterm labour has many causes. But studying preterm labour as a condition without identifying and distinguishing between the different causes can create confusing and sometimes contradictory data. Until now, scientists have not been able to characterise the pathways involved in different forms of preterm labour.
Borne Clinical Scientist and Consultant Obstetrician, Natasha Singh, has collected over 2,000 samples from women delivering at different stages of pregnancy so that we could map out the differences and similarities in the sub-types of preterm labour.
Our research focused on the role of cyclic adenosine monophosphate (cAMP), a key intracellular messenger that mediates smooth muscle relaxation in the airways, gastrointestinal tract, heart and uterus.
Our goal was to understand the changes in the cAMP-effector pathway that happen in early labour, and how they turn a relaxed uterus into a powerful contractile muscle.
We also continued to study the effects of aminophylline in the lab to better understand how it regulates myometrial contractility.
ProgrAm: Testing a new treatment to delay preterm birth
Over the last two years, we have studied the effects of aminophylline, a cAMP agonist often used to treat asthma, to understand how it regulates myometrial contractions.
Combined with progesterone, we hypothesised that aminophylline could be an effective treatment to delay the onset of preterm labour.
We started the first set of feasibility trials in November 2017. Since then we have recruited over 25 women at high risk of preterm labour into the study. Many of them have now delivered healthy babies at near full-term.
This is exciting as we are finding a new application for an existing and readily available drug, aminophylline, and close to identifying a new therapeutic approach to delay the onset of labour – the first in 50 years!
It is a psychological battle having a premature baby. You have no power or control over what is happening, over the health of your baby. When we compare our first pregnancy with our experience taking part in the Borne study, the contrast is almost surreal – from abnormal to normal.
Zarine and Zubeen, program participants
Our year in research
In 2016, our research showed that low levels of fish oils in the blood increased the risk of preterm delivery.
Since then, our findings have received further support from a paper based on data from Scandinavia. They replicated our findings suggesting again that correcting a woman’s fatty acid profile might prolong pregnancy. A systematic review published in the Cochrane Reviews also found that taking omega-3 supplements during pregnancy may lower the risk of preterm birth.
Borne PhD student, AnnieBelle Sassine, has studied how the maternal fatty acid profile influences the maternal immune system at birth. She has explored the transfer of maternal fatty acids to the foetus, understanding the roles of the key placental transporters.
We will next investigate:
- The best way to correct a fatty acid imbalance
- The benefit of pre-conceptual compared with post conception correction, and
- The impact of changing the fatty acid profile on the maternal immune system.
Borne PhD student, Katerina Georgopoulou, has been working on tracing the origins of pre-eclampsia, a condition that occurs in approximately 5% of pregnancies and is responsible for 10% of preterm births.
Her studies provided critical insights into how the enzyme DDAH can cause pre-eclampsia. DDAH indirectly controls the levels of nitric oxide, which controls the tone of our vessels: high levels cause the relaxation of smooth muscle cells within blood vessels and lower blood pressure; low levels result in vasoconstriction and higher blood pressure.
During pre-eclampsia, DDAH activity is reduced resulting in higher blood pressure in the mother. Importantly, these studies provide the first evidence that altered placental function has an impact on maternal physiology, and mechanistic insights into the conversation between the placenta and the mother.
Borne Clinical Scientist, Francois Dos Santos, is in the first year of his work investigating the impact of heart disease on pregnancy outcomes.
Heart disease is a leading cause of maternal death globally. Around 20% of pregnancies complicated by heart disease deliver preterm.
Understanding the interaction between maternal heart disease and pregnancy will help us to explain dramatic changes in the mother’s cardiovascular system during pregnancy, and the link between heart disease and preterm birth.
The incidence of preterm birth among HIV positive women is roughly double that of HIV negative women. Despite multiple studies, the reasons for this are not well understood.
Borne PhD student Alex Cocker is studying the impact of HIV on the maternal immune system during pregnancy and how it may contribute to preterm birth. He has identified a population of cells modulating immune responses (regulatory T cells) that behave differently in the HIV positive group.
These differences could be driving a more active inflammatory response in the mother and/or foetus which could trigger the onset of preterm labour. Further studies are planned.
Collaborating around the world
Our scientists and students are collaborating with experts from across the globe to better understand and prevent premature birth. Zoom into the map below to find out where.
Expanding the Borne Centre for Preterm Birth Research
We have been investing in our laboratory facilities at Chelsea and Westminster Hospital:
- New technicians and a full-time lab manager joined the Borne Centre for Preterm Birth Research.
- Our research midwives continued running Borne-funded clinics and recruited more women into our studies.
- Our research team investigated the mechanisms and processes at the cell level responsible for the initiation of labour, focusing on cAMP pathways that lead to spontaneous preterm labour.
Investing in Big Science
We need to look deeper into pregnancy, and have started a new research programme to understand changes in the maternal immune system in pregnancy and preterm birth, and to identify biomarkers to help screen women who may be at risk of delivering preterm.
- Study 2,000 women who are pregnant for the first time.
- Follow them from 12 weeks until birth, storing their samples for later analysis once we know the outcome of their pregnancy.
- Analyse the changes in the mother’s response to pregnancy to uncover the mechanisms that caused a particular pregnancy to end early.
A study of this scale will be an unprecedented opportunity for a multi-disciplinary team of experts to collaborate to understand the processes and mechanisms of pregnancy in extensive detail, unlike anything that has been done before.
Our hope is to identify biomarkers in the low-risk population that will allow us to screen all pregnant women for risk of preterm birth.
“We are looking to answer these fundamental questions: how does a woman’s body allow a pregnancy to thrive and grow; what are the very first signs that a pregnancy may not progress normally; and what can we do to improve the chances for that baby?”
Professor Mark Johnson
who are pregnant for the first time and are considered "low-risk"
will present with threatened preterm labour; 160 will deliver preterm
we will study women who have delivered preterm 6 months after delivery
We are blessed with generous and passionate supporters who go above and beyond to help us prevent premature birth through research.
- Dame Darcey Bussell
- Will and Caro Greenwood
- Sophie Ellis Bextor
- Nicola Formby
- Jason Fox
- Shanyan Koder
- Francesco Molinari
- Dean Mumm
- Michael Nunn OBE
- Erin O’Connor
- Alistair Petrie
- Greg Rusedski
- Kathleen Brooks and Barry Lane
- William and Jeanne Callanan
- Michael and Blake Daffey
- Nick and Tracey Grace
- Mark and Meekai Johnson
- Charlotte and Andrew Moffat
- Julian and Fiona Mylchreest
- Hetty and Nick Pye
- Smart Cells
- Francesco and Charlotte Vanni d’Archirafi
- William and Jeanne Callanan
- Razan Jafar and Adnan Said
- Julian and Fiona Mylchreest
Trusts and Foundations
- CA Redfern Charitable Foundation
- Patient Care Foundation Hong Kong
- Robert McAlpine Foundation
- The Dr Mortimer and Theresa Sackler Foundation
- The Sackler Trust
- Hannah Barrett
- Lora and Jeff Den Otter
- Amelia Lewis
- Angela MacDonald, her daughter Lois and their friend Freya
- David and Nicola Madoc-Jones
- Hannah Moohand
- Charlie and Bee Pye and their cousins Maisie, Isla and Elsa
- Nishul and Chandrika Shah
- The parents committee of Strawberry Fields Nursery School for nominating Borne to benefit from their Winter Fair
- Charlie Varley and the Oxfordshire Golf Club
- Emma Veitch
- BGC and Cantor Fitzgerald
- Philippa Herbert
Partners and suppliers
- 999 Design
- James Culver
- Annabel Moeller Photography
- Morgan Lewis & Bockius
- Tania Richardson
- Philippa Herbert
- Thinking of You
We are also immensely grateful to everyone who has helped make our fundraising events a success this year.
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