A study supported by our BRC has shown that a blood based RNA test can give an early pregnancy indication that a baby will be born prematurely. By helping to predict preterm births, the work could help clinicians to provide treatment that may prevent early labour and provide care to prevent complications.

A preterm birth is one that happens before the 37th week of pregnancy. About 8 out of 100 babies will be born prematurely.  Babies born pre-term can have a range of complications. However, treatment is available to prevent preterm birth, either through a small tablet of hormone medicine or an operation to put a stitch in the cervix to help support it

The study analysed tens of thousands of RNA messages from 242 pregnant individuals who had taken part in the INSIGHT study, led by Professor Rachel Tribe, King’s College London. The project was supported by our BRC alongside Tommy’s Charity,  Rosetrees Trust, Action Medical Research and the Borne Foundation. The work was also supported through an NIHR Doctoral Research Fellowship.

A strength of the research was that the individuals involved were from ethnically diverse backgrounds, indicating that the findings are widely applicable. The study utilised the Mirvie RNA platform, which uses machine learning to analyse tens of thousands of RNA sequences present in blood samples.

In results, published in The American Journal of Obstetrics and Gynecology, showed that maternal RNA signals can predict the risk of preterm birth early in a pregnancy, months before symptoms occur. The platform could also identify distinct biological pathways driving the development of preterm birth.

Professor Rachel Tribe, from the Department of Women and Children’s Health, King’s College London, led the research. She said: This is a very exciting development that has real potential to aid clinicians with  prediction of PTB in the future. It also provides some valuable clues as to the biology leading to PTB. Our study also highlights the power of academic and commercial collaboration when tackling complex conditions such as preterm birth.

Specific RNA messages were able to predict preterm birth months before the occurrence of any symptoms. Importantly, the platform was able to identify distinct biological pathways likely driving the development of preterm birth, creating new options for therapeutic interventions. Key findings include:

RNA messages related to premature changes to the mother’s cervix predicted three out of four cases of early preterm birth (less than 35 weeks), two months in advance on average.

Distinct RNA messages involved with amino acid metabolism and insulin-like growth factor pathways predicted cases of extremely premature birth (less than 25 weeks).

The results build on research recently published in Nature demonstrating the Mirvie RNA platform can predict preeclampsia months before symptoms occur.