June 11, 2018

expert reaction to claims that half of premature births could be prevented by technique

Scientists from the Genesis Research Trust have claimed that half of premature births could be prevented by bacteria technique test.

Dr Neil Chapman, Group Leader and Non-Clinical Lecturer in Reproductive Medicine, University of Sheffield, said:

“I note it has been presented at a scientific meeting but am not clear if that work has been peer-reviewed.

“One big problem in pre-term birth work is that making a correct diagnosis that a woman will actually go into premature labour is very difficult.

“This swab test is likely to identify women more likely to go into labour based on the bacteria identified in the swab; the aim being “prevention rather than cure” and that is a worthy goal, certainly in obstetrics. No mechanism for this action has been provided but the authors allude to the “good” vs. “bad” bacteria battle and that may involve the mother’s immune system but further work would need to be done to confirm that. The question it does not address, however, is if a woman subsequently goes into active pre-term labour, how will that be stopped? That question has remained unanswered for decades because we don’t know how womb gene expression is controlled and how it is influenced by chemicals from the baby, the placenta or from bacteria as described therein. Indeed, at present, most drug-based interventions for stopping pre-term labour have little use or at best, are short-lived.”

“I can’t comment on the accuracy of the funding statistics provided by the Genesis Trust but I would agree that the field of pregnancy and child birth receives very little long-term funding and it is charities such as Genesis that try to address this (why did you last get a charity bag through your door supporting pre-term birth work?). That initself is a worthy media story too.

Professor Andrew Shennan, Professor of Obstetrics, Kings College London, said:

“We have to say the implications of this method are somewhat overstated, and gives false. impression of making an immediate difference.

“This group have  pioneered a test to identify bacteria in the vagina rapidly. However whether this can be used to predict preterm birth has not been established. Similar tests can still be done in the laboratory, but just take longer. Treating abnormal bacteria, with new “good” bacteria is not a new concept, and as yet has little evidence of benefit. It is rare for the knowledge of a test, even a good one to quickly translate into improved outcomes. This might be a useful bedside test in the future to allow quicker identification of women at risk. How to treat these women remains to be established.”

Declared interests

Neil Chapman: “I have nothing to declare in terms of competing interests.”