About prematurity

Preterm birth is defined as birth at less then 37 weeks of pregnancy.

It is further categorized as:

  • Moderate to late preterm (32 to < 37 weeks)
  • Very preterm (28 to < 32 weeks)
  • Extremely preterm (< 28 weeks)

Key facts (World Health Organization)

  • Every year, an estimated 15 million babies are born preterm (before 37 completed weeks of gestation), and this number is rising.
  • Preterm birth complications are the leading cause of death among children under 5 years of age, responsible for nearly 1 million deaths in 2013.
  • Preterm birth is a leading cause of disability and learning problems in childhood.

The problem

An estimated 15 million babies are born too early every year. That is more than 1 in 10 babies. Almost 1 million children die each year due to complications of preterm birth. Many survivors face a lifetime of disability, including learning disabilities and visual and hearing problems.

Why does preterm birth happen?

Preterm birth occurs for a variety of reasons. Most preterm births happen spontaneously, but some are due to early induction of labour or caesarean birth for medical reasons.

Common causes of preterm birth include multiple pregnancies, infections and chronic conditions such as diabetes and high blood pressure; however, very often no cause is identified. There could also be a genetic influence. Better understanding of the causes and mechanisms will advance the development of solutions to prevent preterm birth.

What happens to preterm babies as they grow up?

Many children born preterm go on to lead happy and fulfilling lives, but a significant number have life-long effects due to the effect of early birth on the developing brain. The following problems are all more common among children born preterm:

  • Neurodevelopmental disorders eg cerebral palsy
  • Difficulties with hearing and vision
  • Learning and behavioural problems
  • Inattentiveness
  • Social difficulties
  • Increased likelihood of receiving a diagnosis of autism spectrum disorder
  • Increased need for educational support

There are also risks of physical problems including sub-optimal growth, respiratory infections, reproductive problems, psychiatric diseases and high blood pressure.

Investigation of the causes, prevention, management and long-term outcome of babies born ‘too early or too small’ is a research priority that requires solutions from different branches of medicine and psychology. And yet, much information about the effects of preterm birth comes from historic cohorts of children that do not reflect modern care practices; studies have tended to focus on preterm infants at one point in time in very early childhood before important cognitive, social and physical functions emerge; diagnostic tests for assessing and predicting impairments are imprecise; and cohorts linked to imaging and biological information are few so the mechanisms that link preterm birth with the problems listed above are poorly understood.

There is an urgent need to study a 21st century cohort that is exceptionally and comprehensively characterised from genetics to cells to medical, educational and social information.

The solution?

We aim to recruit a cohort of 400 preterm infants (born at less than 32 weeks of pregnancy) and healthy controls, and to acquire brain imaging from birth to adulthood that is linked to comprehensive biological information and detailed clinical, environmental and neuropsychological data. This unique, integrated and longitudinal resource will, when combined with molecular and stem cell technologies enable the study of the human biology underlying perinatal brain injury. This is the essential first step for the discovery and clinical testing of preventative and regenerative treatments for preterm brain injury.