Premature birth, caused by preterm labour is now the major cause of both infant deaths and long term handicap.

Cells from the uterus stained with a fluorescent probe which detects NFkappaB. When it is not activated NFkappaB is mostly found outside the nucleus of the cell (top panel). After it is activated it moves into the nucleus, where the DNA that contains gene is found. In the nucleus NFkappaB activates genes that lead to the onset of labour (lower panel)

It is 'early' preterm delivery before 32 weeks which is of greatest importance. Of 600,000 live births per annum in the UK, approximately 8000 will be at birth weights below 1500g. Of these 1600 a year will die and 600 a year will develop cerebral palsy.

Infection and inflammation are important causes of both preterm labour and cerbral palsy. We have previously shown that infection and inflammation cause labour by activating a system in the cells of the uterus called 'NFkappaB'. NFkappaB is a 'transcription factor' which means that it acts to switch on genes, which in turn lead to various proteins being made within the cells of the uterus. NFkappaB switches on the production of a series of proteins which cause the cervix to ripen and the uterus to contract. These same proteins are also thought to be able to damage the brain of the preterm baby and so may be a cause of long term handicap.

We plan to find out how NFkappaB is activated and what proteins within the uterus are switched on by NFkappaB. Understanding this will help us to identify women who are at risk of preterm labour and to identify drugs which can be used to switch off NFkappaB and therefore reduce the risk of preterm delivery.

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