Professor Philip Bennett
Preterm Labour
Preterm labour is the major cause of infant deaths and long-term handicap, particularly <32 weeks, with 8000 births p.a. in the UK at birthweights under 1500g. Infection and inflammation are important causes of both preterm labour and cerebral palsy. Research into the causes of preterm labour and it associated handicap, and into methods for its prediction and prevention, is undertaken in both clinical and laboratory environments.
Clinical Research
Clinical research is undertaken in our three linked prematurity clinics at Queen Charlottes Hospital (Prof Phillip Bennett), St Mary’s Hospital (Mr T G Teoh) and Chelsea Westminster Hospital (Prof Mark Johnson, Dr Vasso Terzidou). These clinics receive referrals of patients at high risk of preterm labour and enable us to undertake studies of the prediction and prevention of preterm labour, and to translate our basic science findings into clinical practice. For example our basic science finding of the central role of COX-2 in parturition led to the TOCOX trial of COX-2 inhibitors in women at high risk of preterm birth. More recently our studies on the effects of progesterone on uterine gene expression, and those of other groups, have led to large clinical trials of progesterone in women at high risk of preterm birth, in particular the UK multicentre OPPTIMUM trial to which we are recruiting. We are also currently undertaking studies of the possible role of 3D ultrasound, and of a variety of biomarkers in the prediction of preterm labour.
Laboratory research, is directed by Professor Phillip Bennett and Professor Mark Johnson, focuses on the mechanisms by which labour begins, in particular regulation of gene expression changes with labour onset and identification of ways in which these could be inhibited clinically. This research uses tissue collected from our linked hospitals.
Our group was the first to identify the central importance of the COX-2 prostaglandin synthetic enzyme in the onset of human labour, and, more recently, the first to identify the central role of the transcription factor system NF kappaB in the regulation of genes involved in the onset of labour. We have also have focussed on the role of stretch in preterm labour, particularly in multiple pregnancy. We have identified an essential role for mitogen activated protein kinases in stretch-induced pro-labour gene expression. Current studies include:
Understanding the role of progesterone in regulating gene expression in the uterus to determine how progesterone might be best used as a preventative treatment.
• Chemokine function in human labour.
• The role of the CRTH-2 receptor in human pregnancy and labour.
• Studies of the stretch regulation of genes in human fetal membranes.
• The roles of prostaglandin receptors and cAMP signalling in human pregnant myometrium.
• The role of oxytocin receptor signalling in human amnion.
• Inhibition of inflammatory signalling in the prevention of preterm labour and associated neonatal injury.
