University of Adelaide receives $23.2 million for preterm birth research

Dec 8 2017

The University of Adelaide has been awarded $23.2 million for new research tackling some of the world's most significant health problems, including one of the biggest killers of children: preterm birth.

The funding, from the National Health and Medical Research Council (NHMRC), will support 30 new projects led by University of Adelaide researchers.

Among the funding is more than $690,000 for a three-year project led by Professor Sarah Robertson, Director of the University's Robinson Research Institute, to develop new drugs aimed at suppressing the triggers of preterm birth.

"This is an outstanding funding result for our research teams and for medical and health research in the State," says the University's Deputy Vice-Chancellor (Research), Professor Julie Owens.

"The latest NHMRC funding will support breakthrough discoveries in women's and children's health, cancer, diabetes, cardiovascular health, infection control, diet and nutrition, oral health, and traumatic brain injury," Professor Owens says.

"Our world-leading researchers in the Robinson Research Institute, the Research Centre for Infectious Diseases and other key centres have been recognised yet again as best able to tackle some of our most common and debilitating health problems," she says.

Preterm birth – worldwide burden

Preterm birth (at less than 37 weeks' gestation) has severe health consequences for families worldwide. Each year, 15 million families experience a preterm birth, and 1.1 million of those babies die. Preterm birth is now the world's biggest killer of children under the age of five, and accounts for three-quarters of all child deaths within the first month of life. In Australia, preterm birth affects 8% of pregnancies.

"As well as being a leading killer of infants, preterm birth often results in health and developmental consequences that can prevent children from reaching their full life potential," says Professor Robertson, who will lead a team of researchers from Australia and the United States on this project.

"Current interventions for inhibiting preterm birth are inadequate to say the least, and new approaches to prevent or delay prematurity are urgently required. Even small advances in this field may have important benefits for children and families," she says.

New direction for preterm birth research

For the first time, University of Adelaide researchers will focus their attention on stopping the activation of an underlying mechanism in the body – inflammation – that links the many causes of preterm labor. This research, involving laboratory and pre-clinical human studies, will inform the design of future clinical trials for women at increased risk of having a preterm delivery.

Professor Robertson says activation of the inflammatory response is the key mechanism leading to spontaneous preterm birth. "This may be in response to such causes as infection, oxidative stress, placental diseases, environmental toxins or the mother's immune system rejecting the fetus," she says.

"It's clear that inflammation-associated damage during gestation can set in motion a series of events that leads to preterm birth. What we need to do is to find ways of protecting the fetus from this inflammatory injury."

The main target in this study is the immune receptor known as Toll-like receptor 4 (TLR4). Other research at the University of Adelaide and elsewhere has shown TLR4 to play in important role in inflammation related to pain and addiction. It's hoped that by stopping the activation of TLR4, researchers can divert "the upstream driver of preterm labor".

Baby Orly's journey

Just 24 weeks and four days into pregnancy with her baby girl Orly, Amy Perone was admitted to hospital after it was identified she had lost all of her amniotic fluid.

"It was a frightening experience," says Amy, who had been hemorrhaging during pregnancy. "We were advised that it was likely Orly would be delivered within days, and I had no idea what would become of our baby daughter if she was born so early."

Labor began naturally the following day, and Orly Gallasch was in such a hurry to arrive that she was born just four minutes after mum Amy was moved to the delivery suite at Adelaide's Women's & Children's Hospital. Born on 26 November 2016, she was only 654g and 31.5cms.

Orly spent the first 107 days of her life being cared for in hospital, and then a further 10 days in hospital as more complications from her preterm birth arose. Today, having now celebrated her first birthday, she no longer requires supplemental oxygen and is making great progress.

"It certainly hasn't been an easy journey, but we've tried to make the most of it. Orly is an inspiration to us all," says Amy, who, with her husband Graham Gallasch, has documented their story on the Facebook page Orly's Journey.

"We felt it was important to record our experiences, as therapy for ourselves, but also so that others could understand what our girl and our family were going through. As it turns out, it has been a wonderful medium of connection with others who have experienced similar journeys but were unable to articulate the trauma at the time."

Amy has welcomed the new direction being taken by University of Adelaide researchers with this project.

"Having a preterm child can be terrifying and heartbreaking, and we know that our family is among the lucky ones. Anything that can be done to help spare families from going through such hardship, and to improve the health of their little ones, will be amazing," she says.​