Mark Vickers

Globally, more than 10% of babies are born preterm (less than 37 weeks of pregnancy) meaning that there are over 15 million preterm births annually, as well as more than one million newborn deaths. In almost all high-income and middle-income countries, preterm birth is the leading cause of child death. In all parts of the world, preterm birth, and complications arising from it, is second only to pneumonia as a cause of death in children under five years old. It is responsible for an elevated risk of death from causes such as infectious disease and, in some cases, it can also cause permanent disabilities. In Aotearoa New Zealand, nearly 8% of babies are born preterm, with the rate disproportionately higher in Māori women at 14.6%. Of particular concern, Māori have a 40% increased risk of neonatal death compared with Pākehā due to extreme prematurity (birth between 20-24 weeks).

miRNAs in maternal plasma may have utility as sensitive early biomarkers for later preterm birth. Image: Mark Vickers

There is currently no accurate way to predict pregnancy complications such as preterm birth in early pregnancy. One potential tool for testing involves detecting levels of particular microRNAs using maternal blood tests. MicroRNAs (miRNAs) are small non-coding RNAs that play a multitude of roles in regulation of gene expression. The relative levels of different miRNAs may indicate future complications in pregnant women. Professor Vickers and his team have completed preliminary research that shows that miRNA levels in maternal blood tests taken at 20 weeks of pregnancy can accurately predict the occurrence of later preterm birth (birth at 28-32 weeks). This pilot study used NanoString digital technology, which counts the number of individual miRNA molecules present in a maternal plasma sample. This technology is ideal for clinical use because it requires only small blood samples, is cost effective, and non-invasive. Over the course of his James Cook Fellowship, Professor Vickers aims to expand his team's preliminary findings towards development and independent validation of an effective non-invasive clinical test to predict preterm birth using miRNAs. If it proves effective, this platform could also be used for detecting other pregnancy complications, including gestational diabetes. Early identification of mothers at later risk of such complications allows for timely intervention strategies with benefits to both mother and child.