Test could warn of premature births

Premature births and the complications that result may be reduced significantly by the use of a new test that will help doctors to pinpoint when pregnant women are likely to go into labour.

Each year more than 50,000 babies are born prematurely - that is before 34 weeks of pregnancy, and they account for around three-quarters of perinatal deaths. Those that survive suffer high rates of illness and disease.

Although advances in neonatal intensive care have increased the chances of survival, the incidence of prematurity has not changed for decades. The new diagnostic test, launched yesterday at the Hamersmith Hospital in west London, poses no risk to mother or foetus since it simply requires a swab of the cervix between 24 weeks and 34 weeks of pregnancy. If the protein foetal fibronectin is present, the mother is likely to give birth within 14 days.

Action to minimise risks in positive tests may include obstetric intervention to suppress contractions or the prescription of antibiotics to combat infection in the womb, a major cause of premature birth. Where birth is inevitable, the mother may also be given steroids to help develop the baby's lungs.

The foetal fibronectin test was developed in the United States, where 90 per cent of premature deliveries were predicted in trials. Doctors there have been been using the technique for more than a year. Clinical trials are already under way at St Mary's Hospital, Manchester, and the University Department of Obstetrics and Gynaecology at Leicester Royal Infirmary.

Professor Murdoch Elder, dean of the Royal Postgraduate Medical School Institute of Obstetrics and Gynaecology, and whose department at the Hammersmith has been investigating causes of premature birth, said he was 'cautiously optimistic' about the test's potential. Although he did not envisage the introduction of automatic screening for all pregnant women, Professor Elder believed the test could be a valuable diagnostic tool for women at high risk of giving birth prematurely.

Stillbirths and infant deaths continued to decline in England and Wales last year, according to official figures published yesterday. The number of babies who died before their first birthday decreased by 7.3 per cent to 5,158. Stillbirths and deaths in the first week of life were down by 1.8 per cent, to a total of 5,650.