This CSG is currently sponsored by Action Medical Research (AMR)
Professor Jane Norman of the University of Edinburgh has recently replaced Professor Steve Thornton as Chair of the Preterm Birth CSG. The CSG has 9 clinical advisers and 6 executive members. Meetings are held every 3-4 months. Minutes are available via the RCOG web-site.
The most high profile output from the preterm birth CSG is the OPPTIMUM study which is a multicentre randomised controlled trial which aims answer the question
‘Does progesterone prophylaxis to prevent preterm labour improve outcome?’
Outline proposals which are currently being developed include
An open meeting of the PTL CSG was held on the 20th April 2012 at the BMFMS annual conference in Glasgow. Minutes from this meeting which was held jointly with the Maternal Medicine CSG are available.
For specific inquiries on the preterm birth CSG you can contact Professor Jane Norman at jane.norman@ed.ac.uk.
The preterm birth CSG held its first open meeting at Perinatal 2011 in Harrogate. This was very well attended with over 60 interested delegates from a range of disciplines. The chair, Professor Jane Norman presented a short overview of the work of the CSG. Since inception the CSG has supported the development of the OPPTIMUM trial which is successfully funded by the Medical Research Council nd a further 4 trials developed by CSG members have applied for external funding.
Delegates then heard from three different researchers who presented their study proposals for feedback from the group.
Professor Zarko Alfirevic from the University of Liverpool/Liverpool Women’s Hospital NHS Foundation Trust gave an outline of the PACS Trial which aims to answer the question
‘Can Personalised Antenatal Care for low risk women based on Sequential risk assessments increase the number of health mothers and babies born at term without significant increase in cost to the NHS?’
The trial will involve singleton pregnancies and women would be randomised to standard care or 1st trimester screening for PET (as yet undefined), TV scanning of the cervix at the time of anomaly scan (progesterone 200mg pv nocte if cervix is ‘short’), and third trimester screening for late IUGR.
Given that the trial would need to recruit 30000+ women in order to look at the primary outcome of term birth with a healthy mother and a healthy baby Professor Alfirevic was keen to get audience opinion on whether people felt they would be happy to recruit and the proposal generated a great deal of debate. The protocol will be developed further based on points raised by the audience and a funding application is likely in the near future.
Professor Leila Duley presented an overview of placental transfusion and cord clamping. Her proposal was for a feasibility pilot study of deferred versus immediate cord clamping in live-births pre 32 weeks gestation. This would involve development of a new BASICS trolley to facilitate neonatal care whilst cord clamping is delayed. The aim would be to recruit 100-110 women with follow up of the baby to age 2. A large range of neonatal and paediatric outcomes would be measured. Funding has already been secured as part of a larger grant. There was discussion regarding; the role of oxytocics, what to do in units who use delayed cord clamping as standard.
Dr Rahini Rattihalli presented a proposal to look at the primary prevention of PTB using variations in biomarkers with social deprivation. The proposed biomarker was hs CRP which reflects a chronic inflammatory state. Initially the group had wanted to look at pre-pregnancy hsCRP levels and pregnancy outcome but from a feasibility point of view this had now been changed to pregnancy. It was felt by a number of audience members that the use of a single biomarker might not be the best approach. Dr Rattihalli was advised to bring the proposal to one of the formal PTB CSG meetings for more detailed review.
Dr Jon Dorling from the Neonatal CSG then gave a brief overview of the work of his CSG which is chaired by Dr Mark Turner. Their key priority areas are nutrition, cardiovascular, respiratory and infection. They were keen to explore areas for collaboration and the executive committees of the 2 CSGs are going to look at how to work together more effectively.