Diagnostics for preterm birth risk prediction in pregnant Australians

Preterm birth (PTB) is a leading cause of morbidity and mortality in children under five years of age. However, there are currently no reliable clinical tools for identifying women at risk. Through a collaboration with the University of Western Australia (UWA), we aim to advance the development of point-of-care diagnostics for spontaneous PTB (sPTB) caused by infection in Australian women, including First Nations women.

Objective

We aim to develop diagnostic tests for sPTB risk prediction in pregnant Australians, including First Nations women.

Timeline

2021–2027.

Approach

Participants 

Pregnant women are being enrolled into two clinical studies being led by Dr Matthew Payne and Prof John Newnham (UWA) in partnership with First Nations researchers and communities. This is the First Nations cohort and Preterm Birth Prevention Study (PTBPS) Clinical Trial in Western Australia and the Northern Territory. Our biomarkers discovery analysis will include 240 and 500 women participating in these studies, respectively.

Sample collection 

Women will complete a medical/lifestyle questionnaire and then provide a self-collected vaginal swab in QIAGEN AllProtect media for metaproteomic and cytokine analysis.

Biomarkers discovery

Metaproteomic analysis will be conducted using liquid chromatography tandem mass spectrometry at the Monash University Proteomics and Metabolomics Facility and cytokines measured using Luminex. We will use a variety of machine learning approaches to identify the biomarkers most accurately predictive of sPTB. We will then validate the biomarkers using targeted quantitative selected reaction monitoring mass spectrometry.

Community impact 

This work may lead to the development of accessible, low-cost diagnostics that could be administered by community health workers or used for home-based self-testing to identify women at risk of sPTB. While existing diagnostics lack accuracy and only detect imminent sPTB, we aim to develop tests that can identify sPTB long before it occurs, enabling the initiation of interventions to prevent this outcome.