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Ahead of Our Time

Long overdue: Developing a treatment to prevent preterm birth

Babies born too soon are vulnerable to a host of health problems, including asthma, vision problems, hearing loss or development delays. Some don’t survive past childhood.

With about 15 million preterm births yearly worldwide, the health consequences are well understood. But there’s very little known about why preterm births happen, who is at risk or what can be done about it.

“We still don’t know exactly how a process as common as birth starts, how it goes wrong,” says researcher Kelycia Leimert.

The senior scientist at the University of Alberta is working to change that.

The current approach to treating preterm birth is to slow contractions, which delays birth by a few days. “We describe it as trying to stop a train when it’s already full-speed ahead down the tracks,” says Leimert.

One of her projects is developing a treatment that will, in a manner of speaking, stop the train before it leaves the station. The second is a diagnostic test to predict when the engine is warming up.

“Otherwise, we’re blind on both sides,” Leimert says. “Even if we come up with the perfect treatment, it’s really hard to understand who to give it to because there aren’t clinical signs until a woman is contracting.”

There are signs — they’re just hard to see.

David Olson, Leimert’s former PhD supervisor and head of the Olson Lab, has spent decades researching factors that influence preterm birth and piecing together molecular changes in the body that precede contractions. A key indicator is inflammation, when cell-level changes from the uterus “signal to the rest of the body to get ready, a big event is coming,” Leimert says.

Tracking inflammation is the basis for their diagnostic test, which looks at white blood cells of a pregnant person to predict — with about 90 per cent accuracy — whether contractions will begin within the week.

Knowing when labour is imminent creates a window to give the treatment, an inhibitor of inflammation, to people who are at risk of preterm birth. Leimert’s research shows that this inhibitor stops contractions from commencing by suppressing the release of some inflammatory proteins.

Animal studies are showing the treatment effectively stops preterm birth without compromising maternal immunity or fetal organs. “Even though we’re delaying birth and prolonging pregnancy, it’s not really going to help outcomes unless we’re also protecting the fetus from those harmful inflammatory effects,” she says.

“People are starting to recognize that women’s health technology is an area that people are very willing to spend money on.”

“Otherwise, we’re blind on both sides,” Leimert says. “Even if we come up with the perfect treatment, it’s really hard to understand who to give it to because there aren’t clinical signs until a woman is contracting.”

Promising results on the bench mean the scientists have already donned their business hats to get it to the bedside. Leimert and Olson helped co-found a company called Livmor Biosciences to develop their diagnostics and therapeutics.

Next steps for the diagnostic are already underway by the National Research Council, which is working on a microfluidic chip to simplify the complex test into one that can be done with a blood pinprick.

Meanwhile, the long-term goal of the inhibitor is to get it to human clinical trials.

Leimert and the team have been meeting with venture capitalists, hoping to raise interest and money to continue development through the first phase of a clinical trial. They hope that a successful first round would interest a pharmaceutical company to come, she says.

But it’s not an easy sell, she says.

Pregnant people are rarely included in clinical trials because of the doubled patient risk. And stigma from the thalidomide tragedy of the 1960s all but ended the development of drugs for conditions related to pregnancy.

That’s one reason Leimert is grateful for the support from WCHRI. She received a grant in 2015 as a PhD student studying inflammatory pathways related to the birth process and another in 2021 as a postdoctoral fellow for her work on the inhibitor.


Kelycia Leimert was supported by the Stollery Children’s Hospital Foundation and the Alberta Women’s Health Foundation through the Women and Children’s Health Research Institute.

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