Investigating the trigger for the onset of labour in humans

... the involvement of endocannabinoids, sphingolipids, ceramides and lymphocytes

Summary

Preterm labour (PTL) is labour before 37 weeks of pregnancy, affecting 7% of pregnancies in the UK. Worldwide, PTL causes 1 million babies to die each year, and more have lifelong disabilities. We don't understand how normal labour starts, which means we cannot reliably prevent PTL nor efficiently start labour when required. This has both social and economic consequences.

I previously compared molecules in blood samples taken immediately following birth from women who laboured and delivered vaginally with those from women who did not labour and had an elective caesarean section. Blood was taken from the cord which attaches the baby to the placenta, and from the mother's blood surrounding the placenta. Many of the molecules were significantly different between the two groups of women. Specifically, in women who laboured, there was an increase in endocannabinoids in the cord blood, and ceramides and sphingolipids in the maternal blood.

My hypothesis is that the trigger for labour comes from the baby, beginning with an increase in endocannabinoids, which is controlled by white blood cells, causing an increase in ceramides and sphingolipids in the mother, resulting in labour.

To test this, I will take blood from women throughout their pregnancies, to see when the changes observed between the two groups first happens. I expect there will be no differences until the group who labour go into labour. I will also assess the white blood cells in the cord blood and maternal blood around the placenta.

If my hypothesis is correct, this would mean in the future we could better predict and look after women with PTL or women who require labour to be started.