Babies born too early (preterm), especially before 28 weeks of pregnancy, are at risk of facing developmental and health problems. These may include delays in learning, difficulties with language, and impaired motor function.

One serious condition that can affect preterm babies is bleeding in the brain, known as germinal matrix–intraventricular haemorrhage (GMH-IVH). This type of bleeding happens in a fragile region of the brain that is very important for early brain development. We still do not fully understand why the blood vessels in this region break so easily in preterm babies and therefore more research is needed.

Our research aims to gain a deeper understanding of the biological differences between the vessels in the region prone to bleeding compared to regions that do not usually bleed.

To do this, we first used a method called spatial transcriptomics, which shows us which genes are turned on or off in specific regions of the brain. We compared healthy brain tissue with brain tissue from babies who had GMH-IVH. This helped us spot important differences in gene activity between the regions where bleeding happens and the areas where it does not.

In the next stage, we will look at brain tissue under the microscope from additional cases. We will check whether the differences we saw in gene activity can also be seen at the protein level, because proteins are what genes produce and what affect how tissues behave.

By combining both sets of information—gene activity and protein changes—we hope to understand why blood vessels in this region are so fragile. This knowledge is an important step toward developing new treatments that could help protect the brains of very preterm babies in the future.