The Borne Foundation Annual Report and Financial Statements 31 March 2025 Comp2ny Llmlted by Guarantee Registratlon Number 09788534 (England and Wales} Charity Registration Number 1167073 (Eng12nd and Wales) Conlents Reports Reference and administrative deteils Trustees, report Independent audllors report 15 Flnanclal Stgtements Statement of financial activities 19 Balance sheet 20 statement of cash flows 21 Principal accounting policies 22 Notes to Ihe financial statements 26 Reference and Admlnlstratlve Details Trustees J R H Mylchreest Ichaiim8n) Lady P Cadogan (appointed Iolh Oct 2024) R Cope laptK)inled l Oth Oct 20241 R Jafar Prof. M Johnson {3ppoir¥led 41h Jul 20241 C L Mof12t ￿M￿e Prof. L Poslon (appointed 16th May 2CTr241 F P Vanni d'Archirafi Reglstered Office 3rd Floor, 315-317 New Kings R08d London SW6 4RF Telephone 07821681 058 Webslte www.borne.org.uk Company reglstfallon number og788534 {Erw18nd and Wales) Chartty reg181ratlon number 1167073 (Engl8nd and Wales) Audltor Barnes Roffe Audll Limited Chailes Lake House, Claire Causeway Crossways Biisines% Park D2rllord DA26QA Bankers CAF Rank 25 Kings Hill Avenue Kings Hill Wesl Melling ME19 4TA Investment Man8gers Insignis Cash Solullons st Johns Innovation Centre Crowley Road Cambridge CB4 OWS The Borne Foundation Paoe11 Trustees Report at 31 March 2025 Thetrustees present their report logelherwith the audited financial slalements of Boine Foundation ('the ch8ritable compan￿) for the year ended 31 KAarch 2025. This report has been prepared in accordance with Parl 8 of the Charities Act 2011 8nd serves as a directors. report for ihe purposes of the Companies Acl 2006. The financial slalemenls have been prepared In accord8ncewilh theaccounling policies Set out on pages 22 to 26 Iherein and cornply with the charitable companys Memorandum and Arllcles of Association, applicable laws and Accounting and Reporllng by Charities.. Statement of Recommended Piaclice applicable to charities preparing their accounts in accord8nce with Ilie Flnanclal Repoillng Stand8rd applicable in the United Kingdom anti Republic of Ireland (FRS 1021. Publlc Benefft The Board of Trustees have taken account of the Chaiity Commlssion's guidance on public benefit in reviewing Borne's aims and objectlves and planning future 8ctivilles, ABOUT BORNE Resear¢h to prevent premalure blrth The Borne Foundation Is a registered chaiity founded by obstetrician Pfofessor Mark Johnson, a physician and obslelrician who has seen the devaslallng effects of premaluiily first-hand. Premalurily Is the term used to describe 811 babies born before 37 weeks of pregnancy. In the UK, a baby is generally considered viable il il is borii al 24 weeks, yet Ihelr chances of survival are only 50°&. abies who are born too soon f8ce many challenges. The eailier a baby Is born, the more likely their organs wlll suffer damage or not develop as Ihey should because they 8re less mature. Each day in the womb Is esscnlial to a babys healthy development and siirvivel. For example, in the UK, babies who 8re born al 23 weeks ai)d survive have a 92.￿ chance of experienclng a dis8bility. If that b2by can stay in the womb an extra three weeks and be bDrn a126 week8, the chance of having 8 dis8bility is reduced to 41 %. Borne believes scientific research is the key lo bring about lasting change. Yel, funding for research into complications during pregnancy and childbiiih lags far behind other medical conditions. We are working to change that. By investing in respareh, we will find answers, improve care and nurture talent in this pressing area if need. ACTIVITIESAND PERFORMANCE Bornds research strategy The research that Borne funds is focused on the pregnancy period and Ihe f8Ctors and conditions In pregnancy that may lead to preterm birth. We seek lo deepen our knowledge of the biologlcal processes of pregnancy and chlldbirth lo beller LJnderst8nd the sionlficance of changes in the maternal environment throughaul pregnancy and define the mechanisms involved in normal and abnormal labour. Only by understanding the normal process can we begln to understand the 8bnormèl in order to delay the onset of preterm labour as well as lo idenlify markers of risk in women that are likely lo deliver their babies preterm. This understanding Is fundamental to the development of diagnostic, treatment and prevention strategies lo ieduce the iale ol pielerm birlh. The Borne Foundation Paoe12 Trustees Report at 31 March 2025 We do not directly participate in research associated with assisted conception, or 8reas of maternal health that ale not directly linked lo pregnancy or birth,. service delivery researah also falls outside our remil. Our primary objeclwes are.. 1. To encourage btg sclence and foster selentlfic collaboratlon We want to invest in cutting edge teehniques 2nd experllse that bring sclenlisls 2nd clinicians together to advance collective knowledge and help make breakthroughs possible. 2. To strengthen the earfy-stage research base We pump-prime promising new research ideas, giving scientists the impetus to develop their analysis and advance Iheir breakthrough projects. We want to make sure that the best ideas. backed up by the strongest science, have the greatest change Its succeed. We invest in world-class early-slage research project.8 vettpd by 2n indppp.nde.nt Scientific Advisory Board. By offering 8 number of projecl-based awards lo support the research prograrnmes of lenured researchers, we enable sclenlist.q to take Ihpir novel ideas forward with preliminary dala that en2ble them to applyfoi furtherfunding from research councils and olhergrant-m8king bodies for larger scale studles, effeclNely leveraging the contribution of Borne's supporters sever81 times over the initial investment. 3. To bulld oapaety In our area of need We must allrecl more of the besl medic81 and scientific minds to develop their research interests in obstetrics research and conditions in pregnancy that m2y lead to preterm biilh. By offering Clinie81 Research Training Fellowships, we provide a means for clinically qualilieg eandidate8 lo establish thelr research track record Ènd the skills required to become academic clinicians through PhD or other higher research clegree. We also supp(vt talented post-doctoral researchers with their Ir8nsilion to independent inve8lig8tor with funding for an embitious proor8mme of research training that offers 8cceler8ted personal and career development to lead their own research plans and establish their own research ieam. Our research In revlew BUMP (Bome's Uterlne Mapplng ProJect) The Borne Uteriiie Mapping Project (BUMP) alms to gather a unioue collection of samples collected during pregnancy and after birth, analysed in delail usiiig cutting-edge technology, to create a map of the womb. By encouraging collaboration, this project will enable clinicians and scientists to get the full pictLtre of the process of labour, and help find the interventions we need to prevent pre-term birth. A project of this scale and ambition has never been 8tlempted before. The first step has beerb to carry out a feasibility study for BUl4JP. In this Iwo-year study, the research team created the infrastructure and eslablisheci the workflows that will make BUMP a success, The project has brouoht together 8 mulll- dlsclplinary leam of scienllsls. cllnic18ns, surgeons, and bioinformallcbans frotn across the UK and beyond. The feeslblllty phase has now been completed. The tearTr focussed on collecling samples from women al full-term, in18boL¢r or not. Focusing on full-term pregnancies made it simpler lo gain consent from mothers lo donate samples, and test the protocols for sample collection before movino onto recruiting women in pre-term labour. The Borne Foundation Page13 Trustees RetK)rt at 31 March 2025 This approach also allows the research team lo sl811 uncieislanding the fundamenlals of normal full- term labour, which will allow them to Identify what goes wr(M)g in pre-leim18bour. By sh8ring their knowledge and resources, the BUMP team designed Standard Opelaling Pfocedures (SOPS) for sample collection and 8nalysls. Then, they recruited 24 women with a full-term pregnancy to donate samples and data. The bioinformalicians, scienlisls and clinicians worked collaboratively lo analyse these samples, creatino a comprehenslve map of molecular changes in the womb durino the Iransilion from pregn8ncy to labour. Uliimalely. the research team successfully demonstrated Ih8t BUMP was not only feasible bui would achieve its aims, laying the lound81ions for the next phase ol BUMP. hloving Forward, the goal of the next phase, which we are calling Blg BUMP, is lo bulld new biological foundations for understanding pre-terffl birth. This will be achieved by uslng stale-of-thparl molecular techniques lo analyse the cells and tissues donated by pregnant women. These meihods can be used lo idenllfy changes in key molecules before and during18bour, to declpher the mechanisms driving pre- term birth arid uncover potential targets for new inlervenlions. The data generated from the core analysis will be linked to gamples and anonymised information from mothers and babies, and 811 this will be stored in a central bioinformatlcs hub. This will allow Ihe BUMP team lo securely share the dat8 with scientists worldwide lo acceler8le their resedrch. Eventually, we will open a communilyweb portal, where all data ielalino to the project wlll be available to approved scienlisls, including $18ndard operating procedures {SOPsl, data, and results from ihe study. The plan for BUMP Is lo expand local centres to locations across the UK and the world, to recrult donors from a moro diverse backgraiind, and from different eounlries where the causes of pre-term birth may differ from the UK. It will also provide an opportunity to test prevenlalive inlervenllons in different settings, to make sure they are appropriate and effective for mothers worldwide. Flndlng Answers We fund research that helps creale a deeper understanding of pregnancy lo achieve the seientific breakthroughs which will prevent premature blrth. Thls resea¥ch lays the foundations for lasting change and gives hope to those who have experienced premature birth. INSIGHT-2 is o longitudin81 study into pregnancy complications and thelr Impact on matern81 and child health. This five-ye8r 81udy is recruiting a diverse cohort of 1,70J pregnant women and follow up their children to 2 years ol age. Data collected Includes clinical and lifestyle faLlors. and a range of biologic81 samples, providing 2 comprehensive resource for mulllple investig2tlons. The exploration of pre- preonancy and pregnancy factors Iliat may impact felal wellbeing and future health will provide 8 comprehensive picture ol clisease mechanisms In both ihe tnolher and child, aiding the idenlificalion of biomarkers forprediction, diagnosis, and management of pregnancycompllcallons. This study LFliimalely aims lo improve maternal and child health by providing a valuable longitudinal study of the relalionship between the in-ulero environmenl, pregnancy management, and long-term maleinal and child health. We recently awarded lunding lo DrJulla Zollner from University College London to investigate the genetic 8rchlleclure of spontaneous premature birth within the British South Asian community, which has a high premature birth rale but is underrepresented in genomic and pregnancy-relaled studies. The project InclLJdes both genotype array and hlgh-deplh exome seouenclng data, allowing investigation into common and rare variants contributing lo risks ol premature birth. A beller understanding of the biological reasons behind prematuie birth could lead to the development of new ways lo predlcl and polenllally prevent premature birth. The ￿orrte Found81ion Page14 Trustees Report at 31 March 2025 We also awarded fundlng to Professor StLJerl Haslam from Imperial College Londor¢ to look at the role of lower reproductive Iracl glycosylation in maintaining a healthy pregnancy. This project Is fundatnental to shed light on the causes of preterm birth in woinen who are not considered at high risk. This knowledge will aid the development of new inlervenlions 2nd therapies to prevent microbiome-driven preterm birth and improve the health OLJtcomes of expec18nt mothers and their babies. DrAshley Boyle and Professors Sirnon Waddington and Donald Peebles of University College London 8re developing an innovative antimicrobial therapy lo boost the bodls natural clefences against Infection. Evidence suggests thal b8Cteria can enter the womb, triggering infl2mmation and increasirig the risk of early labour. Using mice lo mimic preterm birth, this project investigates whether increasing the concenliation of an anlibaclerial protein in the ￿rviX wlll prevent preterm birth and piotecl pups from brain damage. It will also investigate whether this Irealment, combined with progesterone (the current gold standard preventative Irealmenll provides additional benelil. Additionally, the project examines their anti-lnflammatory and 8nlib8clerial effects both in mice and in human ceNic81 and vaginal cells. The idenllficalion of novel approaches will lay the louridation lo further develop and progress them into human trials, uliim81ely transforming maternal and neonatÈl healthcare. Strengthening the research base is key to bringing about lasllng change. Through our coll8borallon with Aclion Medical research, we provide scientists with the momentum needed to advance lhp.ir pioneering projects. This progress enèbles them to pursue competitive funding research opportunities fiom research Councils, fecili18ting the transition of iheir discoveries into the testing and Iranslallon inlo new treatmenls. Dr Victoria Male and her team from Imperial College London have Identified a new klnd of immune cell in the lining of the uterus. whose number and activity incre8se8 during12hnur. These cells switch on genes that aclivale the local immune response and help the waters to bleak. The aim of this project Is to determine whether or not these cells trigger labour. The leam 8re comparing the nuinber and characteristics of cells donated by pregn8nt women al full term, who arp. either not in13bour or in e3ily laboLJr. If these cells are involved in starling labou¥, changes should be seen in early labour. The researchers expect the cells to be more numerous and 2clive when the waters h8ve broken. The lea will then investig8le whether simllar mechanisms are involved in preterm18EKJur. 8y fully undeistanding how these Immune cells 2re involved in18bour, future studies might be able to target them, or some of the molecules they make, lo prevent preterm labour. Finding an effective Irealmenl lo reduce the number of babies born loo soon would mitigate some of the emotional, physical and finanei21 costs of premature birth, Improvlng Trealmenl Until we can end premature birth, we need to do all we can lo improve Irealmenl and results for those experiencing the trauma that it brlngs. OLJr research looks 81 ways that treatment can be improved by deepenbng OLJr understanding of triggers. signs and indicators during pregnar￿Y and how these could help prolong the time a baby remains in the womb. The PROMPT project is cre81ing a point-of-care test lo detect infection-induced pieterrn latK)ur, enabling us to treat the infection and delay blrth. Dr Nlshel Shah 8nd his team from Imperlal College London are developlng a new poinl-of-care testing methodology lo identify preleim labour caused by infecllon and therefore be able lo provide the most appropriate Iiealmenl forthe specific infection and delay blrih. This approach requires amnlocentesis and, before commencing the sludy the researchers completed a systematic review and engaged the public. Importantly, the results fiom thls research Indicated that the use ol amniocentesis is both sale and acceptable to patients. The Borne Foundation Page15 Trustees Report at 31 March 2025 Recruilment inlo the main study is now underway and the team have been able to obtain point of care results withln 2 hours and commence antlbiolic Iieatment. Clinically, the rapid results have been useful to promptly initiate steroids and cerebral neuroprotecllon Iwilh magnesiLJm IV) where these were not given initially and have been informative for the neonalèl team. Professor A H Shennan and his team at St Thomas Hospital, Klngs College London are conducting a ranéomised control trial comparing tranS￿gInal cerclage and tr3nsabdominal cerclage in women who have had a previous In-labour caesarean section and subsequent pre-term birth or mid-tiimesler loss. This research will identify the most effective treatment for women at particular￿ high risk of preterm birth, resulting in prolonged pregn3ney gesl2lions and associated recluction in fetal mortality and morbidity. If transabdomin81 terclage is found lo be superior lo transv8gSnal cerclage In women with a previous in-labour caesarean section. transabdominal cwclage may be offered ats the first line inlervention in the future. NurtUTlng Talent For advances to be m8de, we need the best scientists and clinician8 to choo%e lo forge their careers in this area of medical research. We support obstetiicians, neonalologisls, midwives and neona131 nurses to embrace their research interests. An important component of our approach at Borne Is lo build research capaclty by fundsng the tralning of the next generation of scientists through project based PhD fellowbhips and also through our partnershlp wlth the Medical Research Council IMRCI. By offering cllnlcal rosearch tr2inlng fellowships in partnership with the MRL. we provide a means for clinlcally Qualified candidates to obtain the research track record and skills required through a PhD or oiher Iiigher resedfLlI degree. We albo support talented post-doctoral rcscarchers wlth thclr Iransillon lo Independent investigatoi with a Career Development Award, also jointly funded wsih the MRC while additional phD students are supported as part of specific projects. Emilie Patterson, Imperial College London is 8 PhD sludenl working with Dr Vikl Male al Imperial College London on her Borne furlded grant focussed on inflammation. In about a third ol cases of premature laboLJr, the reason why labour hag sl8rted early Is unkllown. A greater understanding of how labour s18rls al term will help determine whether the seme processes are Involved in premalure birth. This will help Identify ihe cause of premature labour and Inform the development of inlervenlions to prevent or delay early onset of18bour. Previous Bome-funded research identified 8 new kind of immune cell, which is only present in Antonia Cuff is a Pho student at Imperial College, is also working on inflammation with Di Viki I￿ale al Imperial College London. There is evidence fiom mice lo suggest Ihal a kind of immune ell, called ILC3, can help lo prevent preterm birth when Iheie is a bacteri81 infection in the uterus. Antonia wanted to find out if the same thing happens In humans. Antonia didn't find ILC3 responding to bacterial infection in Preg￿ar￿y, bul she did find that Ihey are active in uterine repalr immediately aller 8 period or giving blith. She also found Ihal ILC3 are further from the cells they need lo comtnunlcate with lo help repalr the uterus In endornetrk)sls patients. Endometriosis makes il 2-3 limes more likely that someone will give birth preterm so Anlonia's findings on ILC3 and endomelriosls could sllll help prevent preterm blith, Dr Shreya Shelh, Imperial College London is looking al the role of uterine NK cell subset5 Iri mediating placental implemenlalion. The lining of the uterus Is Ilch in uterine n81urel killer cells that promote placental implantation, and 3 subsets have recently been found. This project will deleimine which subsellsl mediate placental implanlalion, and how,. by comp8ring dif*erences belweern fertile palienls and those affected by disorders of insufficient implanlalion. The Borne FouncFalian Page16 Trustees Report at 31 March 2025 Preliminary c12ta indicates that UNKI may be defective in those with insufficlenl placental imp18ntalion', as UNK1 are most active at the lime of implantation and thelr activity is reduced in patients experiencing failures of early pregnancy. This research w(11 Identify the UNK SLrbsel(s) that are subfunctional in disorders of placental irnplantation, as well as the molecules Involved in thls process. This will inform the development of inleivenlions to promote implanlalion, thereby reducing ihe burden of premature birth associated with insufficlenl implantation. Our fundralslng We are deeply grateful lo all our supporters who h8ve don8ted to Borne over the past year. Thelr contributions are essential for funding our lifesaving research aimed al preventing premature blrlh. In June 2024, we celebrated a beautiful summers evening of Ilallan fine dining, thanks lo our Ambassador. the world-renowned chef Fr8ncesco Mazzei and his team. This speclal event, hosted by Borne Truslee Francesco Vanni d'Archirafi, gathered supporters lo update them on our latesl aims, with a specific focus on our Uterine Mapping Project (BUMP). Oui special thanks to our Ambassador Allslalr Pelrie for hosting a spect2cular auction and for bravely sharing his story ol premature birth wlth gLJests. Our annual golf day, one of our most impoitant annu81 events. returned once again al the beautiful Surrey golf course in Sunningdale. Led byour Patron Will Greenwood MBE, thi8 yea¢s event raised over £1 00.000 for the very first lime. Our heartfelt Ihanks go to everyone who enjoyed this unforgellable day and generously bid for auction prizes and made donations. In March 2025, we were thrilled to seeihe return of Wonderland. The first tlme we have held this event in sixyears, our biggest fundiaising ga12 was brought to the spectacular V&A Inuseum in Lonofon. The event Was hosted by acclaimed actor and Rorne Amba.£qador Alislair Petrie, and featured an exclusive performance by Ellie Goulding. Thanks to the generosity of our suppoiters. we raised over £35D,000, far exceeding ourexpeclalions. We were overwhelmed by the support by so m