CLAHRC: a collaboration for leadership in applied health research and care

CLAHRC South London is a body of researchers, doctors and NHS managers working to improve healthcare south of the River Thames. Two studies are currently looking at pregnancy care: “Birth and Beyond” and “POPPiE”.

CLAHRC South London, or the Collaboration for Leadership in Applied Health Research and Care, is a partnership of researchers, doctors, and NHS managers working south of the River Thames. It aims to help the NHS give the highest standard of care to everyone, wherever they live and whatever their background. South London is more diverse than a lot of the country, but it is also poorer and has higher levels of ill health.

One of CLAHRC’s current themes is “maternity, birth and beyond.” Pregnancy is a great time to promote a healthy lifestyle so that babies are protected from health risks, beginning in the womb. Within this theme, there are two studies running: “Birth and Beyond” and “POPPiE.”

Birth and Beyond

This study aims to lower the risks for mothers and babies from complicated medical conditions and pregnancy complications. It will do this by reviewing practices that are used now, to see what can be done better in the future. So far, the project has been looking at services for women with high-risk pregnancies in South London. It is also reviewing the best way to support mothers who developed pre-eclampsia during pregnancy. Initially, this study will be run in one South London maternity unit. If successful, we aim to apply for funding for a larger study in the future. 

POPPiE

POPPiE is a pilot study of a new way of caring for women at risk of premature birth. At the moment, it is difficult to say which babies are at risk of being born too early. When they are, 40% of the time, the cause cannot be found. Research into the how we care for women throughout pregnancy, and how this can affect a baby’s chances, is vital.

Women who have ongoing care from a midwife throughout pregnancy and birth are 24% less likely to give birth too early. However, often women end up with fragmented care. This is even more likely if they suffer from a premature birth.

We think that preterm surveillance clinics, like the Tommy’s clinic at St Thomas’, are the best way of preventing hospital admissions, while keeping track of women at risk of giving birth too early. That is why CLAHRC South London is working with Lewisham CCG (Clinical Commissioning Group) to create and test a new way of caring for women at risk. This includes a preterm surveillance clinic, and makes sure that women are cared for consistently from the start of pregnancy until after birth. We will look at whether this can help prevent premature births, while also asking women and families about their experiences of care.

The POPPiE trial: social and psychological factors in premature birth

There is growing evidence that social and psychological factors can make an expecting mother more likely to give birth early. However, there hasn’t been much research on how this works, or on how we can care for women that are affected to try and prevent premature birth.

Working with other international experts, we are carrying out a review of these social and psychological factors. This will help us to work out the best way to care for women, and will also be used to help design the POPPiE trial. This research is ongoing, and should be finished in March 2017. 

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Researchers

Professor Jane Sandall, Professor Lucilla Poston, Dr Annette Briley, Mr Paul Seed, Professor Debra Bick, Professor Andrew Shennan, Dr Rachel Tribe, Professor Lucy Chappell, Professor Graham Thornicroft, Professor Louise Howard, Dr Emma Molyneux

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Funding

This study is taking place in a Tommy's centre and is funded by Tommy's and the National Institute for Health Research's CLAHRC Scheme

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