Using EPOS to find out more about the impact of COVID-19 on pregnancy

To understand miscarriage better, Tommy’s researchers have been carrying out EPOS, a study that has so far followed over 1,500 pregnant women from early pregnancy to delivery. Now, our researchers are using this study to find out whether COVID-19 infection during pregnancy can lead to miscarriage or other complications later in pregnancy.
  • Authors list

    Professor Tom Bourne, Professor Phillip Bennett, Dr David MacIntyre, Dr Maya Al-Memar, Professor Christoph Lees, Dr Hanine Fourie and external collaborators

    Start date: 2021
    End date: 2024

Why do we need this research?

At the start of the COVID-19 pandemic, pregnant women were considered to be an ‘at risk’ group and were advised to shield. While the effects of COVID-19 infection during pregnancy are unclear, there is growing evidence to suggest that pregnant women may be at increased risk of becoming seriously unwell if they catch it, particularly in the third trimester.

We need to find out whether COVID-19 infection can cause complications in pregnancy, such as miscarriage, slow growth or premature birth. We also need to understand whether the risk of something going wrong is altered by either the stage of pregnancy at which a woman is infected with COVID-19 or by the presence of other pregnancy complications such as gestational diabetes or pre-eclampsia.

What’s happening in this project?

For several years, our researchers have been asking women to take part in The Early Pregnancy Observational Study (EPOS), which follows women from five weeks of pregnancy through to birth. Through this study, our researchers are able to work with many women and gather a vast amount of data. As well as recording information about each woman’s clinical history and the outcome of their pregnancy, the researchers collect blood, urine and vaginal samples from the women throughout their pregnancies. So far, more than 1,500 women have been included in this study, and more are being recruited.

Our researchers are now using EPOS to discover more about the effects of COVID-19 infection during pregnancy. To find out if a woman has been infected, the team will analyse the samples taken throughout pregnancy and at delivery to check for antibodies for COVID-19; they will also look for other biological markers that are associated with COVID-19 infection. By taking samples at different points in pregnancy, it should be possible to work out at what stage infection occurred or if the woman had the virus before she became pregnant. The researchers will then look at the final pregnancy outcomes for each woman to see whether COVID-19 infection during pregnancy is linked to early or late pregnancy complications.

What difference will this project make?

This project will give us a better understanding of how many women are infected with COVID-19 during pregnancy, and whether infection with the virus is linked to miscarriage or other complications later in pregnancy.