The SCOPE study - an international search for answers
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Author's list
Dr Dharmintra Pasupathy, Mr Paul Seed, Professor Lucilla Poston, Dr Matias Vieira, Professor Louise Kenny (collaborator and principal investigator for SCOPE)
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Research centre
The SCOPE study is an international study looking at how to predict and prevent the major diseases of late pregnancy: pre-eclampsia, preterm birth and fetal growth restriction. Tommy’s London and Manchester research centres were both involved in the project. A total of 5,690 first-time mothers took part in New Zealand, Australia, the UK and Ireland, and more than 50 papers have been published.
The study has already led to useful ways to predict pre-eclampsia and also identify healthy pregnancies. It has also given us valuable information about many problems during pregnancy, including miscarriage and the influence of smoking on the developing baby.
The SCOPE study has established a unique, international pregnancy biobank that will serve as a platform to:
- identify novel molecular markers that predict in early pregnancy women who will subsequently develop late pregnancy complications.
- test and validate combinations of key clinical, known and novel molecular markers to predict each disease .
- develop predictive tests that offer first time mothers an accurate, personalised risk rating for each disease.
The SCOPE study exists because we know there are a number of potential clinical and molecular markers (certain proteins, fats and small molecules in blood) for these complications.
None of these candidate markers are useful as individual predictive tests, but combinations of markers are likely to result in clinically useful screening tests.
Further, recent advances in proteomic and metabolomic technologies and bioinformatics (advanced mathematics) allow us to discover and map differences in molecules circulating in the blood of women who later develop these conditions. This has created the opportunity to develop effective methods of predicting these diseases, with the potential to dramatically improve maternal and infant health worldwide.
Research papers
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An achievement of SCOPE is the development of algorithms (flow charts) that can be used to work out the risk of pre-eclampsia early in pregnancy. These use clinical factors, ultrasound measurements and 'biomarkers' found in the blood, and are based on information from all the women involved in SCOPE. However, the way that pre-eclampsia happens in obese women may be different to women of normal weight. In the women taking part in SCOPE, the number of obese women who developed pre-eclampsia (9.2%) was almost three times as high as women of a healthy weight (3.4%).
Researchers found that a protein made by the placenta – placental growth factor or PlGF – was associated with pre-eclampsia in obese women, but not in non-obese women. Meanwhile, blood pressure measurements at 15 weeks of pregnancy were more strongly associated with pre-eclampsia in women of normal weight than in obese women.
This suggests that different tests may be needed for obese and non-obese women when trying to predict the risk of pre-eclampsia.
This study takes place in a Tommy's centre and is funded by Tommy's and the Brazilian Ministry of Education
Read more on this topic
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Research into premature birth
Around 60,000 babies are born prematurely each year in the UK. These babies are vulnerable – they are born before they have grown to cope with the outside world. Tommy’s is saving lives by researching how we can prevent premature births by finding those at risk early on. -
What are the effects of corticosteroids for babies born at term?
Corticosteroids are given to mothers at risk of premature labour to prevent health complications for their baby. However, many of these women will go on to have a normal birth at term. Our researchers are investigating what effect these drugs have for babies who are not born prematurely after all. -
What impact does ‘mild’ ICP have on the baby?
Tommy’s researchers want to find out what the risks are in intrahepatic cholestasis pregnancies with lower levels of bile acids. -
The QUIPP app: helping doctors decide who is at risk of premature birth
Researchers in Tommy’s Prematurity Clinic are helping develop an app that will reduce unnecessary hospital admissions for women with symptoms of premature labour. -
SuPPoRT: finding the best way to prevent preterm birth in women with short cervixes
Our researchers are comparing 3 different ways of treating a short cervix during pregnancy, to help stop babies being born too early. -
Predicting premature labour using the body’s natural defences
Our researchers have found that a natural substance made in the vagina and cervix could help us tell whether a woman will go into early labour. The team hope this could lead to new ways to prevent premature birth. -
Why does cervical damage cause preterm labour?
Scientists think that damage to the cervix makes it easier for infections to travel to the womb, resulting in preterm labour. Our researchers have developed a new way to study how this happens, so that we can prevent premature birth and problems it causes. -
Finding out who’s at risk: how can we predict preterm labour?
Researchers supported by Tommy’s are building a tool for women with symptoms of threatened preterm labour, to work out how likely they are to give birth too soon. -
Treating preterm labour with statins
Tommy’s researchers have shown that statins – drugs normally used to prevent heart disease – could also help to prevent premature birth and the health problems it can cause. Our researchers are now running a clinical trial to test this in pregnant women in preterm labour. -
How does inducing labour early affect educational achievement later in life?
Researchers are linking information about births to children’s school records to help doctors and parents make informed decisions about early induction. -
The Preterm Trials Consortium: using long-term trials to answer difficult questions
Tommy’s is setting up a platform that will help researchers study premature birth more effectively. -
Using statins to prevent brain injury during premature birth
Premature birth can lead to health problems for the baby, including brain injury. Our researchers are looking into whether statins – drugs to prevent heart disease – could also be used to prevent brain injury in premature babies.