Why do we need this research?
When a baby dies after 24 weeks of pregnancy and before or during birth, it is known as a stillbirth. For around half of all stillbirths, there is no obvious cause, meaning that parents are left without answers for why it happened. We need to better understand the causes of stillbirth, so that we can give parents the answers they need at a difficult time and find ways of preventing stillbirth from happening in the future.
What’s happening in this project?
We know that there are several things that increase a woman’s risk of having an ‘unexplained’ stillbirth close to the end of her pregnancy. As well as age – being younger than 20 or being 35 and older – some health conditions during pregnancy can increase the risk of stillbirth. For example, we know that women with intrahepatic cholestasis of pregnancy (ICP) or gestational diabetes are more likely to have a stillbirth. However, we don’t fully understand why this is the case. Our researchers are looking for clues in the heartbeats of unborn babies.
In this project, women with ICP or gestational diabetes are being asked to wear a portable heart monitor to measure the rhythm of their baby’s heart. This test – an ECG – produces a waveform on a computer screen or on paper, which doctors can use to spot problems. Our researchers are also taking blood samples from the umbilical cord after birth to check for levels of a protein called NT-proBNP. Levels of this protein are known to go up when there is heart failure.
So far, the team have found that babies of mothers with ICP had abnormal heart rhythms, compared with babies from healthy pregnancies. These babies also had higher levels of NT-proBNP in their cord blood. Importantly, when women with ICP were treated with a drug called ursodeoxycholic acid (UDCA), their babies did not have such severe problems with their hearts.
The team are now carrying out the same studies in pregnant women with gestational diabetes, as their babies are also more likely to have problems with their hearts.
What difference will this project make?
This project is helping us to understand more about how health conditions such as ICP or gestational diabetes increase the chances of a pregnant woman having a stillbirth. By understanding more about which babies are most at risk, it should be possible for doctors, where necessary, to intervene as early as possible and increase the chances that a mother will give birth to a healthy baby.