Measuring and managing pregnancy risks
Pre-eclampsia affects up to 6% of pregnancies in the UK and can cause serious problems for mothers and babies, but the exact cause is unknown which can make it hard to find and support those at risk before it’s too late. Current methods of assessing pre-eclampsia risk depend on clinical information that’s not generally available for someone’s first pregnancy, so doctors need new tools to help these families and make sure all vulnerable mothers and babies get the care they need.
Tommy’s pre-eclampsia experts at our London Research Centre have been investigating how expectant mothers likely to develop the disease could be identified through blood tests for certain metabolites (basically small molecules naturally created by chemical processes in the body that keep us alive, such as vitamins and amino acids). Their recently published study in the journal PLOS One found 2 metabolites (dilinoleoyl-glycerol and heptadecanoyl-2-hydroxy-sn-glycero-3-phosphocholine) which could act as warning signs that first-time mums-to-be were at risk of pre-eclampsia. Existing tools like placental growth factor (PlGF) tests could be combined with these new metabolites to help new families avoid this potentially life-threatening condition.
One of our leading pre-eclampsia experts Professor Lucy Chappell has also been researching new ways to diagnose the related pregnancy problem, hypertension (high blood pressure), as part of her work leading our specialist clinic in St Thomas’ Hospital to protect mothers and babies from its dangerous consequences. Prof Chappell is exploring the use of magnetic resonance imaging (MRI) to study the placenta in very close detail, and her team’s new study in the journal Placenta found various differences between those of mums with hypertension and those without it, which could help identify the most high-risk pregnancies so they can be given specialist care.
Mothers with chronic kidney disease can face higher risks of hypertension and pre-eclampsia, as the intense pressure on the body during pregnancy can add to the stress their condition already puts on their kidneys and cause more damage. Another recently published study from Prof Chappell’s team suggests that expectant mothers in stages 3-5 of the disease are more likely to give birth early and have babies with low birth-weight, as well as losing 2.5 years of kidney function over the 9 months of pregnancy. This research highlights the urgent need to make pregnancy safer for all.
Tommy’s work supporting wider research
New research has boosted the evidence in support of our #SleepOnSide campaign, which we launched back in 2017 to raise awareness of how side-sleeping can reduce the risk of stillbirth. In late pregnancy, lying flat means the combined weight of baby and womb can restrict the flow of blood and oxygen to the baby, so lying on your side is safer.
Building on the link our experts in Manchester found, scientists at UCL have now developed a way of using MRI to study blood and oxygen flow across the placenta during pregnancy, which confirmed the dangers of lying flat; their study in the Journal of Physiology showed that blood flow to the uterus decreased by 23.7% and oxygen movement through the placenta fell by 6.2% when mums-to-be slept on their back. Speaking to the Daily Mail about this, our CEO Jane Brewin said:
“8 babies are stillborn every day in the UK, and this is one of the ways to reduce the risk, so hopefully sharing this information will help save babies’ lives and reduce the unacceptable rates of stillbirth across the country.”
We’ve also been representing the baby loss community as part of a recent Cochrane review (high-quality research used to help make evidence-based decisions about healthcare policy and practice), helping the advisory panel to investigate how healthcare professionals can better support patients and families when a problem suddenly becomes life‐threatening – for example, if a mother with an ectopic pregnancy needs urgent care. The evidence isn’t very clear, but we concluded that helping expectant parents to understand when pregnancy symptoms can be danger signs is an important part of improving mothers’ care and ultimately saving babies’ lives.