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A major new study on stillbirths, undertaken at the Rosie Maternity Hospital in Cambridge, is now producing its first results.
The Pregnancy Outcome Prediction (POP) study, funded by the National Institute for Health Research (NIHR) at the Cambridge Biomedical Research Centre, aims to determine both the risk women face of losing their baby during their first pregnancy and how this can be reduced.
One in 200 babies dies before birth in the UK and most occur in women with no known risk factors. Globally, every year 2.6 million babies are stillborn and 3.2 million live-born children die in the first month of life.
Gordon Smith, Professor of Obstetrics and Gynaecology at the University of Cambridge and Honorary Consultant at CUH Addenbrooke’s hospital is leading the study.
"I’ve spoken to many bereaved parents and the loss of a baby has a profound and life-long impact. There’s a whole life to be gained if you identify a baby who will die in the womb at 40 weeks of pregnancy, and this huge gain can be achieved relatively easily by early delivery of the baby at 38 or 39 weeks."
It’s thought that over half of the 4,000 stillbirths a year in the UK are caused by placental dysfunction, which is often linked to impaired growth of the fetus. At the moment, the standard means of identifying a baby that’s small for gestational age in low-risk women is measuring the mother’s ‘bump’ with a tape measure.
Through the POP study, Professor Smith has monitored more than 4,500 women during their first pregnancy at several stages until the end of pregnancy. As well as regular ultrasound scans and blood sampling, maternal and paternal DNA samples were taken, alongside samples of placenta, fetal membranes and umbilical cord, taken at the time of delivery.
The first results from the ultrasound scans were presented at a major international meeting in New Orleans earlier this year, and further analyses of the scan data are in progress. A major focus of the laboratory side of the project is to exploit the latest developments in sequencing technology. Work is focused on both trying to understand the mechanisms that lead to a poorly functioning placenta, and trying to identify proteins that might be measured in the mother's blood that could act as markers of underlying poor placental function. In addition to the core funding from the Biomedical Research Centre, there is over £2 million of current funding from the MRC to achieve these aims. The work involves close collaboration with other experts both in the BRC and in neighbouring centres of excellence, such as the Wellcome Trust Sanger Institute.
Professor Smith concludes: "The idea that we could come up with one magic solution for pre-eclampsia or stillbirth is beyond everyone’s expectations at the moment. Our primary aim is to generate clinically useful screening tests that allow us to focus medical care on women who are truly high risk for complications."
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