Prediction, diagnosis and prevention of adverse perinatal outcomes

Led by Deborah Lawlor

It is important to be able to identify women or infants at increased risk of stillbirth, perinatal asphyxia and gestational diabetes in advance, however currently there are limited diagnostic tools to enable early detection. We aim to develop and refine accurate models to identify women at risk of adverse perinatal outcomes through linking data sets, including detailed population group studies.

We will complete and extend preliminary analyses to predict stillbirth, infant mortality and illness using linked data on one million women. This will include exploring whether different prediction tools are required for different ethnic groups and evaluating the optimal time and method of intervening to prevent mortality and illness in term infants (infants born at a gestational age of 37 to 42 weeks).

Perinatal asphyxia (Led by Dr David Odd)
Asymptomatic birth hypoxia (a deficiency of oxygen to the baby’s tissues during birth) affects around seven per cent of births and is associated with later cognitive impairment. No methods exist for identifying those at risk of hypoxia (oxygen starvation) or subsequent cognitive impairment.

We will develop accurate tools to predict both risk of asymptomatic birth hypoxia and consequential cognitive impairment. To do so, we will link and analyse existing Swedish data (on up to three million pregnancies) with British cohort data (such as ALSPAC and BiB) and more detailed clinical measures including biomarkers. We will evaluate the optimal time and method of intervening to prevent illness and mortality in term infants, as well as the benefit of more intensive monitoring and enhanced educational support in those predicted to have cognitive impairment.

Gestational diabetes and large for gestational age
Gestational diabetes is when women develop high blood sugar during pregnancy. It usually disappears after giving birth. We will test the validity of a new biomarker for the diagnosis of gestational diabetes in Europeans. Biomarkers are naturally occurring genes, other molecules or characteristics in the brain or body. We will also test the potential of biomarkers as a diagnostic tool in early pregnancy to identify those at risk of gestational diabetes-related adverse perinatal outcomes in different ethnic groups.