Pregnancy: detecting complications earlier so women can get help sooner
First published on 25 April 2016
Updated on 23 November 2018
What did the project achieve?
“Our results show, for the first time, that pre-existing issues with a woman’s heart function and blood circulation may play a role in the development of pre-eclampsia and fetal growth restriction during pregnancy,” says Professor Christoph Lees of Imperial College London.
Pre-eclampsia affects up to six per cent of pregnancies and is diagnosed by high blood pressure in the mum-to-be.1 In severe cases, it can be life-threatening and as a result around 1,000 babies die each year in the UK, mainly because they had to be delivered prematurely.2,3
To investigate the root causes of these complications, the researchers tracked the health of hundreds of women, before and during their pregnancy. All participants were outwardly healthy, with a normal weight and blood pressure.
“We found significant differences in the pre-pregnancy heart function and blood circulation of those women who went on to develop either pre-eclampsia or fetal growth restriction,” says Professor Lees.
“Their hearts pumped less blood per minute than those who went on to have uncomplicated pregnancies, and their blood vessels were more resistant to blood flow – causing their blood pressure to be at a higher point within the normal range prior to pregnancy.”
If these findings are confirmed in larger studies, it provides a potential new route for screening women before pregnancy and could lead to new therapies.
“Finding ways to improve a woman’s heart function and circulation – such as through lifestyle changes – could be an effective way to lower their risk of developing these potentially dangerous complications,” says Professor Lees.
1.NHS website: https://www.nhs.uk/conditions/pre-eclampsia/ [website accessed 18 Sep 2018]
2.Davenport F. 2014 Imperial College London. Researchers track mums-to-be in search for pre-eclampsia risk factors. Available at: http://www3.imperial.ac.uk/newsandeventspggrp/imperialcollege/newssummary/news_21-10-2014-10-39-0 [Website accessed 18 Sept 2018]
3.NHS Choices. Pre-eclampsia – Complications. http://www.nhs.uk/Conditions/Pre-eclampsia/Pages/Complications.aspx [Website accessed 18 Sept 2018]
This research was completed on 31 October 2017
Up to six per cent of pregnant women develop a mild form of a condition called pre-eclampsia.1 Severe pre-eclampsia occurs in around one to two per cent of pregnancies, putting the lives of both mothers and babies at risk.1 Sadly, an estimated 1,000 babies die each year because of pre-eclampsia.2,3 Professor Christoph Lees, of London’s Queen Charlotte's & Chelsea Hospital, is looking for new ways to identify women at risk of developing pre-eclampsia much earlier in pregnancy, so they can access more tailored antenatal care sooner, before symptoms develop.
How are babies’ lives affected now?
Although most cases of pre-eclampsia cause no serious problems, when severe, the condition can endanger the lives of both mother and child. Sometimes this means babies have to be delivered prematurely.
“If a pregnant woman with pre-eclampsia becomes severely ill, the only ‘cure’ is to deliver the baby,” says Professor Lees. “Similarly, if her baby stops growing properly in the womb – a problem that can occur with or without pre-eclampsia– the baby sometimes has to be delivered early to avoid stillbirth.”
Babies who are born too soon, and babies who stop growing properly during pregnancy, can both face difficulties after birth.
“The onset of pre-eclampsia is often subtle, so pregnant women may not immediately realise that something is wrong,” says Professor Lees. “What’s more, we don’t fully understand what causes the condition, or why babies stop growing properly in the womb, which is hindering efforts to find new treatments.”
How could this research help?
“We’re investigating the possibility that problems with a mother’s heart and circulation could play a crucial role in the development of pre-eclampsia and in the poor growth of babies in the womb,” says Professor Lees. “We think these two complications might develop if the mother’s heart and circulation system don’t adapt properly to the additional demands that pregnancy places on them.”
The researchers are monitoring 600 women who are trying for a baby and tracking them until after birth if they get pregnant. The team is searching for early warning signs of later problems, by studying changes in heart function. (Women with pre-eclampsia have high blood pressure.)
“We hope our work will eventually lead to new screening tests so midwives and doctors can identify women and babies who are at risk very early in pregnancy, well before the onset of any noticeable symptoms,” says Professor Lees. “This could enable more tailored maternity care, with women at risk getting help sooner. A better understanding of changes in the body that lead to pre-eclampsia would also help in the development of new treatments.”
- NHS Choices. Pre-eclampsia. http://www.nhs.uk/conditions/Pre-eclampsia/Pages/Introduction.aspx Website accessed 11 February 2016.
- Davenport F. 2014 Imperial College London. Researchers track mums-to-be in search for pre-eclampsia risk factors. Available at: http://www3.imperial.ac.uk/newsandeventspggrp/imperialcollege/newssummary/news_21-10-2014-10-39-0 Website accessed 12/03/2016
- NHS Choices. Pre-eclampsia – Complications. http://www.nhs.uk/Conditions/Pre-eclampsia/Pages/Complications.aspx Website accessed 12/03/2016
|Project Leader||Professor Christoph C Lees MD MRCOG|
|Location||Centre for Fetal Care, Queen Charlotte's & Chelsea Hospital, Imperial College NHS Trust|
|Grant awarded||18 December 2015|
|Start date||1 March 2016|
|End date||31 October 2017|
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