The development of an early pregnancy screening test that will detect major complications of pregnancy in first-time mothers, including the potentially fatal disease pre-eclampsia, is the aim of a new research project starting at Cork University Maternity Hospital (CUMH).
The project has just been awarded a grant of €1.7 million by the Health Research Board for the project at CUMH - the largest award ever made to a single project in Ireland for obstetrics and gynaecological research.
This funding will enable the CUMH team to join the international Scope (Screening of Pregnancy Endpoints) project which involves the world's leading obstetricians and scientists in a study of 10,000 women.
"Our group, Scope Ireland, will be the largest single contributor to the project biobank with samples from 3,000 women," said Dr Louise Kennedy, senior lecturer in obstetrics and gynaecology at UCC and consultant obstet- rician/gynaecology at CUMH, who is leading Scope Ireland.
"The Scope project is the single biggest and probably most important initiative on women and babies on an international level ever and I am thrilled that through the HRB funding, we are going to be such a big part of it, particularly as research into women and babies' health has traditionally been chronically underfunded," she said.
Identifying a woman's risk for complications will mean the level of prenatal care can be matched to each woman's personal risk profile and preventative therapies offered to those at high risk, explained Dr Kenny.
On the other hand, women who are at low risk could be reassured and medical intervention in their pregnancy care minimised.
From September this year, 3,000 women will be recruited over three years to take part in the study which will involve having extra blood tests and scans during the course of their pregnancy.
Pre-eclampsia, fetal growth restriction and spontaneous preterm birth are the major complications of late pregnancy and the leading causes of illness and death in mothers and newborn babies. In the developed world, in almost half the cases, either the mother and/or the baby require admission to an intensive care unit.
Dr Kenny explained that pre-eclampsia is a severe high blood pressure condition where the mother can develop kidney or liver problems, stroke and seizures which affects 5 per cent of first-time mothers.
Each year, the number of maternal deaths from pre-eclampsia worldwide is equivalent to the loss of 170 jumbo jets full of pregnant women. A quarter of the babies born to mothers with pre-eclampsia are growth restricted and a third are premature.
She said: "Our knowledge of pre-eclampsia is very limited, we don't even understand why it happens to certain women so we don't have very good ways of treating it.
"There is no particular drug or cure for it and no predictive test at the outset of pregnancy. The reality is that if you develop pre-eclampsia in pregnancy in 2007, you will not be treated much differently than if you had it in 1907."
Unfortunately, the only treatment for pre-eclampsia in pregnancy is early delivery of the baby through Caesarean section, according to Dr Kenny, as the mother will die if the baby is not taken from the womb.
"In Ireland, where we have a developed healthcare system, we can do Caesarean sections to deliver pre-term babies, but in sub-Saharan Africa, pre-eclampsia kills between 50-100,000 women every year. There are similarities between pre-eclampsia and the other two main complications of pregnancy, but we do not have a good understanding or predictive test for those either."
Dr Kenny will be recruiting specialist midwives and scientists to the project over the summer months and will be taking a break from her own clinical work in order to get it up and running for September.
