UK (Commonwealth Union) – Scientists, led by researchers from the University College London (UCL), have formed new methods capable of forecasting outcomes for pregnancies which have problems in regards to poor growth of the baby within the womb.
The study, which has been published in the Journal of Clinical Investigation, involved a cohort of 142 women participating in the EVERREST Prospective Study. These women were facing the challenge of severe early-onset fetal growth restriction (FGR), a condition characterized by their babies being significantly underdeveloped as observed in ultrasound scans during the latter part of the second trimester (between 20 and 27 weeks).
The researchers pointed out that fetal growth restriction poses a substantial concern, affecting approximately 60,000 infants each year in both Europe and the USA. While some infants with FGR manage to catch up in growth and are born close to their expected due dates, many others face a more dire outlook. They either necessitate extremely premature delivery (prior to 28 weeks of pregnancy) or, tragically, do not survive the pregnancy, resulting in stillbirth. In England alone, the estimated annual expenditure for neonatal care amounts to a staggering £262 million.
The lead author of this study, Dr. Rebecca Spencer, affiliated with both the UCL EGA Institute for Women’s Health and the University of Leeds, remarked on the prevailing uncertainty that plagues both the families of unborn babies grappling with early-onset fetal growth restriction and the healthcare providers tasked with their care. She said, “We want to give them a better idea of what to expect if they are affected – as many people find uncertainty harder to cope with than definite bad news. Predicting pregnancy outcomes may also help doctors decide how often to do ultrasound scans and when to give antenatal steroids to prepare the baby for preterm delivery.”
The analysis focused on a cohort of 123 women who had undergone blood sample collection and regular ultrasound examinations to monitor their baby’s size and overall well-being.
Initially, the researchers quantified the levels of 102 different proteins present in the blood samples from 63 of these women. They then integrated these protein measurements with data from the ultrasound scans to construct statistical models capable of predicting various pregnancy outcomes.
To ensure the relevance of their findings, the research team engaged both the participating women and their healthcare providers to ascertain the pregnancy outcomes that held particular significance to them. These outcomes consisted of the fetal or neonatal death, death or delivery before 28 weeks, development of abnormal umbilical artery Dopplers, a marker of placental insufficiency that can lead to fetal growth restriction or preterm delivery, delivery at 37 weeks or later, and subsequently, the models devised to predict these outcomes were validated using data from the remaining 60 women within the study cohort.
Dr. Spencer indicated that their investigation revealed that by assessing ultrasound and protein measurements, either separately or in combination, they could effectively predict which pregnancies were at risk of ending in stillbirth or neonatal death and which might require extremely premature delivery before reaching 28 weeks of pregnancy.
These findings offer the prospect of identifying suitable candidates for potential treatment trials, a development that the researchers hope will prove invaluable, according to researchers.
Heading the multinational EVERREST consortium is Senior Author Professor Anna David, affiliated with the UCL EGA Institute for Women’s Health. The EVERREST consortium is dedicated to developing innovative treatments aimed at enhancing the growth and outcomes of fetuses with significant growth restriction while still in the womb.
“Currently we have no therapy to improve fetal growth inside the womb but a novel drug is being developed by our team. This will need to be tested in clinical trials. These results will help researchers to identify those women who might be most suitable to participate in the clinical trial, where the possible benefits outweigh the risks,” added Professor David.
