The Autumn/Winter Research Newsletter 2012 is now available for download. This issue highlights some of our recently awarded research projects and exciting new research partnership with the Royal College of Midwives.
We have seen some very important outcomes from our funded research announced during this year. In addition we have been able to award further grants to young doctors and midwives in partnership with The Wellcome Trust, Royal College of Midwives, British Maternal and Fetal Medicine Society. Here are the latest updates (click on the title to expand the content):
In 2009 we funded Professor Fenella Wojnarowska (Nuffield Department of Clinical Medicine and Department of Dermatology) and Dr Ching-Chi Chi to look at Pregnancy outcomes after maternal exposure to topical corticosteroids. This study was a big success and has already produced several high-impact outcomes, including feeding into the Guideline on Steroids in Pregnancy produced by the European Dermatology Forum. They have now had a paper accepted for publication by the high-impact JAMA Dermatology journal. Their paper is called Pregnancy Outcomes after Maternal Exposure to Topical Corticosteroids and it found no associations of maternal topical corticosteroid exposure with facial cleft, preterm delivery, fetal death, low Apgar score, and mode of delivery. It did however find that risk of low birth weight appears to correlate with the quantity of topical corticosteroid exposure.
In 2005 we funded Professor Mark Kilby to look at A multi-centre randomised controlled trial comparing intra-uterine vesico-amniotic shunting vs. not shunting in the treatment of congenital bladder outflow obstruction. A paper arising from this work has just been accepted for publication in The Lancet journal. The paper, entitled Percutaneous vesicoamniotic shunting versus conservative management for fetal lower urinary tract obstruction (PLUTO): a randomised trial, found that overall survival appeared higher in foetuses affected by urinary tract obstruction receiving vesicoamniotic shunting, but there remained uncertainty in the direction and magnitude of the effect such that it is not possible to conclusively prove benefit.
Professor Ian Sargent of Oxford University has had a paper arising from his project The regulation of immune cells in normal and abnormal pregnancy published in Pregnancy Hypertension: An International Journal of Women’s Cardiovascular Health. The paper is called Measurement of sST2 is comparable to PlGF in the diagnosis of early-onset pre-eclampsia and it appeared online on 6th March 2013.
Dr David Carr at UCL Institute of Women’s Health is looking at Understanding how gene therapy can help small babies grow in the womb. His work has already had great success and he was awarded a prestigious travel award by the International Fetal Medicine and Surgery Society to support presentation of his research at their upcoming meeting in Jerusalem in May. This is a great opportunity to showcase the ground-breaking work in gene therapy for growth-restriction and is wonderful exposure for Wellbeing of Women.
Dr Sarah Hillman at UCL is leading An investigation of how parental insulin genes might be altered during pregnancy to affect fetal growth and future risk of age-related disease. The first publication arising from this work appeared in the journal Diabetes Care earlier this year. The article was called ‘Paternal Metabolic and Cardiovascular Risk Factors for Fetal Growth Restriction’ and it found that paternal lifestyle may influence heritable factors important for fetal growth. Fathers who had recently had growth-restricted babies had evidence of insulin resistance syndrome and were more likely to smoke than fathers of normal grown offspring.
In 2007 we funded Dr Innocent Maranga in Manchester to study The effects of viruses and antiviral therapy on the development of cervical cancer in HIV+ve women. Dr Maranga fed into a larger team in Manchester and his work in Kenya has been important in an exciting new finding that certain types of HPV (human papilloma virus) might actually prevent cervical cancer. You can read more about this here: and see our grant to Dr Maranga here:
You can read about our new training grants for 2013 HERE
In 2007 we funded Dr Nikki Robertson at University College London to look at the question of whether melatonin enhanced hypothermic neuroprotection following perinatal asphyxia.
Perinatal asphyxia remains an important complication in term new-born infants, occurring in approximately 2 per 1000 births in the UK and being associated with a high risk of death or major neurodevelopmental abnormalities in survivors. An infant so affected constitutes a catastrophic end to pregnancy: 10-15% of cases will die in the neonatal unit, 10-15% will develop cerebral palsy and up to 40% will have other significant severe disabilities including blindness, deafness, autism, global developmental delay, or problems with cognition, memory, fine motor skills and behaviour. In the last decade, therapeutic cooling has been a significant interventional advance in this field and is becoming established as a postnatal therapy for neonatal encephalopathy. However, other therapies are urgently required as >50% of treated infants still have an abnormal outcome.
Dr Robertson believed that a combination of therapies in addition to cooling may be more effective than cooling alone. Melatonin, used clinically in children to treat sleep disorders, is neuroprotective in experimental studies due to its anti-oxidant, anti-inflammatory and anti-apoptotic properties. Previous studies showing the remarkable multi-targeted neuroprotectant potency of melatonin have been performed mainly in rodent models; our study was designed to assess its efficacy in a large animal model with and without cooling prior to translating its use to the clinical field.
The study has been an outstanding success and has showed for the first time that melatonin administered after perinatal asphyxia confers additional neuroprotective benefits above that achieved with hypothermia alone.
This major finding has been published in the prestigious Brain journal – the abstract can be read here
Dr Robertson intends to take this work forward to clinical trials with the aim of translating these exciting findings into improved care for affected babies. This year we awarded an additional grant to Dr Robertson to allow her to investigate the use of argon in combination with cooling, which you can read about here
Dr Tom Morewood at the Royal Free Hospital was awarded The Betty Austin Entry-Level Scholarship in 2011 to study Investigating the possibility of removing and freezing part of a woman’s ovaries prior to cancer treatment, and then reimplanting them after treatment so that she can have a family. This is an exciting and important project and we are pleased to report that Dr Morewood has had an abstract arising from this work, titled The effect of thawing on tissue conservation in ovarian cryopreservation, accepted for oral presentation at Fertility 2013 - the 8th Biennial Conference of the British Fertility Societies. This Conference will take place on the 3rd-5th January in Liverpool. Congratulations to Dr Morewood.
Irum Sunderji from Imperial College was given a grant in 2011 for an elective focussed on the Cervical Smear Programme in Fiji and looked to further improve it through education and raising awareness.
Irum been accepted to present a poster of this same work at the BMJ Evidence Live Conference 2013 in Oxford. Congratulations to Irum for this achievement!
Between 2005 and 2007 we funded the PLUTO study, led by Professor Mark Kilby at Birmingham Women’s Hospital. This study is a multi-centre trial looking at lower urinary tract obstruction, the term given to a blockage from the unborn baby’s bladder to the amniotic fluid that surrounds the baby until birth. The build-up of urine within the baby can cause restricted growth and kidney damage. In half these cases, the babies will die in the period shortly before or after birth. The paper Congenital lower urinary tract obstruction: a population based epidemiological study has just been published in the British Journal of Obstetrics and Gynaecology: BJOG 2012;119:1455-1464.
We are pleased to announce the second midwife to receive a Wellbeing of Women Entry-Level Scholarship, awarded in partnership with the Royal College of Midwives and the British Maternal & Fetal Medicine Society. The recipient is Miss Kerry Evans, a midwife at the University of Nottingham. Kerry will be undertaking a project called “The development of a health instrument to identify women who experience stress and anxiety during their pregnancy.”
It is hoped that this project will help identify stress and anxiety in pregnancy at an early stage, enabling women to be linked to appropriate services and therefore improving outcomes.
The 2013 Entry-Level Research Scholarship round, Research Training Fellowship round and Medical and Midwfery Student Bursaries round are now open. Please see details of application HERE
This project recently successfully concluded and has already produced three publications: Prevention of preterm labour via the modulation of inflammatory pathways (The Journal of Maternal-Fetal and Neonatal Medicine, 2012; 25(S(1)): 17–20); Changes in the Th1 : Th2 Cytokine Bias in Pregnancy and theEffects of the Anti-Inflammatory Cyclopentenone Prostaglandin15-Deoxy-Δ12,14-Prostaglandin J2 (Mediators of Inflammation, Volume 2012, Article ID 416739, 12 pages) and The Th1:Th2 Dichotomy of Pregnancy and Preterm Labour(Mediators of Inflammation Volume 2012, Article ID 967629, 12 pages).
Following her Wellbeing of Women-funded study, Dr Marian Knight of Oxford has published a major paper providing the first national study of the incidence of uterine rupture by mode of delivery. The paper, called “Uterine Rupture by Intended Mode of Delivery in the UK: A National Case-Control Study”, appeared in the high-impact journal PLoS Medicine.
The study found that, overall, uterine rupture is rare. However the risk of occurrence increases for women who have previously had a caesarean section; furthermore this risk increases with the number of previous caesarean sections. The time since the previous caesarean section and the induction of labour were also factors.
Dr Knight expects the study to impact on NICE guidelines. Our Research Advisory Committee rated the project an ‘A’ and noted “This will be a study of major impact”.
The condition affects one in five women aged 40 and over and can cause urinary incontinence.
Dr Douglas Tincello, Senior Lecturer at the University of Leicester, found that just a single treatment of Botox - typically used as a cosmetic treatment to smooth out facial wrinkles – can reduce the symptoms of urinary incontinence by half in the majority of patients.
Our elective student Reshma Shah from King’s College London, who visited Teule Hospital , Muheza, Tanzania, has had the research findings from her visit accepted for presentation at the British Maternal and Fetal Medicine Society conference in Glasgow on 19-20th April 2012.
Miss Roxanne Keynejad, a Wellbeing of Women elective student from King’s College London, presented her elective poster at the RCOG Medical Students and Young Doctors' Evening on Thursday 26th January and was awarded the prize for Best Poster Presentation. This follows from her commendation for the Elizabeth Garrett Anderson at the Medical Women's Federation Global Health Meeting in London.
The second newsletter from the Baby Bio Bank team is now available providing an update on their recruitment and progress with a Baby Bio Bank Database. You can download the newsletter by clicking HERE. You can read about the Baby Bio Bank project HERE
The Autumn 2011 Research Newsletter focuses on the different partnerships Wellbeing of Women is involved in and looks in detail at some of the researchers we
Dr. Katie Morris of Birmingham University was awarded the best oral presentation prize at the British Maternal Fetal Medicine Society Meeting in Harrogate in June 2011 for her work on the PLUTO study. This study is a multi-centre trial looking at lower urinary tract obstruction, the term given to a blockage from the unborn baby’s bladder to the amniotic fluid that surrounds the baby until birth. The build-up of urine within the baby can cause restricted growth and kidney damage. In half these cases, the babies will die in the period shortly before or after birth. The trial was funded by Wellbeing of Women between 2005 and 2007 and is ongoing.
Miss Roxanne Keynejad of King’s College London was awarded one of our 2011 Student Elective Bursaries for her visit to Mulago Hospital in Uganda. Roxanne returned at the end of August and an abstract based on the elective was accepted for presentation at the Medical Women's Federation Global Health Meeting in London. On Friday 11th November Roxanne presented this abstract and it was commended for the Elizabeth Garrett Anderson prize (awarded to the best abstract presentation). You can find further details about the meeting HERE
Wellbeing of Women has a close relationship with Dr Evangelia Bakali of the University of Leicester. We previously funded her with an Entry-Level Scholarship and this year she was successful in obtaining a Research Training Fellowship. This will enable Dr Bakali to continue her research entitled “Cannabis and the bladder: a study of the effects of cannabis on overactive bladders”, which will improve our understanding of how cannabis affects the bladder and be the first step towards identifying a new drug for bladder control.
We are thrilled to report that Dr Bakali was invited to give a podium presentation at the International Scientific Conference RCOG in Athens, Greece held on the 28-30th of September. This presentation won a prize for Best Oral Presentation in the stream of benign and office gynaecology. Dr Bakali describes her presentation below:“My presentation was on my results from my pilot work funded by the Entry-Level Scholarship from Wellbeing of Women. Overactive bladder symptoms affect 5 million people in the UK and the current available medication is not curative. A recent study randomized patients who had Multiple sclerosis and overactive bladder in a placebo group or a group taking a tablet form of cannabis and found that the patients in the cannabis group had a marked improvement in incontinence episodes. This led us to explore this further and we were able to localized the receptors in the rat bladder and also found that these receptors have a function in the bladder. We looked at some of the signalling pathways that these receptors may work through and found that both the cannabinoid receptors are coupled to Gi/o protein. In order for cannabis to have a therapeutic role in patients with overactive bladder, the mechanism by which it works in the bladder must be understood and we are due to start further studies to explore this."
Congratulations to Dr Bakali and we look forward to more exciting results from the Research Training Fellowship.
We are excited to share the news that one of our researchers has been nominated for a Pioneer Award by Red magazine. Dr Sarah Blagden is at the Gary Weston Cancer Centre, Imperial College and in 2011 we awarded her £183,855 over 3 years to study The role of Larp1 protein in the development of ovarian cancer chemotherapy resistance.
Details of the Project can be found HERE
We wish Dr. Blagden the best of luck! The full shortlist can be seen HERE
Back in 1999 Wellbeing of Women funded Dr David Edwards at Imperial College for a project called “Fetoplacental infection and brain injury in extremely preterm infants”. The results of this work led to further research and a paper has just been published in the prestigious Neurology journal. The research suggests that growth rate of the brain's cerebral cortex (the outer layer of the brain, responsible for cognitive functions) in premature babies may predict how well they are able to think, speak, plan and pay attention later in childhood.
“In babies born preterm, the more the cerebral cortex grows early in life the better children perform complex tasks when they reach six years old,” said Dr Edwards, “The period before a full-term birth is critical for brain development. Problems occurring at this time have long-term consequences, and it appears that preterm birth affects brain growth.”
These findings have important implications for diagnosing potential problems in babies.
A Wellbeing of Women-funded project hit the headlines recently after a major discovery linking smoking and Chlamydia to an increased risk of developing ectopic pregnancies. The project was able to attribute this increased risk in both instances to raised levels of a specific protein in the Fallopian tubes, greatly enhancing our understanding of the link.
The project was based at the University of Edinburgh and led by Dr Andrew Horne, who hopes that this groundbreaking research will lead to a simple test which can diagnose ectopic pregnancy and an effective tablet-based treatment. This would have a dramatic impact as ectopic pregnancy is the leading cause of maternal mortality in the first three months of pregnancy.
Our Elective Bursaries continue to provide valuable support and encouragement for students taking their first steps into research in obstetrics and gynaecology.
Two 2010 recipients of these bursaries, Rowena Mills and Olivia Kenney (both from the University of Birmingham), undertook an elective study examining awareness of cervical cancer and the human papilloma virus (HPV), and acceptance of the HPV Vaccine amongst Guatemalan women. This study was so outstanding that they were invited to present a poster of their findings at the prestigious annual conference of BASHH (British Association of Sexual Health and HIV). Wellbeing of Women provided further support to enable Rowena and Olivia to attend this conference and we are thrilled to report that they won the Best Poster Prize for their work.
Another 2010 bursary recipient, Leena Pandit, undertook an elective in Auckland exploring maternal screening for sexually transmitted infections. This project won the University of Aberdeen prize for Best Medical Elective and has led to Leena being the co-author of a paper which is due to be published soon.
One of our Entry-Level Scholarship awardees is already making waves despite his scholarship not being due to complete until the end of the year.
Dr Innocent Maranga is studying the effects of viruses and antiviral therapy on the development of cervical cancer (caused by the HPV virus) in HIV positive women. It is hoped that this study will shed light on the complex interaction between the HPV and HIV viruses and enable better prediction, prevention and treatment of cervical cancer.
As a result of his work to date, Dr Maranga has been invited to give two very prestigious oral presentations at the International Papillomavirus Conference (IPC) in Berlin. Furthermore, he has won an IPC Travel Bursary after being highly-graded by the IPC Scientific Committee.
We are thrilled for Dr Maranga and pleased that Wellbeing of Women are funding such exciting work that is, as is already clear, of a very high standard.
A twelve-year study which Wellbeing of Women co-funded has cast strong doubt on the commonly-held belief that having caesarean sections protects women from the distressing after-effect of urinary or faecal incontinence.
It has found that 40% of those who had their babies delivered exclusively by caesarean section still reported urinary incontinence, while there was no difference in the occurrence of faecal incontinence between women who had only natural deliveries and those who had only caesareans.
The results were published in the prestigious BJOG Journal of Obstetrics and Gynaecology and were picked up worldwide by Reuters, leading to widespread coverage.
The researchers intend to follow-up with the women in 2014, twenty years after they gave birth. This will hopefully lead to further findings and is a perfect example of how research funded by Wellbeing of Women can continue to provide valuable outcomes long after our financial commitment has ended.
Each year Wellbeing of Women awards Research Training Fellowships to outstanding candidates eager to pursue a career in academic obstetrics and gynaecology. This year we are very pleased to be able to announce our first ever joint-fellowship with the prestigious Wellcome Trust.
Wellbeing of Women entered into discussions with the Wellcome Trust in recognition of the fact that academic obstetrics and gynaecology is a frequently-neglected field. Under the terms of the agreement, candidates that met the standards of funding in our Peer Review and interview process can be nominated for interview by Wellcome.
In an outstanding outcome for Wellbeing of Women, both of the candidates we put forward to Wellcome were chosen for funding. This is a strong validation of our standards and achievements in attracting world-class candidates. Indeed, one of these candidates was subsequently awarded a Fellowship by the Medical Research Council.
This means that we have the first ever Wellbeing of Women/Wellcome Trust Research Fellow. Dr Catherine James of UCL is an outstanding candidate who will be examining the role of the immune system of the cervix in preventing preterm birth.
Wellbeing of Women also awarded two Research Training Fellowships of its own.
Dr Evangelia Bakali, University of Leicester will be embarking on a study called Cannabis and the bladder: a study to explore the action of cannabis on calcium action and differences between normal and overactive bladders, This is a continuation of an Entry-Level Scholarship funded by Wellbeing of Women.
Dr David Carr, UCL Institute for Women’s Health, will be looking at Understanding how gene therapy can help small babies grow in the womb.
Dr Leo Gurney, University of Newcastle, with the project Developing New Drug tools for Pregnancy Research.
Dr Tom Morewood, Royal Free Hospital, London with the project Freezing the ovaries of women undergoing cancer treatment to preserve fertility. This scholarship was made possible by a generous legacy left by a Wellbeing of Women volunteer and is named after her: The Betty Austin Memorial Scholarship.
Dr Gareth Waring, University of Newcastle, will conduct An investigation into the role of infection in causing premature birth.
Dr Natalie Suff, UCL Institute for Women’s Health, studying Prevention of premature labour by reducing infection within the womb. This ELS is awarded in conjunction with the British Maternal and Fetal Medicine Society.
Mrs Josephine Mary Holleran, University of Central Lancashire, will study Does the use of computers in birthing rooms affect the care that women receive during childbirth? This ELS is awarded in conjunction with the Royal College of Midwives and the British Maternal and Fetal Medicine Society and is our first ever Entry-Level Scholarship to be awarded to a midwife.