Epidemiological research on women’s health in general and pregnancy and childbirth in particular. I am interested in pregnancy loss – miscarriage, ectopic pregnancy and stillbirths; preeclampsia or high blood pressure in pregnancy and maternal obesity in pregnancy.
My work involves innovative use of routinely collected health data – analysing and interpreting these data to inform and improve clinical practice. The Aberdeen Maternity and Neonatal Databank forms the main basis of my research, linking records to Scottish hospital admissions and mortality records in order to follow up mothers and their offspring to assess their long term health outcomes.
Epidemiology of pregnancy loss:
One of the areas of particular interest in this work programme is the epidemiology of pregnancy loss. This includes work around stillbirth, miscarriage, ectopic pregnancy and induced abortions.
Stillbirth: The systematic review and meta-analysis of risk of recurrent stillbirth that formed Kathleen Lamont’s MSc thesis has now been published in the BMJ and received some media attention.
Miscarriage: The joint project with University of Leiden - Recurrent miscarriage and subsequent risk of cardiovascular disease and mortality is now complete and the paper has been published in Heart.
Induced Abortion: A project exploring repeat abortions in Grampian has been extended to August 2015 by NHS Grampian Sexual health and Blood Borne Virus Managed Care Network. This involves a systematic review of the literature around risk factors for repeat abortions and secondary analysis of the Termination of Pregnancy database in Grampian comparing determinant factors for single versus repeat abortions. First phase has been completed and report submitted to NHS Grampian Sexual Health and BBV MCN. First paper entitled “Who has repeat abortions? Identifying women at risk of repeated terminations of pregnancy: Analysis of routinely collected health care data” has been revised and resubmitted to the Journal of Family Planning and Reproductive Health. Second phase involving detailed analysis of the TOPS database looking at contraceptive behaviour pre- and post-abortion is underway.
Preeclampsia and its sequelae:
Work continues on the CSO funded project “Early identification of women at risk of preeclampsia using applanation tonomentry and pulse wave analysis”. Although recruitment was slow at the start, this has now picked up and set to reach the target within the next 6 months. Repeatability of the measure assessed during the pilot phase of the project has resulted in a publication in Pregnancy Hypertension and another paper assessing the predictive value of PWA in a triage ward has also been published. Recruitment is now complete and follow up to end of pregnancy and data entry finished. We are awaiting data linkage and analysis. Final report needs to be submitted to CSO by 30th April 2015.
“Predicting the severe complications of preeclampsia” is a PhD project for Sheidu Sadiku with a MacArthur Foundation studentship which involves developing and testing a prediction model for the immediate complications of preeclampsia using clinical and laboratory parameters.
We Contributed data to an IPD meta-analysis assessing the risk of preeclampsia in the second pregnancy. The first paper was published in AJOG and formed part of Miriam Von Oostwaard’s PhD from University of Amsterdam.
Collaborations with the Queen Mary University London is underway for an IPD meta-analysis for predicting pre-eclampsia (IPPIC collaboration) which has been funded by NIHR.
A joint funding application to British Heart Foundation with colleagues at the Universities of Aberdeen, Edinburgh, Manchester, Oxford and Keele is underway looking at “Maternal gestational Hypertension and Preeclampsia and risk of cardiovascular disease in the offspring”.
This is an emerging theme for this work programme due to the public health importance of this topic. Another paper exploring the association of maternal gestational weight gain and offspring cardiovascular morbidity and mortality has been revised and resubmitted to Heart. A third paper, arising from the same data linkage, looks at maternal obesity in pregnancy and her own risk of cardiovascular disease has been published in Hypertension.
University of Edinburgh - Prof Jane Norman; Prof Rebecca Reynolds
National Perinatal Epidemiology Unit Oxford - Prof Jenny Kurinczuk; Prof Marian Knight
Queen Mary University of London - Prof Shakila Thangaratinam
University of Groningen, Netherlands - Prof J J Erwich
As senior lecturer in Obstetric Epidemiology, I am involved with both undergraduate medical teaching of Obstetrics and Gynaecology and Epidemiology teaching at undergraduate as well as post graduate levels. I am written exam coordinator for the Year 2 MBChB exam. I conduct small group tutorials for 1st year Medical students on reproductive health.
I am course coordinator for the post graduate Global Health course and co- programme coordinator for the MSc in Global Health and Management. I am also involved in supervising and assessing undergraduate and postgraduate students for their research projects.