Priority Area Two

Developing new approaches for identifying women at increased risk of stillbirth

Priority Area Two leads: Professor Euan Wallace, Professor Vicki Clifton, Professor Sailesh Kumar

Novel tests to improve antenatal detection of women at increased risk of stillbirth are needed. Many of the unexplained stillbirths that occur in high-income countries may be due to problems with how the placenta develops and functions. Such problems may contribute to stillbirth, even in babies who appear to be growing well during pregnancy. By assessing the function of the placenta, it may be possible to predict which babies have a greater chance of stillbirth. We may then be able to intervene before stillbirth occurs.

As well as identifying babies who might be at-risk of stillbirth, assessing the function of the placenta and looking at placental biomarkers may help to detect babies who have an increased chance of experiencing distress during labour. Babies who experience distress during labour are at-risk of developing brain injury and resulting disability, such as cerebral palsy. Therefore, detecting babies who have an increased chance of experiencing distress during labour may help to reduce both stillbirth and childhood disability.

A national collaboration has been established to identify novel placental biomarkers for pre-clinical testing. An initial one-day workshop held in Brisbane in July 2017 confirmed support for this national project and ongoing workshops throughout the life of the CRE continue to progress this work and foster new collaborations.

  • Identifying novel placental biomarkers

    Study Team: Vicki Clifton, Euan Wallace

     

    This is a national consortium of placental biologists and clinicians working on placental mechanisms and circulating biomarkers that may be early indicators of pregnancies at risk of a stillbirth.

    Part of this work involves developing a national database of placental samples to promote and facilitate collaborative placental research, as well as standardised processes for the collection and analysis of placental samples. Collection protocols are designed as a basic minimal guide to placental tissue collection for biobank storage that meets the agreed standards of the Stillbirth Centre for Research Excellence. Current protocols and procedures are listed below.

    >>Protocol: Human placental tissue collection

  • An Investigation into Placental Biomarkers of Maturation and Ageing in South Asian Women

    Study Team: Miranda Davies-Tuck, Dr Stacey Ellery, Euan Wallace Student: Shalini Ponnampalam

     


    This project aims to measure known markers of fetal and placental maturation (cortisol, progesterone and IGF-1) in maternal blood collected prospectively over pregnancy and cord and placental tissue to determine whether expression patterns differ between women of different ethnicities and correlate with gestation of birth, onset of labour and baby birth weight.

    It is expected that this study will provide a greater understanding of how maternal and placental factors influence birth outcomes; in a diverse population. Results may identify biomarkers to help track the pregnancy progression of South Asian born women, allowing for interventions that are tailored to this unique population.

  • Evaluating prediction strategies for adverse outcomes at term

    Study Team: Sailesh Kumar, Jane Fox

     

    This study aims to evaluate strategies for detecting mothers and babies at an increased-risk of late-pregnancy stillbirth and other adverse pregnancy outcomes. Specific aims include:

    • Improving understanding and prediction of decreased fetal movements
    • Assessing the role of routine third-trimester ultrasound scanning in reducing adverse outcomes
    • Examining the role of PlGF (placental growth factor) in identifying women at-risk
    • Assessing barriers to morphology scanning