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Screening for Pregnancy Endpoints

15 December 2004

Screening for Pregnancy Endpoints

Two University of Auckland medical researchers are leading a major international study aimed at predicting and eventually preventing the three major diseases of late pregnancy.

The SCOPE (Screening for Pregnancy Endpoints) study begins this month in Auckland, where the researchers will be recruiting 3000 women who are pregnant for the first time with a single child. This initiates the international study in which 15,000 women are expected to participate.

Associate Professors Lesley McCowan and Robyn North from the Faculty of Medical and Health Sciences say the overall goal of SCOPE is to produce a clinically useful screening test for three late pregnancy conditions: preeclampsia (a severe high blood pressure complication triggered by pregnancy); fetal growth restriction; and spontaneous preterm birth.

"These conditions complicate almost one in five first pregnancies, and cause significant maternal and infant ill-health or death worldwide. In more than half the affected pregnancies, the conditions are so severe the mother and/or the baby require admission to an intensive care unit, or result in death of the fetus or newborn baby," say Associate Professors McCowan and North.

"In the developed world, an estimated $NZ41 billion is spent annually on healthcare costs to provide antenatal care, neonatal intensive care and hospitalisation for first time mothers and babies affected with these diseases.

"All three conditions can have lifelong consequences for the child. These range from severe disabilities including significant neuro-developmental delay, deafness and blindness, to milder learning and behavioural disabilities.

"Although there are known therapies that could prevent approximately one third of cases if high risk women could be identified, there are no effective methods of screening for these diseases early in the first pregnancy."

The SCOPE study will establish a high-quality biobank that can then be used as a platform for scientific discovery and the development of predictive tests. Initial methods of prediction developed will be based on clinical and lifestyle information. The biobank will also provide the necessary blood and urine specimens for identification of novel combinations of molecular "markers" that could indicate if a woman was at high risk of one or more of the three late pregnancy conditions being studied by the SCOPE team.

The researchers will then evaluate the predictive potential of these markers - and hope to develop a method of offering first time mothers an accurate risk rating for each of the three important pregnancy complications.

"Reliable risk prediction will enable preventative treatment for first time mothers at high risk. It will also mean less intervention for women at low risk," say Associate Professors McCowan and North.

The SCOPE research collaborators are: Auckland University of Technology; University of London (UK); University of Leeds (UK); University of Manchester (UK); Adelaide University (Australia); University of California, San Francisco (USA); University of Texas, Galveston (USA); Karolinska Institute (Sweden); Technical University of Munich (Germany).

The SCOPE team has received major funding from the Foundation of Research, Science and Technology and the Health Research Council of New Zealand.

Any women in Auckland interested in participating in the study can contact the researchers on: 09 308 2300.


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