A TOTAL of 1,500 Cork women have been recruited as part of a European-wide clinical study to determine the risk of developing pre-eclampsia during pregnancy.

Pre-eclampsia is a complex disorder that requires a personalised medical approach.

The IMPROvED Project commenced in November, 2013, at Cork University Hospital, led by award-winning Professor Louise Kenny, Consultant Obstetrician and Director of INFANT Research Centre.

The world-leading Science Foundation Ireland research centre is based in University College Cork and CUMH. Professor Kenny specialises in the management of high-risk pregnancy and was recently the recipient of the Guaranteed Irish Science Hero Award 2017.

The main goal of the project is to develop a clinically robust predictive blood test for pre-eclampsia, a serious condition which affects 5%-8% of women globally, as currently no such screening exists for expectant mothers.

Professor Kenny says pre-eclampsia can be difficult to detect due to the insidious nature of the condition.

“Pre-eclampsia can come on without much warning and can be very aggressive. Classic signs and symptoms include rapid swelling, particularly of the face and fingers, throbbing headaches and distorted vision.

“Some may experience gastric pain, which is worrying because it indicates that the liver is affected, which tells us that the condition is at an advanced stage.

“Conversely, there may be none of those symptoms and the expectant mother may just feel vaguely unwell. It runs in families so you have a 3-4% increased risk of developing pre-eclampsia if your mother or sister has had it.”

Professor Kenny says that if women are known to be at risk, they can take aspirin during pregnancy and be monitored closely throughout.

Typically, pre-eclampsia occurs after 20 weeks gestation (middle to late pregnancy) and up to six weeks after delivery. In rare cases, it can occur earlier than 20 weeks.

To be eligible for the IMPROvED project, participants had to be first-time expectant mothers, in good general health, and under 17 weeks pregnant.

The EU-funded study has 4,000 participants in total and for the 1,500 Cork women who took part, it comprised of visits with the midwives and research team where blood and urine samples were taken, blood pressure was monitored, medical history recorded, and participants received a growth scan at 20 weeks.

“My research team developed a prototype test that predicts risk in early pregnancy by looking at the chemical signature in women’s bloods,” explains Professor Kenny, “but we needed to see how effective it is within a large real-life scale so that’s where the idea for the IMPROvED study was conceived. We want to make sure it works with every population, for every type of woman across Europe and hopefully beyond.”

The most recent estimates, according to Prof Kenny, are that somewhere between 70,000 and 100,000 globally die each year as a direct result of pre-eclampsia and most of these women are in low-resourced areas like sub-Saharan Africa and parts of Asia.

“As a woman, a mother and a doctor, I think those figures are horrific. We are not talking about some exotic condition that we have only just discovered. Preeclampsia has been around since Hippocrates’s time. There are hieroglyphics in the Valley of the Kings which depict Egyptian women who have pre-eclampsia. Yet we still don’t know what causes it and we still don’t have a screening test.

“In the early 1980s, the first case medical records of HIV and AIDS emerged in medical literature, which was at the time a fatal condition. Now three and half decades on, we know what causes the condition, we’ve identified the virus and have developed such an array of drugs and treatment that someone with the virus will have an almost normal life-span.”

Professor Kenny says that this is due to the billions of dollars investment into HIV and AIDS research and education. Yet only a fraction of that has been spent on perinatal disease research and education. Professor Kenny believes the poor progress made so far reflects that.

She was overwhelmed at the level of interest and commitment from the 1,500 Cork mothers who participated.

“I’m always amazed at how altruistic pregnant women are. These Cork women realise that we are trying to do something beneficial. They gave up their time willingly to participate, which is very impressive.”

Professor Kenny had recent reason to celebrate as the winner of the Guaranteed Irish Science Hero Award earlier this month.

“I was incredibly moved, as it was by public vote,” she said. “We work in a Cinderella discipline that doesn’t normally garner much attention or funding so for the public to acknowledge the work we do, that was personally very moving for me. It’s very much a team award.

“My team are really bright, young, enthusiastic and talented researchers who are responsible for getting all the data together and doing really great work.”

With the recruitment process for IMPROvED completed, Professor Kenny and her team aim to have the study and results published next year.

For information on the IMPROvED study, see www.infantcentre.ie

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Happy to lend support

MONIKA Zygowska, right, aged 32, is from Poland originally and lives in Wilton with partner Alan McCarthy.

She made Cork her home seven years ago when she pursued her PHD studies in Bioelectric Chemistry at the Tyndall Institute in UCC. She currently works as a lab scientist at Johnson & Johnson. Monika is 27 weeks pregnant with her first baby due on Friday, October 13.

Prior to her participation in the study, Monika didn’t know much about preeclampsia as none of her family or friends had experienced complicated pregnancies. However, her interest in science was one of the deciding factors in her participation in the project.

“I found the whole idea of the study very interesting. As a scientist myself, any contribution I can make to help develop this screening and to help women in the future... then I am more than happy to do so.” Monika speaks highly of her experience throughout the process. “During the visits, the midwives and research team members were so lovely and friendly. They put me at ease and were happy to answer any questions I had in relation to my pregnancy, which was reassuring because as a first-time mum, you don’t know much about pregnancy or what to expect!”

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Raising more awareness

Maggie O’ Leary, 28, from Carrigaline is married to Brian and is mum to 11- month-old Finn, pictured right.

She trained as a midwife , though hasn’t worked as one to date.

The mum worked in child care up until recently when she started working in infant health research at UCC. This is what motivated her to participate in the IMPROvED Project.

“I’m interested in research myself so having seen a leaflet in CUMH on the day of my first scan, I contacted the team on Facebook, told them that I was 13 weeks pregnant, and that was it!” Despite relentless morning sickness for the first 20 weeks of her pregnancy, Maggie had an uncomplicated pregnancy.

She hopes that by taking part, in some way it will lead to more awareness around pre-eclampsia.

“If you think about it, 1,500 mothers equates with 1,500 families so you have 1,500 women who will potentially go to mother and baby and or pregnancy related events and activities where they will end up talking about preeclampsia and so word will spread.”