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Objective 4: CoLab Update (Apr-May 2017)

L to R: PhD student Tsehayneh Kelemu and Dr Stefan Hansson

Global Pregnancy Collaboration (CoLab) Update (April- May 2017)

2017 CoLab Annual Membership Meeting

Planning and preparations continue for the CoLab annual membership meeting to be held October 2-3, 2017 as part of the large PRE-EMPT Sixth Annual Meeting at the Sheraton Heathrow Hotel in London, United Kingdom. The planning committee has selected the Scientific Workshop theme: Prepregnancy and pregnancy nutrition. Speakers are being invited. A few of the topics include, Calcium in pregnancy, Obesity in high and low resource settings, Sodium in pregnancy revisited and insulin resistance—more to come.

The COLLECT Database Update

COLLECT has gone live with the CHERRY study in Manchester (PI: Jenny Myers) and an air pollution study in Ethiopia (PI: Stefan Hansson). The system is now open to users. Rates will be reduced during the initial beta testing. Editorials are in process for submission to Obstetrics and Gynecology, Pregnancy Hypertension, Hypertension, Placenta and COLLECT will be highlighted on the CoLab website on the Global Health Network, https://pregnancycolab.tghn.org.

The COLLECT Medical Birth Registry (MBR)

Annetine Staff and Chris Redman have followed up on their February visit to Cape Town and continue their efforts to promote the development of a simplified version of the CoLab database, namely a CoLab Medical Birth Register. This would develop COLLECT in line with LMIC needs. As we reported previously, during the February visit, the COLLECT electronic MBR was discussed in relation to the requirements of a proposed South African national register. The aim was agreed that a prototype could be built and tested in one or two hospital settings for UCT/US. If these tests were successful, testing would be extended for 3-6 months using an added preeclampsia screen.  We are also reaching out to WHO to update a registry they had worked on several years ago

Since February, Annetine and Chris have had extensive discussions with several physician researchers including Dr Robert Pattinson, Pretoria, South Africa; Dr Metin Gulmezoglu, director perinatal group WHO; Dr Monir Islam, formerly of WHO; Dr Fredrik Frøen, Norwegian Public Health; Drs Mushi Matjila, John Anthony, Sue Fawcus, Henie Botha, Gabriel Gebhard, David Hall of Cape Town (Tygerberg and Grote Schuur obstetric departments); Dr Louise Kenny regarding birth registry in Tanzania and Professor Tippawan Liabsuetrakul, Thailand regarding the MBR applicability in various populations. These discussions have been quite productive and enthusiastic. Stay tuned for future developments.

Project Highlights: COLLECT in Ethiopia:

In November 2015 Stefan Hansson of Lund University began recruitment of a cohort in Ethiopia that will eventually comprise 2,000 pregnant women for his project, “The role of air pollution in relation to pro-inflammatory and pro-oxidative tissue damaging mechanisms in preeclampsia (PE): a serious health care problem in low- and middle-income countries. Women are recruited at Adama regional hospital and two urban health centers at the time of their first antenatal care visit. Following written consent plasma and later also placenta are collected and a standardized questionnaire is completed. Currently they have collected 350 placenta samples. All routine and study data are collected and entered into the CoLab COLLECT Database that has been specially adapted to include questions about air pollution specific to the project. The study team plans to measure exposure and collect air pollution particles in Adama.

They will investigate in vitro the role of air pollution particles as contributors to oxidative stress and endothelial cell damage in PE; investigate in vivo the role of air pollution particles as inducers of oxidative stress and inflammation in PE using animal models; study DNA methylation pattern in human placenta-derived trophoblast and endothelial cells; investigate the inflammatory maternal plasma profile in PE and IUGR; investigate placental structure and gene profile and investigate the health of children born in the cohort during a 4-year follow-up. A growing body of evidence supports the view that PE begins in the utero-placental unit and is amplified by oxidative stress and inflammation. Recent findings have demonstrated an association between exposure to air pollutants and oxidative stress and inflammation as well as a correlation between air pollution exposure and increased risk of PE. Air pollution in LMIC is a tremendous and increasing health problem and these countries have the highest maternal mortality rates in the world. The overarching purpose of this translational project is to investigate exogenous factors in air pollution and to study how they induce oxidative stress and inflammation during pregnancy. Increased insight into pregnancy outcomes in relation to air pollution exposure is crucial to combat an increasing air pollution problem on maternal and child health and morbidity.

PRE-PARE Brazil

Dr Leandro Gustavo de Oliveira gave a presentation on the PRE-PARE study during Preeclampsia Day, May 22, 2017, pictured with residents at Botucatu São Paulo State University Medical School.

Jim Roberts presented at the 2017 Experimental Biology meeting in Chicago

Jim delivered the keynote address at the American Physiological Society Workshop: “Novel genetic risk factors and early pregnancy mechanisms contributing to preeclampsia” on the topic Pregnancy: What next? In this he addressed the need for collaboration for solving complex problems such as preeclampsia and highlighted the role of CoLab and COLLECT and pointed out their availability to investigators worldwide.