Funding offers hope to thousands of babies 

23/01/2013 00:00 

UCLH clinicians and researchers are in line to lead on a clinical trial to develop a therapy for fetal growth restriction, which could save the lives of thousands of babies.

 Tiny baby Abigail who was a severely growth restricted baby born at UCLH. She sadly died just before her first birthday from com

Tiny baby Abigail who was a severely growth restricted baby born at UCLH. She sadly died just before her first birthday from complications of being born very small and too prematurely. Copyright The Times


UCL is leading a consortium, known as EVERREST,which has been awarded a €6 million grant for a research programme that will culminate in a first-in-woman trial into the condition which affects eight per cent of all pregnancies. It is severe in approximately 1 in 500 fetuses and affected fetuses are extremely small, usually less than 500g. There is no cure.

In the first three years of the programme, UCLH clinicians will develop the clinical trial protocol and closely study pregnant women with the condition in preparation for the trial. If the consortium is successful in getting ethical and regulatory approval for the trial, it will be run at UCLH with recruitment of patients nationally.

Those involved are:

Anna, Reader/Associate Professor at UCL Institute for Women’s Health and the coordinator of the EVERREST consortium said: “This award will enable the development of a highly innovative new therapy in the field of obstetrics, a specialty in which there is currently a lack of investment in new treatments. If successful, this would be the first evidence-based therapy for fetal growth restriction and could save thousands of lives.”

Fetal growth restriction affects approximately 60,000 babies per year in Europe and the USA. Many of these premature, very small babies stay in hospital for months after birth, which is stressful for parents and very costly for the NHS (neonatal intensive care costs approximately £1,000 per day).

Potential benefits from the research could include reduced stillbirths and neonatal deaths, and improved outcome in pregnancies affected by severe early onset fetal growth restriction.

Dr Anna David, consultant obstetrician and fetal medicine specialist

Dr Anna David, consultant obstetrician and fetal medicine specialist


Babies born from growth restricted pregnancies are not only at increased risk of perinatal death and complications such as cerebral palsy, but there are long term consequences for their health which include diabetes and cardiovascular disease.The recent improvements in the postnatal care of premature growth restricted babies means that more of them survive delivery, but at great cost. Inadequate uterine blood flow, termed ‘utero-placental insufficiency’, is the underlying abnormality in many cases.

Once severe early onset fetal growth restriction is identified in mid pregnancy, couples currently face a stark choice between delivering their baby very prematurely in the knowledge that they might die in the neonatal intensive care unit, or allowing the pregnancy to continue with the strong likelihood that the baby will die in the womb.

Relatively small increases in fetal growth and gestation at delivery are associated with major improvements in survival and morbidity. Studies performed at UCL Institute for Women’s health showed that the therapy, whichdelivers a growth factor to the uterine circulation, increasesuterine blood flow and improves fetal growth.

For the trial, the consortium includes some of the leading fetal medicine centres and academic health science centres in Sweden (Lund University), Germany (University Medical Center Hamburg-Eppendorf), Spain (Hospital Clinic Barcelona and IDIBAPS) and the UK (UCL and UCLH) with strong backgrounds in the management of pregnancies affected by severe early onset fetal growth restriction.

Women from these centres who present with an affected pregnancy in mid-gestation will be invited to participate in the trial, and the safety and efficacy of the intervention will be studied.

This project is partially funded by the European Commission under the 7th Framework Programme

More information on European Commission funded projects is available here

 

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