PROBLEMATIC PREGNANCIES

Professor Claire Roberts is searching for signs that can identify and therefore prevent dangers to the health of a mother and baby but also predict their lifelong health.

“Families are at the centre of our society, but difficulties that are still being faced in pregnancy and childbirth are so often overlooked. We tend to think that in an advanced western society, all pregnancies will turn out fine. But it’s a hidden fact that over 35% of the more than 300,000 Australian pregnancies each year has one of four major complications. There are also 2000 stillbirths in Australia every year, yet mostly we assume that nothing goes wrong.”

Previously a Deputy Director of the Robinson Research Institute that focuses on women’s and children’s health, Professor Roberts came to Flinders University in 2020, establishing the Pregnancy Health and Beyond Laboratory (PHaB Lab) to focus on women’s and children’s health. Current projects in the PHaB Lab include studying fetal sex differences in pregnancy outcomes, maternal nutrition and the placental transcriptome (genome-wide gene expression assessed by RNA sequencing).

Professor Roberts’ research program brings together Flinders University’s research strengths and the clinical activity at Flinders Medical Centre – a synergy that perfectly realises the intention of the university campus and hospital being built beside each other as companion institutions. “FMC has everything needed to look after women and babies: obstetrics services, an adult intensive care unit, a neonatal intensive care unit and paediatrics department. It is South Australia’s centre for the unwell woman. For example, SA pregnant women with placenta accreta, that can cause severe blood loss, are all treated at FMC and those with COVID-19 would all be treated here too.”

Through follow-up of her large pregnancy cohorts, Professor Roberts and her team are following the long-term health pathways of women and children, particularly those who had a complication during pregnancy. “We now know these women are more likely to get chronic disease later in their life, and not necessarily a lot later. For example, women who have preeclampsia are more likely to have hypertension, stroke or heart disease in middle and older age. Gestational diabetes is on the rise and these women are more likely to develop Type 2 diabetes.”

Professor Roberts has a strong personal motivation for this research. The first of her three children died when he was five days old from a serious heart defect. Now a grandmother of four, she cherishes family and is alert to the vulnerability of mothers and babies. “I’ve always wanted to solve problems in pregnancy. I knew it would require big picture observations to achieve it.”

As a result, Professor Roberts and her team have been following the health journeys of mothers and their children through large studies: SCOPE, a pregnancy cohort of 1,200 women recruited between 2005 and 2008, then the STOP cohort involving 1,300 women recruited between 2015 and 2018, and new large collaborating cohort studies at Flinders Medical Centre and around Australia are currently being planned.

The researchers hope to build multi-generational pictures of health in families and identify genetic and lifestyle factors at play, with a focus on the early origins of chronic disease. Professor Roberts says these long-term studies can become a large resource for medical researchers. “We know research informs clinical practice but a multi-generational study can bring scientists, clinicians and the community together, people with apparently different interests but actually with a common goal. With the right design, a pregnancy study can be used to foreshadow future health in women. By reflecting back on the previous generation and forward into the next we can develop a powerful resource to study health across the lifespan.”