Leads: Professor Marian Knight, Professor Paul Leeson
Acquired cardiovascular diseases are recognised as the leading cause of death during and after pregnancy in the UK, yet there has been little work to understand how best to tackle the problem. We are bringing together Oxford’s strengths in population maternal health and discovery science targeting the perinatal period to address this neglected window of opportunity.
We aim to identify which women are at highest risk of poorer cardiovascular outcomes after having a baby and prioritise them for new therapies and personalised medicine. Once we have identified effective new treatments, we will carry out largescale clinical trials with a view to them being translated into clinical practice.
We have already made progress in identifying: critical factors driving adverse uteroplacental and cardiovascular remodelling during pregnancy; how pregnancy complications associated with changes in the cardiovascular system in the decades after pregnancy; and that interventions soon after birth can prevent long-term cardiovascular diseases. Among our main area of work:
We will be carrying out detailed magnetic resonance imaging on patients who had specific cardiovascular diseases during pregnancy in collaboration with the UK Obstetric Surveillance System (UKOSS). The scans will take place immediately after birth and one year later to identify phenotypic clusters of women at risk of poorer recovery so they can be given more targeted support.
We are addressing the long-term risk of cardiovascular disease after gestational diabetes and hypertension by identifying mechanisms linking pregnancy with later health, using samples collected at birth such as placenta, fat cells and small blood vessels. Multi-omics screening of these tissues will identify molecular disease drivers that may be amenable to targeted protective interventions.
We are investigating which therapies, when given immediately before or after birth, could improve the long-term cardiovascular health of the mother and baby, building on previous discoveries of certain molecules that are able to improve blood vessel health and the novel therapies identified in our other cardiovascular sub-themes.