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Pre-eclampsia is a major contributor to death and disability in pregnancy. Diagnosis, based on accurate blood pressure (BP)/proteinuria determination, is limited by measurement errors and being late features of the disease. In collaboration with industry, King's College London (KCL) researchers have developed an inexpensive, accurate, simple BP device suitable for rural clinics. This device allows intervention to reduce mortality/morbidity and is currently being rolled out in a Gates Foundation project in Africa and Asia. KCL researchers have also helped the company Alere Inc. with the development of a diagnostically accurate test of placental growth factor (PlGF) in women with suspected pre-eclampsia: Alere Triage®PlGF. This demonstrates high sensitivity, superior to current tests, and following commercialisation is being adopted internationally. Their work is additionally reflected in guidelines of international standards for BP device accuracy.
Pioneering new immunoassays for inhibin A and B, developed by Professor Nigel Groome at Oxford Brookes University, have contributed to a significant improvement in the accuracy of pre- natal screening for Downs Syndrome. Use of inhibin A in the `Quad' and `integrated' tests, protected by international patents, is widespread in the US (c.3million screened annually) and was recommended by the NHS in 2010, leading to a significant increase in the use of the assays (c.120,000 annually) in the UK. They are also used in clinical diagnostic and monitoring applications for male and female infertility, abnormalities in sexual development in children and ovarian granulosa tumours. Commercialisation has led to royalty income to Brookes from sales which totalled approximately c.£5million in the period January 2008 to December 2012, indicative of the c.US$135million earned in worldwide sales in the same period.
Professor Susan Golombok's research has made a significant contribution to policy formation and legislation regarding families created by assisted reproductive technologies. Her research has directly informed the Human Fertilisation and Embryology Act (2008); the policies of the Human Fertilisation and Embryology Authority (HFEA); and recommendations of the Nuffield Council on Bioethics, in relation to assisted reproductive technologies involving the donation of eggs, sperm or embryos and surrogacy, and with respect to families with single and same-sex parents. Moreover, her research has been widely recognised as having made a fundamental contribution to public debate on the social and ethical implications of assisted reproduction for individuals, families and society.
Every year 15 million babies are born premature and prematurity is the world's single biggest cause of newborn death. Babies born preterm cannot shiver and are dependent on interventions to prevent low body temperature (hypothermia). Implementing evidence-based interventions such as provision of thermal care at high coverage (99%) could increase survival of premature babies by 35-55% worldwide. In light of this, a Cochrane systematic review of evidence on low cost/low tech interventions to prevent low body temperature at birth in preterm and low birthweight babies was conducted. This produced strong evidence to support their routine use in practice, with particular support for use in low and middle-income countries. The findings and recommendations of the review are included in global action agendas of bodies such as the World Health Organization and UNICEF and they have been used as the foundation of numerous clinical practice guidelines worldwide.
Research undertaken at the University of Ulster has had a global impact on public health advice about fish consumption during pregnancy. Ulster's international collaborative research has been used by the Food and Agriculture Organisation (FAO) of the United Nations and the World Health Organization (WHO), and also by industry, to promote greater fish consumption during pregnancy. The work has also been evaluated by the European Food Safety Authority (EFSA) in its assessment of the public health risk of methyl-mercury in food.
University of Bristol research has led to a marked and persisting reduction in the number of cot deaths (sudden infant death syndrome or SIDS). The dramatic 67% fall from 1988 to 1992 in England and Wales resulted from the identification of risks associated with putting babies to sleep face-down (prone). Nationally, death rates have more than halved again (54% fall) between from 1992 and 2011, with an estimated additional 1025 lives saved between 2008 and 2011, after two studies conducted in 1993-6 and 2003-6 identified further contributory risk factors. Tens of thousands of SIDS deaths worldwide have been prevented thanks to the team's research, international collaboration and development of risk-reduction recommendations.
Smith identified four novel findings around the relationship between caesarean section and perinatal death (i.e. stillbirth or neonatal death). 1. Vaginal birth after previous caesarean had a low absolute risk of death, but the risk was lower still with planned caesarean delivery. 2. The second twin had a higher risk of death at term. 3 Caesarean section was associated with an increased future risk of stillbirth. 4. Use of prostaglandins to induce labour in women with a previous caesarean increased the risk of death. The studies subsequently led to changes in national and international clinical guidelines, which remain current.
Approximately 25,000 people in the UK die each year from venous thromboembolism (VTE); furthermore, VTE affects 1 in 100,000 women of childbearing age and causes one-third of all maternal deaths. Thrombophilia, pregnancy and the use of oral oestrogens can all place women at increased risk of VTE when compared with other individuals. University of Glasgow researchers quantified the probability of VTE among at-risk women and analysed the benefits and cost-effectiveness of thrombophilia screening. Their research is cited in the recommendations and evidence bases of leading national and international clinical guidelines. This work also galvanised an overhaul of VTE prevention policy within NHS Scotland by emphasising the need for regional health boards to implement and audit standardised in-house protocols and provide accessible patient information on VTE.
New criteria for the diagnosis of diabetes in pregnancy have been developed by the International Association of Diabetes in Pregnancy Study Groups and adopted by the American Diabetes Association on the basis of the Hyperglycaemia and Pregnancy Outcomes (HAPO) study. These new criteria double the percentage of women diagnosed with diabetes in pregnancy from approximately 8.5% to 17%. Appropriate management improves outcomes for them and their new born children. The results, which proved valid for all ethnic groups and countries, have led to a worldwide re-appraisal of glycaemic risk in pregnancy and the introduction of new guidelines to manage this.
Research on Congenital Adrenal Hyperplasia (CAH) at the University of Sheffield has resulted in both health and commercial impacts. The research has led to a new drug treatment, Chronocort®, being developed for CAH. Chronocort® has been tested in CAH patients with the positive outcome of improved disease control.
Commercial impact arose from the creation of a spin-out company, Diurnal Ltd, in 2004 which has raised investment of £3.8M since 2008, including £0.4M from pharmaceutical industry sources, and (as an SME partner) a €5.6M Framework 7 grant to develop a paediatric treatment for CAH. Diurnal has created five new jobs and has contracts with six UK companies worth £2.7M.