The Joint Annual Scientific Meetings of the Endocrine Society of Australia and the Society for Reproductive Biology 2018

Identifying new markers of placental insufficiency (#84)

Tu'uhevaha Kaitu'u-Lino 1
  1. Department of Obstetrics and Gynaecology, Tranlsational Obstetrics Group, Mercy Hospital for Women, University of Melbourne, Heidelberg, Vic, Australia

Stillbirth is a tragedy that ends 1:130 pregnancies in Australia. 50% of stillbirths are associated with fetal growth restriction (FGR) which arises from placental insufficiency. FGR is also a major determinant of perinatal morbidity, with low-birthweight infants experiencing poorer neurodevelopmental outcomes then infants of normal birthweight. Moreover, FGR is associated with adverse outcomes later in life; school-aged children who were growth restricted have higher rates of impaired cognition, memory, attention and gross motor proficiencies and its effects can persist lifelong - adults have a higher prevalence of major chronic diseases such as cardiovascular disease, stroke and diabetes.  Surprisingly, current clinical practice only identifies 20-30% of pregnancies compromised by fetal growth restriction, thus new tools are desperately needed.  Combining clinical and scientific expertise, our team have completed a prospective cohort collection of 2000 blood samples from women at both 28 and 36 weeks’ gestation and have identified a panel of biomarkers present within the circulation of mothers preceding their delivery of a baby weighing <10th centile. Importantly, some biomarkers are deranged as early as 10-12 weeks before disease onset and correlate with fetal growth and neonatal body composition.  We have subsequently used our biomarker findings to return back to the laboratory and use ‘reverse translation’ to provide a better understanding of how these deranged markers are likely to be contributing to the pathogenesis of placental insufficiency.