Cohort profile: Improved Pregnancy Outcomes via Early Detection (IMPROvED), an International Multicentre Prospective Cohort.

HRB open research Pub Date : 2024-06-24 eCollection Date: 2023-01-01 DOI:10.12688/hrbopenres.13812.2
Gillian M Maher, Louise C Kenny, Kate Navaratnam, Zarko Alfirevic, Darina Sheehan, Philip N Baker, Christian Gluud, Robin Tuytten, Marius Kublickas, Boel Niklasson, Johannes J Duvekot, Caroline B van den Berg, Pensee Wu, Karolina Kublickiene, Fergus P McCarthy, Ali S Khashan
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引用次数: 0

Abstract

Background: Improved Pregnancy Outcomes via Early Detection (IMPROvED) is a multi-centre, European phase IIa clinical study. The primary aim of IMPROvED is to enable the assessment and refinement of innovative prototype preeclampsia risk assessment tests based on emerging biomarker technologies. Here we describe IMPROvED's profile and invite researchers to collaborate.

Methods: A total of 4,038 low-risk nulliparous singleton pregnancies were recruited from maternity units in Ireland (N=1,501), United Kingdom (N=1,108), The Netherlands (N=810), and Sweden (N=619) between November 2013 to August 2017. Participants were interviewed by a research midwife at ~11 weeks (optional visit), ~15 weeks, ~20 weeks, ~34 weeks' gestation (optional visit), and postpartum (within 72-hours following delivery).

Findings to date: Clinical data included information on maternal sociodemographic, medical history, and lifestyle factors collected at ~15 weeks' gestation, and maternal measurements, collected at each study visit. Biobank samples included blood, urine, and hair collected at each study visit throughout pregnancy in all units plus umbilical cord/blood samples collected at birth in Ireland and Sweden. A total of 74.0% (N=2,922) had an uncomplicated pregnancy, 3.1% (N=122) developed preeclampsia, 3.6% (N=143) had a spontaneous preterm birth, and 10.5% (N=416) had a small for gestational age baby. We evaluated a panel of metabolite biomarkers and a panel of protein biomarkers at 15 weeks and 20 weeks' gestation for preeclampsia risk assessment. Their translation into tests with clinical application, as conducted by commercial entities, was hampered by technical issues and changes in test requirements. Work on the panel of proteins was abandoned, while work on the use of metabolite biomarkers for preeclampsia risk assessment is ongoing.

Future plans: In accordance with the original goals of the IMPROvED study, the data and biobank are now available for international collaboration to conduct high quality research into the cause and prevention of adverse pregnancy outcomes.

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队列概况:通过早期检测改善妊娠结局(IMPROvED),一项国际多中心前瞻性队列研究。
研究背景通过早期检测改善妊娠结局(IMPROvED)是一项欧洲多中心 IIa 期临床研究。IMPROvED的主要目的是评估和完善基于新兴生物标记技术的创新型子痫前期风险评估测试原型。在此,我们将介绍 IMPROvED 的概况,并邀请研究人员合作:2013年11月至2017年8月期间,我们从爱尔兰(N=1,501)、英国(N=1,108)、荷兰(N=810)和瑞典(N=619)的产科医院共招募了4,038名低风险无子宫单胎孕妇。参与者在妊娠约 11 周(可选访问)、约 15 周、约 20 周、约 34 周(可选访问)和产后(产后 72 小时内)接受了研究助产士的访谈。迄今为止的研究结果:临床数据包括在妊娠约 15 周时收集的产妇社会人口学、病史和生活方式因素信息,以及在每次研究访问时收集的产妇测量值。生物库样本包括所有单位在整个孕期每次就诊时收集的血液、尿液和毛发样本,以及在爱尔兰和瑞典出生时收集的脐带/血液样本。共有 74.0%(样本数=2,922)的孕妇妊娠过程并不复杂,3.1%(样本数=122)的孕妇出现子痫前期,3.6%(样本数=143)的孕妇自然早产,10.5%(样本数=416)的孕妇产下小于胎龄儿。我们在妊娠15周和20周时评估了一组代谢物生物标志物和一组蛋白质生物标志物,用于评估子痫前期风险。由于技术问题和测试要求的变化,商业实体将这些指标转化为临床应用测试的工作受到了阻碍。蛋白质小组的工作已经放弃,而利用代谢物生物标志物进行子痫前期风险评估的工作仍在进行中:未来计划:根据 IMPROvED 研究的最初目标,现在可以利用数据和生物库开展国际合作,对不良妊娠结局的原因和预防进行高质量的研究。
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