Circulating Delta-like homolog 1 (DLK1) at 36 weeks is correlated with birthweight and is placental origin
As a pregnancy advances past 38 weeks gestation, the risk of stillbirth slowly rises. This risk is even higher if the fetus has impaired growth due to placental insufficiency. Better detection of fetal growth restriction at term could prevent many cases of stillbirth by identifying those that would benefit from planned timing of birth.
We know that the traditional methods of identifying small babies using the tape measure and physical examination of the woman’s abdomen misses two out of three growth restricted babies. Ultrasound is the not easy solution as it misses just over half of small babies. A new approach is urgently needed.
Our work so far: the FLAG study
We have previously undertaken the Fetal Longitudinal Assessment of Growth (FLAG) study. This study involved over 2000 women providing a blood sample in late pregnancy. We identified potential markers of ‘poor placental health’ in women's blood samples, and then awaited the birth of the baby to see if these markers could reliably predict which babies would be born small. The FLAG study also looked at new ultrasound markers that might better identify babies with fetal growth restriction.
Our FLAG study created some very exciting leads. The new blood markers and ultrasound parameters are very promising, but are not ready to be used as a clinical test on their own. But it shows us we are on the right track. We now plan to look at a further group of molecules in the blood stream to see if they might improve prediction of the small baby. Introducing...the BUMPS study!
The BUMPS Study
The BUMPS study takes our discoveries from the FLAG study to the next crucial stage. We have received two large grants from the National Health and Medical Research Council to undertake this important work, including a Synergy grant of $5 million.
In the midst of the current COVID19 pandemic, such a test has never been needed more. A test that could reliably differentiate between those babies that are compromised and need deluvert from those that are healthy (and can safely await birth at full term), would help optimise pregnancy care for women across the globe.
