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Diseases of pregnant women
Diseases of pregnant women are a major health problem. Approximately 500,000 women die in pregnancy every year worldwide and one of the United Nations Health goals was to improve maternal health. Medical disorders are a major cause of pregnant women dying.
Professor Catherine Williamson’s research focuses on medical diseases in pregnant women and their impact on the outcome of pregnancy for the mother, the unborn baby and subsequent health of the child. Her research focuses on liver disease, endocrine tumours, pre-eclampsia and prediction of poor pregnancy outcome.
Liver disease in pregnancy: Professor Williamson has a program studying obstetric cholestasis (OC). It affects approximately 1 in 200 pregnant women in the UK. Affected women have itchy skin and liver impairment with raised bile acids in the blood. OC can be merely very unpleasant for pregnant women but most women improve rapidly after they have their baby. Fortunately most women improve rapidly after they deliver. However, the condition can affect the unborn baby with in increased risk of preterm labour, fetal distress and, in the worst cases, stillbirth.
Professor Williamson’s group have identified genetic causes of OC, including the first report of a common genetic factor found in affected women. The group is also studying the hormonal signals that cause the condition to occur in pregnancy. There are specific hormones that rise in pregnant women, and some of their breakdown products are higher in women that develop OC. Recent work shows that these hormone breakdown products can cause genetically susceptible women to develop OC. The Genesis Research Trust has provided invaluable pump-priming money for this research. Catherine is also studying the ways that raised bile acids in the mother’s blood may cause the unborn baby to become ill. She has done collaborative work with Dr Julia Gorelik to show how bile acids may affect the heart of the unborn baby. At present, the work has used laboratory studies of heart cells and has shown that higt levels of bile acids may cause the heart to beat abnormally and ultimately stop. She hopes that future clinical studies of the heart rate of OC babies in the womb will show whether this is of relevance to the unborn baby in OC. She is also involved in investigating research drugs that may protect the fetal heart from the bile acid effects and how these acids affect the placenta. This work should help us to choose the best treatment to prevent the complications of preterm labour, fetal distress and stillbirth in OC.
Endocrine tumours: Professor Williamson is currently using a national database (the UK Obstetric Surveillance System) to study the influence of tumours of the pituitary gland on the health of pregnant women and their babies. This study will evaluate the influence of pregnancy on the tumour and also whether the tumour or the drugs used to treat it have adverse effects on the health of pregnant women or their babies. The initial studies are focusing on pituitary tumours, but the team hopes to extend these studies to other tumours of endocrine glands
Pre-eclampsia and prediction of adverse pregnancy outcome: Professor Williamson is a member of the UK Genetics of Pre-eclampsia (GOPEC) Genetic Steering Group. This is a national committee that uses a DNA resource from 1000 women with pre-eclampsia to understand the genetic causes of the disease. She is also developing a new project using blood samples from women with OC and other important pregnancy complications (including pre-eclampsia) to identify ways of predicting women who will have disease in pregnancy. This work will involve large-scale studies and we hope it will allow researchers to identify women at risk of problems for themselves or their unborn baby at a very early stage of pregnancy so clinicians can give them treatments to prevent disease and improve maternal and fetal health.