Pitt/Magee Research Institute Researcher Roberts to Help Lead International Project on Preeclampsia

James Roberts

A renowned researcher at the University of Pittsburgh and Magee-Womens Research Institute (MWRI) will help lead a multiproject program to prevent and treat the pregnancy complication preeclampsia and also will head a component project aimed at creating a database of biological samples from women around the world.

James Roberts, a professor of obstetrics, gynecology, and reproductive sciences in the University of Pittsburgh School of Medicine and an MWRI member, is the senior advisor to the executive committee of PRE-eclampsia-Eclampsia Monitoring, Prevention, and Treatment (PRE-EMPT). The $7 million, four-year international research and community intervention effort is funded by the Bill and Melinda Gates Foundation (BMGF). PRE-EMPT is being led by researchers at the University of British Columbia (UBC) and the Child & Family Research Institute (CFRI), also in British Columbia. Roberts’ database initiative is one of five projects within PRE-EMPT.

“By using a strategy that has been quite successful in studying cardiovascular disease and cancer, we will bring together data, blood, urine, and other biological samples from study groups around the world to gain rapid insight into preeclampsia and its treatment,” Roberts said. “These samples currently come from developed countries, but the BMGF has 50,000 women in pregnancy studies, and we plan to begin collections at sites in developing countries. Also, we will extend our studies to other pregnancy complications, such as preterm birth and stillbirth that have great impact in low- and middle-income countries, by using data and samples especially relevant to women in these settings.”

Hypertensive disorders, or high blood pressure, complicate 5 to 10 percent of pregnancies and can lead to serious maternal and fetal illness or death. Preeclampsia, the most serious of these disorders, is the second-leading cause of maternal death worldwide, resulting in as many as 76,000 maternal deaths each year.

“That translates into the death of one mother every seven minutes, and 99 per cent of these deaths occur in lower- and middle-income countries,” said Peter von Dadelszen, an associate professor of obstetrics and gynecology in UBC’s Faculty of Medicine and codirector of the Reproduction and Healthy Pregnancy research cluster at CFRI.

The World Health Organization (WHO) estimates that more than 500,000 fetuses and newborns die annually as a result of preeclampsia. Because preeclampsia can be treated only by delivering the placenta and infant, preeclampsia-related maternal deaths primarily result from delays in diagnosis, transport, and treatment.

Led by von Dadelszen, the PRE-EMPT team—comprising researchers, physicians, and community health professionals from Canada, the U.S., Africa, Asia, Oceania, the U.K., and WHO—will study, develop, and implement a set of clinical guidelines tailored for lower- and middle-income countries.

The five PRE-EMPT projects are:

• A clinical trial of prepregnancy and early-pregnancy calcium supplementation in women with low calcium intake and at high risk for preeclampsia in a subsequent pregnancy. The goal of this South African and Zimbabwean trial is to determine whether pre- and early-pregnancy calcium supplementation prevents both the diagnosis and consequences of preeclampsia;

• A study to develop and validate tools to better identify, diagnose, and assess risks to accelerate triage and transport to centers where women will receive effective and evidence-based treatment. This effective care will avert the adverse maternal and perinatal consequences of preeclampsia;

• A study to test the impact of a community-level care program for reducing adverse maternal and perinatal outcomes related to preeclampsia. This program will be tailored to different levels of care in four South Asian and sub-Saharan countries;

• The establishment of an international collaboration, led by Roberts, to share clinical data and biological samples for further collaborative studies; and

• A knowledge translation group to update the relevant WHO guidelines.