Research in this area is concerned with identifying risk factors for adverse outcomes in pregnancy and early life.
Using large primary care databases we have explored interrelationships between maternal and child health and the effects family structure.
Working across divisional groups we have assessed drug safety and the impact of illness in respiratory medicine and gastroenterology.
We are currently exploring risk factors for congenital malformations and other early life outcomes including survival, particularly in relation to use of essential medications during pregnancy.
- Dates: 2009-2013
- Funding: Wellcome Trust Project Grant
- Principle investigator: Laila Tata
Each year in the United Kingdom, 20,000 children are born with severe congenital malformations, which are now a leading cause of stillbirth and infant mortality.
Despite increasing use of essential medications in pregnancy, the extent to which common drug exposures contribute to malformations is mainly limited to small, non-population based studies and register data have drawbacks of no appropriate controls and voluntary notification.
Young women of childbearing age are increasingly receiving drug treatments to manage chronic conditions such as high blood pressure or depression, although there are no clinical trials of these drugs in pregnant women.
Can we use general practice data to study gestational drug safety?
Computerisation of general practices in the United Kingdom, providing records of medical diagnoses and prescriptions from doctor and hospital visits for each registered patient, has lead to widespread use of large general practice databases for researching many health questions such as the safety of routinely prescribed drugs.
It has not been possible to look at drug safety in pregnancy because individual records are anonymous, however, methods can be used to recover links between the records of mothers and children.
With the aim of addressing these issues, we are using UK-wide primary care data from The Health Improvement Network (THIN) to establish an automated routinely- updated database of pregnancies and linked maternal-child longitudinal health records.
Five key drug studies
In this Wellcome Trust funded project, we are using the database to conduct five key studies of common gestational drug exposures to medications that are often essential for the management of chronic conditions during gestation, yet require further research to understand the potential risks to the foetus: antihypertensives, statins, antidepressants, antiepileptics and diabetes medications.
We plan to integrate this database of pregnancies into routine THIN updates available for further research, to fully exploit the potential effectiveness of primary care databases as a tool to assess the impact of chronic and infectious illnesses and associated drug treatments on pregnancy, and particularly as an early warning surveillance system for newly marketed drugs.