Little is known about the impact of pre-pregnancy factors and pregnancy itself on women’s long-term health and wellbeing. Some specific pregnancy disorders are known to be associated with increased incidence of long-term maternal ill health (e.g. late onset type 2 diabetes with gestational diabetes; arterial disease with pre-eclampsia; mental health problems with antenatal anxiety and depression). To what degree these later health conditions are a consequence of the woman’s constitution prior to pregnancy or whether pregnancy itself triggers changes in a woman’s health is unknown. To distinguish the influence of pre-pregnancy from pregnancy-specific factors requires a large cohort of women recruited prior to a first successful pregnancy.
The proposed cohort of 12000 nulliparous women (18-40 years) has three phases: detailed characterisation of nulliparous women; assessment of events during and immediately after a first viable pregnancy; and follow up of all pregnancies to determine long-term pregnancy-specific sequelae. Women will be recruited via GP surgery mail-outs and local advertisements. Baseline assessments of biophysical, genetic, socioeconomic, behavioural and psychological measurements will be conducted and samples of blood, urine, saliva and DNA will be collected. Women who become pregnant will be recalled for pregnancy and post-pregnancy assessments. The cohort study will evaluate women’s long-term health and wellbeing and will identify pre-pregnancy and pregnancy-specific predictors of adverse pregnancy and health outcomes.
We are currently conducting a pilot study to assess the feasibility of undertaking the pre-pregnancy cohort and to test whether 300 women can be successfully recruited into the first phase of the study.
The cohort study will generate a comprehensive and unique health profile of women aged 18-40 years and provide vital insight into how specific problems with later health and wellbeing evolve in relation to baseline characteristics and pregnancy-specific factors. The results will enable health care services to target those women at risk of adverse health and pregnancy outcomes and to provide optimal care to women before, during and after pregnancy.
- A protocol paper, systematic review and feasibility study paper are in the pipeline.
OxWATCH website – www.osprea.ox.ac.uk/oxwatch
OxWATCH press release – details to follow