A Vancouver-led research initiative to prevent deaths of moms and babies got a boost recently with a new $1.5-million grant from the Bill & Melinda Gates Foundation. The grant will expand efforts to improve diagnosis and care for pregnant women with pre-eclampsia.
The project, Community-Level Interventions for Pre-eclampsia (CLIP), engages communities around health issues faced by pregnant women. It provides training and resources to help health care workers in remote or underserved areas better identify and care for women at risk of the often-fatal complications of pre-eclampsia. The new grant will fund expanding the trial from its current locations in Nigeria, Pakistan and India, to Mozambique. Together, these four countries bear over half the global burden of maternal and newborn deaths.
This trial is part of a larger project to develop and test new strategies to save the lives of pregnant women with pre-eclampsia and their babies. Pre-eclampsia and Eclampsia Monitoring, Prevention & Treatment (PRE-EMPT) is led by Dr. Peter von Dadelszen and includes researchers, health care providers, and experts in Africa, Asia, the Pacific, Europe, and North and South America.
This new grant brings the total funding awarded from the Bill & Melinda Gates Foundation to PRE-EMPT to $25.9 million.
“This is great recognition by the Gates Foundation of this vital global partnership, which I have the immense honour to lead,” says Dr. von Dadelszen. “Its legacy, and that of our global team, will be counted in the thousands of women’s and infants’ lives saved.”
Dr. von Dadelszen is a senior clinician scientist at the Child & Family Research Institute at BC Children’s Hospital, consultant in Maternal Fetal Medicine at BC Women's Hospital & Health Centre, and professor with the UBC Department of Obstetrics & Gynaecology. BC Children’s and BC Women’s are agencies of the Provincial Health Services Authority.
“The findings of this trial may be as pertinent in rural and remote Canada, as they will be throughout less developed countries,” says Dr. von Dadelszen.
This announcement comes just as the research team has published new findings in PLOS Medicine showing that their clinical diagnostic predictive model, miniPIERS, is accurate 85.5 per cent of the time at identifying women with a greater-than-average risk of developing a potential fatal complication of pre-eclampsia such as seizures, stroke or failure of the lungs, kidney or liver.
Every year, ten million women around the world develop a hypertensive (high blood pressure) disorder during pregnancy and 76,000 women die as a result. Pre-eclampsia, the most serious of these disorders, is the second leading cause of child-birth related death worldwide. Over 99 per cent of those deaths occur in developing countries.
"The fatal complications of pre-eclampsia are usually preventable," says Dr. Peter von Dadelszen. "Too many deaths in Asia and Africa are because women are arriving at hospital having already suffered strokes or lost their baby. We can prevent this with training, community education and technology.”
The miniPIERS (Pre-eclampsia Integrated Estimate of RiSk) model is embedded within a simple mobile-phone app, called PIERS on the Move, that was devised by Dr. von Dadelszen and his team. The app prompts health care providers to collect and input clinical data, calculates an overall risk score, and provides information for further treatment that’s based on the latest research. With this information, caregivers can administer medication and arrange urgent transportation to a larger health care facility if needed.
The development of this app was featured in a new publication in the IEEE Journal of Biomedical and Health Informatics. Developed in collaboration with Dr. Mark Ansermino and Dr. Guy Dumont, this technology also makes use of the phone pulse oximeter, a small smart-phone based device developed by Dr. Ansermino, Dr. Dumont and their teams that can be used to measure oxygen saturation in the blood.
These initiatives are part of the larger PRE-EMPT project led by Dr. von Dadelszen. PRE-EMPT is a research and community-level intervention project to develop and test new strategies to save the lives of pregnant women with pre-eclampsia and their babies. PRE-EMPT includes five sub-projects with researchers, clinicians and experts in Africa, Asia, the Pacific, Europe, and North and South America.
Dr. Ansermino is a senior associate clinician scientist and Director of the Innovations in Acute Care & Technology research cluster at CFRI; Director of Research for Pediatric Anesthesia, BC Children’s; associate professor with the UBC Department of Anesthesiology, Pharmacology and Therapeutics.
Dr. Dumont is a CFRI scientist; co-director of the Electrical & Computer Engineering in Medicine (ECEM) research group at UBC; professor with the UBC Department of Electrical and Computer Engineering and associate member of the UBC Department of Anesthesiology, Pharmacology and Therapeutics.
For more information:
- A risk prediction model for the assessment and triage of women with hypertensive disorders of pregnancy in low-resourced settings: the miniPIERS (Pre-eclampsia Integrated Estimate of RiSk) multi-country prospective cohort study (PLoS Med., January 2014)
- Development of mHealth Applications for Pre-eclampsia Triage (Journal of Biomedical and Health Informatics, January 2014)
- UBC-CFRI effort to save pregnant women awarded additional $17-million
- UBC/CFRI project receives $7M to reduce maternal, fetal and newborn deaths