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BEGOTTEN Study : Blood prEssure GrOwth TrajecTories EthNicity study

 How maternal blood pressure and baby’s growth change across different ethnicities? An observational study in women of East London 

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Background: 

The research is aimed to look at fetal growth and maternal blood pressure, amongst a multi-ethnic cohort of pregnant women in East London. This population includes 60% of non-white ethnicity, with a particularly high Bangladeshi population.

 

Hypertensive disorders of pregnancy (HDP) affect 8-10% of pregnant women and contribute majorly to feto-neonatal and maternal morbidity and mortality. Incidence of HDP varies substantially according to ethnicity, with Black African and South-Asian women being disproportionately affected. Screening for HDP with BP thresholds of >/140/90mmHg has low sensitivity. There is evidence that the use of BP trajectories during pregnancy, accounting for ethnic differences, may improve this. Several maternal biomarkers have been identified as valuable as screening tools for pre-eclampsia. Despite BP trajectories and biomarkers concentrations being shown to differ according to ethnicity, studies in non-White populations are scarce.

 

Intrauterine growth restriction (IUGR) is associated with significant perinatal morbidity and mortality. Accurate diagnosis of IUGR is warranted to meet the national priority of halving stillbirths by 2025. It is now well-recognised that an ultrasound diagnosis of fetal smallness is not a proxy for IUGR as fetuses who exhibit intrauterine “slow growth” born within the normal range of birthweight are also at risk of adverse outcomes. However, strategies to identify these fetuses and thresholds to define ‘slow growth’, especially in pregnancies from ethnic diverse populations are poorly studied.

 

The aim of this study is to study trajectories of fetal growth and maternal cardio-metabolic markers such as BP. This can hopefully better predict adverse fetal and maternal outcomes, to compare trajectories for women of different ethnic backgrounds and to ascertain cut-offs for blood pressure and fetal growth velocity, to reduce adverse outcomes.

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Aims:

The aim of this study is to determine whether BP and fetal growth trajectories can better predict adverse fetal and maternal outcomes, to compare trajectories for women of different ethnic backgrounds. We aim to measure blood pressure and, perform blood tests at multiple gestation points and ultrasound scans at 32 and 36 weeks. Data of pregnancy, and outcome will be collected.

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Study start: July 2023

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Study Duration: 18 Months

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Participating Sites:  Royal London Hospital

 

Recruitment target: 1536

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