Getting pregnancy right – The MothersBabies Study

Over the next five months, we will interview the 2021 SSMRF Grant recipients to find out more about them and their research.

This month we spoke with Professor Emad El-Omar, Professor of Medicine, Director of the UNSW Microbiome Research Centre (MRC) and Consultant Gastroenterologist at St George Hospital, and Naomi Strout, Project Manager/Executive Officer, MRC, about their inspiring careers and The MothersBabies Study.

Naomi Strout and Prof Emad El-Omar

Meet Professor Emad El-Omar

Professor El-Omar studied Science and Medicine at Glasgow University in Scotland and trained as a physician and specialist in gastroenterology in Scotland and the USA.

“I have always wanted to be a physician and realised early on that the best way to help our patients is to seek the best knowledge and to challenge dogma through scientific research backed up by robust clinical studies. As such, research really fires me up, because it offers opportunities to help people on a global scale,” said Professor El-Omar on his passion for his chosen field.

“I have a fascination with the digestive system, hence my choice to become a gastroenterologist. One of the most exciting developments in our field over the past 20 years has been the realisation that the trillions of bugs that live in and on us (the so-called microbiome) have a major impact on our health and have a role in many diseases that afflict humans. This is not just relevant to the digestive system, but to all organs in the body. I guess the most fundamental human activity (and all species for that matter), is to produce a fit and healthy “next generation”. This is why I am dedicating most of my time and effort to understanding how the microbiome impacts on maternal and child outcomes. If we can get pregnancy right, we will guarantee a healthy and prosperous future for humanity. To get pregnancy right, we MUST start the research before pregnancy, i.e., the pre-conception phase. This is why we designed the optimal microbiome study in the pregnancy field, starting pre-conception, and lasting till at least one year after delivery. Naturally, the babies will also be followed up into the future. This study is very difficult to conduct, but it is worth all the hard work. We owe it to humanity.

Professor El-Omar has been published many papers in scientific journals, book chapters and news articles. The topics cover many conditions that we deal with in gastroenterology, including stomach, colon and liver cancers, peptic ulcers, dyspepsia, inflammatory bowel disease and many papers on the microbiome.

Outside of work Professor El-Omar is a keen gardener. “I like to grow things. Like everything in life, patience, dedication and love will always be rewarded with great outcomes! I also enjoy fly fishing and hill walking. Most of all, I love to spend quality time with my family, including my beautiful six children.”

Meet Naomi Strout

Ms Strout studied nursing and midwifery at Charles Sturt University Wagga Wagga, receiving a Bachelor of Nursing and Postgraduate Diploma of Midwifery. She received a Master of Advanced Nursing from the University of Technology Sydney.

“Healthy mothers (and fathers) are the key step in making healthy babies and children for the future,” said Ms Strout, who has a strong personal connection with The MothersBabies Study she project manages. “I have recently returned to work after the birth of my first daughter and quite a difficult pregnancy. On the outside, I would have thought my microbiome was picture perfect (I eat well, exercise, don’t smoke and my BMI is in the ‘normal’ range) however during pregnancy I developed gestational diabetes (requiring insulin as it just did not respond to any changes in diet!) and pre-eclampsia which resulted in my daughter being born 4 weeks early via emergency caesarean section and spending 4 days in the NICU after birth. I also had a postpartum haemorrhage and developed postnatal depression after the trauma of the whole situation!”

“If there was a test I could have done prior to falling pregnant that would have predicted any of what happened, and then there have been a way of changing it (as your microbiome can be changed back to a positive state!) in order to prevent any of those adverse outcomes I would have jumped straight on that to avoid the complications and trauma both my husband, myself and our bub went through! This study is super exciting as it wants to uncover how our microbiome (the DNA of all the bugs that live on us and in us) can impact on our pregnancies, in both good and bad ways.”

Outside of work Ms Strout enjoys AFL, bike polo, cycling and camping for fun and relaxation.

The MothersBabies Study

A Medical Research Future Fund grant of $1,000,000 was awarded in 2019 to SSMRF which established the initial research project. In December 2021, SSMRF, with support from Michael Tynan Challenge – Tynan Motors, awarded $10,000 to Professor El-Omar to continue working on The MothersBabies Study.

This new funding will help Professor El-Omar with the essential tasks of recruitment and publishing interim analysis results.

The MothersBabies study aims to investigate the role of the microbiome in pregnancy and its outcomes in the mothers and their babies. It is unique in starting at the preconception stage and following women for up to a year postpartum and their babies for the first few years of life. The study outcomes will determine what constitutes a healthy preconception microbiome for women planning pregnancy, and what constitutes a microbiome that will lead to adverse pregnancy outcomes such as pre-eclampsia, gestational diabetes, excessive gestational weight and perinatal mood disorders.

To date, it is only possible to test for risk of development of adverse pregnancy outcomes, once the woman has fallen pregnant or has been pregnant previously. There are no reliable pre-emptive diagnostic tools to predict or reduce these outcomes in the preconception period, or predict how many women will be affected by them. The team hope to change this by identifying non-invasive predictive biomarkers (something in our body that could indicate disease) in the preconception period.

Early diagnosis in the preconception phase of potential adverse outcomes will ensure women can be adequately managed and treated prior to falling pregnant, therefore shifting current perinatal practice towards prevention of disease as opposed to symptom management.

Preventing disease in women also has the follow-on effect of preventing potential non-communicable diseases in their children too, such as asthma, allergy, cardiometabolic disease and adverse neurodevelopment outcomes such as autism.

The MothersBabies Study is projected to be completed in May 2024, but it may run potentially longer with follow up required for at least two years after the last woman in the study gives birth.

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