An Irish researcher in Cork University Maternity Hospital is leading investigations to discover a treatment for two common pregnancy complications which are becoming more prevalent in Ireland, writes Cillian Sherlock.
Dr Cathal McCarthy, originally from Co Kerry, is investigating the causes of pre-eclampsia, which has no treatment, and gestational diabetes.
"Pre-eclampsia is a condition that occurs after 20 weeks of pregnancy. It affects approximately 3-5% of pregnancy complications so it’s a relatively well-known condition and even though we’re doing a lot of research into it, there’s actually no treatment for it.
"It’s been around for centuries and yet, even though we know quite a lot about it, we still can’t actually treat it effectively," he said.
Dr McCarthy works in the Infant Centre, Ireland’s first dedicated perinatal research centre which aims to develop innovative technologies to improve treatment for mothers and newborn babies.
Dr McCarthy said he has been working with the Infant Centre (INFANT) since 2013.
"The principle of the Infant Centre is to make pregnancy safer and improve health outcomes for mothers and babies. That can be during pregnancy or directly after pregnancy. We have a component of infant health as well," he said.
The Infant Centre, in partnership with University College Cork and Science Foundation Ireland, is researching a wide variety of subjects including developing new, advanced methods for detecting seizures in newborn children.
He said the rise in number of cases of the pre-eclampsia and gestational diabetes is caused by an increasingly overweight population.
"Obesity is a risk factor for both conditions. If a woman develops gestational diabetes she has an increased risk of developing pre-eclampsia. With the increase of obesity levels in Ireland and Europe, and particularly in the reproductive population, the incidence of both conditions is increasing," he said.
"Mothers would have an increase in blood pressure and there’d be evidence of increased protein in the urine. The symptoms would be they would have increased, strong headaches they couldn’t get rid of, nausea and a general feeling of being unwell," he added.
The current difficulty with tackling gestational diabetes is that women are encouraged to change their diet and exercise more, however this only resolves 60% of cases and can be difficult for pregnant women.
While insulin is also used as a treatment, this can cause more problems as retention of weight is a potential side effect of the drug.
The effects on babies can also be dramatic.
"Babies are often born too small or too soon because it’s a toxic condition. The longer the baby is in the womb the more toxic it is. Ultimately, sometimes the obstetrician has to make the decision to take the baby out before the end of pregnancy or leave it in there.
"It’s obviously a difficult decision they have to make. Obviously, if we could discover a therapy or treatment, the longer we could keep the baby in the womb the better it will be for the mom and baby," Dr McCarthy said.
In cases of gestational diabetes, there is an increased risk for both the mother and baby of developing diabetes later in life.
Dr McCarthy is attempting to identify the signalling pathways between the placenta and adipose (fat) tissue.
"Ultimately, once we figure out what those pathways are we can target them and alter them to improve the conversation between the placenta and adipose. We can create more effective therapies for both conditions he said," he added.
He takes cell and blood samples from women with the condition and cultures them in the lab to mimic the conditions of the womb.
Those tissues are treated with different compounds to see if improvement can be made in the signalling pathways.
They are also recruiting 4,000 women for their 'PARROT' study across seven maternity hospitals in Ireland in an effort to enable doctors to detect pre-eclampsia earlier.
Dr McCarthy is also using flow cytometry, an immunology method, in his research.
He said the Infant Centre, which employs around 150 people across different medical fields and clerical positions, is in an ideal location in Cork University Maternity Hospital.
"Being on the top floor of a hospital offers you the benefit of having your 'samples' on all floors below you.We have the ease of access in getting to patients, it's all literally within seconds down the stairs. It makes life a lot easier," he said.
Dr McCarthy was a recent recipient of an Emerging Investigator Award from the Health Research Board.
"I'm delighted. It was a lot of work but hopefully the outcome will be that we can expand obstetrician perinatal research here in INFANT," he said.
Dr Jane English, also from the Infant Center, was another of the 11 successful researchers to receive the award for her research into early diagnosis of Autism Spectrum Disorder through blood biomarkers.