The identification of novel biomarkers for the small for gestational age human fetus

在子宫内发育不良的婴儿(称为胎龄小[SGA])，发生包括死产在内的一系列不良后果的风险增加。对孕妇进行筛查，试图发现SGA婴儿，有可能减少这些不良后果的数量，特别是死产，这是英国每年约4000名婴儿死亡的原因。在英国，目前筛查一般人群中的SGA婴儿的做法仅限于测量女性？S隆起(技术上称为联合-眼底高度？)。用卷尺测量。然而，众所周知，这种方法并不是特别擅长抱起小婴儿。与孕期筛查唐氏S综合征婴儿的方法相比，SGA的方法非常粗略。S综合症筛查采用扫描和血液标志物相结合的方法，现在可以发现90%的病例，只有一小部分女性需要进一步检查。也有一些扫描和血液标志物用于SGA婴儿，但这些指标本身都不足以预测他们。我们相信，有可能找到比现有血液检测更有效的新标记物。事实上，系统地寻找更好的标志物的研究相对较少，现有的大多数有助于预测SGA的血液测试都是偶然发现的。我们可以从一项大规模研究中获得扫描信息、血液样本和胎盘(胎盘)样本，该研究对首次怀孕的未选定女性(2800名女性，目标招募5000名)进行了研究。本申请的主要目的是看看我们是否能在发育不良的婴儿的母亲S的血液中找到更好的标记。具体地说，我们计划确定SGA婴儿和匹配对照组胎盘中表达的基因的关键差异。然后，我们的目标是看看这些基因编码的蛋白质是否在胎盘和母亲S的血液中以不同的浓度被发现。最后，我们的目标是确定关于这些蛋白质水平的信息是否改善了对SGA婴儿的预测。最终的结果将是一种预测工具(算法)，以检测小婴儿。然后，我们可以设计该工具的试验，看看它是否改善了结果。最终目的是提高对孕妇的护理效率，减少因死产而死亡的婴儿数量。

Babies who grow poorly in the womb (called small for gestational age [SGA]) are at increased risk of a number of adverse outcomes, including stillbirth. Screening pregnant women in an attempt to detect SGA babies has the potential to reduce the number of these adverse outcomes, in particular stillbirth, which accounts for the death of about 4000 babies per annum in the UK. Current practice in the UK in screening the general population for SGA babies is confined to measuring the woman?s bump (technically called ?symphysis-fundal height?) with a tape measure. However, this approach is known not to be particularly good at picking up small babies. The approach to SGA is very crude in comparison to the approach to screening for Down?s syndrome babies in pregnancy. Down?s syndrome screening utilises a combination of scan and blood markers and now detects 90% of cases with only a small proportion of women requiring further tests. There are also a number of scan and blood markers for SGA babies, but none of these is good enough on its own to predict them. We believe that it will be possible to identify novel markers which may be more effective than existing blood tests. In fact, relatively few studies have systematically looked for better markers and most of the existing blood tests which could help predict SGA were discovered by chance. We have access to scan information, blood samples and placental (afterbirth) samples from a large scale study of unselected women in their first pregnancy ( 2800 women and on target to recruit 5000). The overarching aim of the present application is to see if we can find better markers in the mother?s blood of poorly grown babies. Specifically, we plan to determine the key differences in the genes expressed in the placenta of SGA babies and matched controls. We then aim to see if the proteins encoded by these genes are found at different concentrations in the placenta and in the mother?s blood. Finally, we aim to determine whether information about the levels of these proteins improves the prediction of SGA babies. The end result will be a predictive tool (algorithm) to detect small babies. We could then design trials of the tool to see if it improved outcome. The ultimate aim is to make care of pregnant women more effective and to reduce the number of babies lost to stillbirth.