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

在子宫内生长不良的婴儿（称为小胎龄[SGA]）面临许多不良后果的风险增加，包括死产。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，特别是死胎，这在英国每年造成约4000名婴儿死亡。目前在英国筛查SGA婴儿的一般人群的做法仅限于测量妇女？S bump(技术上叫？联合-基底高度？)然而，这种方法在抱起小婴儿时并不特别有效。与筛查唐氏综合症的方法相比，SGA的方法非常粗糙。妊娠期S综合征婴儿下来吗?S综合征筛查结合了扫描和血液标记物，现在可以检测到90%的病例，只有一小部分妇女需要进一步检查。还有一些针对SGA婴儿的扫描和血液标记物，但这些都不足以预测他们。我们相信，有可能发现比现有血液检测更有效的新型标记物。事实上，相对较少的研究系统地寻找更好的标记物，现有的大多数可以帮助预测SGA的血液测试都是偶然发现的。我们可以获得扫描信息、血液样本和胎盘（产后）样本，这些样本来自一项大规模的研究，研究对象是未被选中的首次怀孕的女性（2800名女性，目标是招募5000名女性）。目前应用的首要目的是看看我们是否能在母亲身上找到更好的标记。发育不良婴儿的血液。具体来说，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在胎盘和母亲体内的浓度是否不同？年代的血液。最后，我们的目标是确定这些蛋白质水平的信息是否能提高对SGA婴儿的预测。最终的结果将是一个预测工具（算法）来检测小婴儿。然后我们可以设计该工具的试验，看看它是否能改善结果。最终目的是使孕妇的护理更有效，并减少死产婴儿的数量。

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.