OAA Large Project Grants

University of Glasgow

Title
Effect of maternal anaesthesia on short and long-term offspring outcomes: A population-based study

Amount
£59,942

Scientific Abstract
Around 60% of women receive anaesthetic interventions during labour or delivery. Whilst there are reassuring data on the effects of anaesthesia on neonatal outcomes including survival and resuscitation at birth, long-term effects remain unclear. Anaesthesia during labour and delivery includes general anaesthesia as well as epidural and spinal techniques, however research is lacking into the relative safety of these alternatives.

In December 2016 the US Food and Drug Administration (FDA) warned that exposure to general anaesthesia in the third trimester of pregnancy may affect the development of children's brains. The FDA and the James Lind Alliance have identified the potential effects of anaesthesia on the developing brain as a research priority.

This proposal will create a unique national resource linking ten different national population datasets, with ethical and regulatory approval already obtained. Our ability to examine and compare exposure to different forms of anaesthesia during pregnancy and link to long-term outcomes in the Scottish population and in particular growth, health, pharmaceutical use and educational outcomes will be a critical step in providing clinically relevant data with global importance.

University of Edinburgh

Title
Maternal critical care: identifying at-risk women and understanding the short and long term consequences of critical illness in pregnant or recently pregnant women

Amount
£48,262

Scientific Abstract
Maternal mortality is at low levels in the UK. However, 1% of women experience critical illness complicating pregnancy/childbirth, which can have long-term consequences. Recent national reports advocate improving care for critically ill pregnant women regardless of where they are cared for. They recommend better recognition of critical illness, improved team working across hospital professional groups and improved care for women who survive critical care. However, we have little research to guide these improvements.

Our study proposes to link the Scottish maternity database to the critical care database. This will enable us to identify a complete national cohort of women (2005-2017) who receive critical care during pregnancy/childbirth across Scotland. By using multivariable regression methods to analyse this unique linked database, we aim to i) quantify and better identify pregnant women who need critical care, and ii) report, for the first time at a population level, the long term health consequences of surviving critical care for pregnant women and their babies. This information will facilitate pre-emptive recognition of women needing critical care and by identifying major problems that women experience after surviving critical care, will enable researchers and healthcare workers to develop targeted interventions and services to improve care for these women.