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Author Notes:

Correspondence: Louis J. Muglia, lmuglia@bwfund.org

We thank Lori Hedrick for Pregnancy Think Tank meeting planning, Russ Campbell and Seamus Duerr for assistance with the figures, and Sandra Ackerman for meeting notes.

The participants thank the BWF for providing travel support for the participants and hosting the event in Research Triangle Park, November 19–20, 2019. The authors also thank all the Working Group participants for their contributions to the discussions and review of this summary.

Disclosures: Y.S. is a consultant to Illumina, Inc. L.J.M. is a consultant to Mirvie, Inc. R.S. is on the advisory boards of CareDx, iRhythm, and Liquidia. The other authors report no conflict of interest.

Subjects:

Research Funding:

Support for convening this meeting was provided by the Burroughs Wellcome Fund.

R.M.F. is funded by a Wellcome Trust and Royal Society Sir Henry Dale Fellowship (104150/Z/14/Z).

J.A.C. was supported by the National Institutes of Health (grant R35GM127087), the Burroughs Wellcome Fund Preterm Birth Initiative, and the March of Dimes through the Prematurity Research Center Ohio Collaborative.

Keywords:

  • adverse outcomes
  • artificial intelligence
  • birthweight
  • computational biology
  • developmental origins of adult disease
  • disparities
  • drug discovery
  • evolutionary biology
  • fetal growth
  • fetal growth restriction
  • genomics
  • gestational diabetes mellitus
  • immune tolerance
  • maternal health
  • metabolomics
  • multiomics
  • parturition
  • physiology
  • population health
  • precision medicine
  • preeclampsia
  • pregnancy
  • preterm birth
  • stillbirth

Advancing human health in the decade ahead: pregnancy as a key window for discovery

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Journal Title:

American Journal of Obstetrics and Gynecology

Volume:

Volume 223, Number 3

Publisher:

, Pages 312-321

Type of Work:

Article | Final Publisher PDF

Abstract:

Recent revolutionary advances at the intersection of medicine, omics, data sciences, computing, epidemiology, and related technologies inspire us to ponder their impact on health. Their potential impact is particularly germane to the biology of pregnancy and perinatal medicine, where limited improvement in health outcomes for women and children has remained a global challenge. We assembled a group of experts to establish a Pregnancy Think Tank to discuss a broad spectrum of major gestational disorders and adverse pregnancy outcomes that affect maternal-infant lifelong health and should serve as targets for leveraging the many recent advances. This report reflects avenues for future effects that hold great potential in 3 major areas: developmental genomics, including the application of methodologies designed to bridge genotypes, physiology, and diseases, addressing vexing questions in early human development; gestational physiology, from immune tolerance to growth and the timing of parturition; and personalized and population medicine, focusing on amalgamating health record data and deep phenotypes to create broad knowledge that can be integrated into healthcare systems and drive discovery to address pregnancy-related disease and promote general health. We propose a series of questions reflecting development, systems biology, diseases, clinical approaches and tools, and population health, and a call for scientific action. Clearly, transdisciplinary science must advance and accelerate to address adverse pregnancy outcomes. Disciplines not traditionally involved in the reproductive sciences, such as computer science, engineering, mathematics, and pharmacology, should be engaged at the study design phase to optimize the information gathered and to identify and further evaluate potentially actionable therapeutic targets. Information sources should include noninvasive personalized sensors and monitors, alongside instructive “liquid biopsies” for noninvasive pregnancy assessment. Future research should also address the diversity of human cohorts in terms of geography, racial and ethnic distributions, and social and health disparities. Modern technologies, for both data-gathering and data-analyzing, make this possible at a scale that was previously unachievable. Finally, the psychosocial and economic environment in which pregnancy takes place must be considered to promote the health and wellness of communities worldwide.

Copyright information:

© 2020 Published by Elsevier Inc.

This is an Open Access work distributed under the terms of the Creative Commons Attribution 4.0 International License (https://creativecommons.org/licenses/by/4.0/).
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