Maternity nurse with patient & baby

Women & Children's Current Research

The Women and Children’s Research Unit conducts research that aims to improve the care of women and children using Obstetrics and Gynaecology services. This includes pre-conception services though to postnatal care.

The Unit collaborates widely with other disciplines and professions, as well as with women and their companions, to develop ground-breaking research and care, for our patients and throughout the NHS.

Please speak to the person treating you to find out if there is a research study that may be able to help you.

Maternity Studies:

ABA-Feed

Breastfeeding can improve health of mothers and babies, but fewer UK women breastfeed compared to other countries. Many women stop breastfeeding within the first two weeks; most would have liked more support to help them continue. Younger mothers and those from lower income homes are less likely to breastfeed.

The aim of the trial is to find out whether a ‘feeding helper’ service (ABA-feed) that supports women to feed their babies helps them to breastfeed for longer and whether it is good value for money.

We will invite women aged 16 years or over expecting their first baby who have given informed consent, 20+0 to 35+6 weeks gestation at 10-15 sites to take part, approaching them in antenatal/scanning clinics. 2730 women will be allocated by chance to either receive usual care for feeding or the additional ABA-feed service.

‘Feeding helpers will respect women’s feeding choices. They will help them identify friends/family who may help and will provide information about local groups, helplines and websites about infant feeding. They will provide a ‘listening ear’ when women have had their baby.

We will train existing peer supporters to become ‘feeding helpers. They will contact women around 30 weeks of pregnancy and meet to talk about infant feeding; then keep in contact throughout pregnancy. After birth, the feeding helper will contact mothers daily for 2 weeks by text message or phone and refer those with particular difficulties to specialist feeding support. Women will be offered less frequent texts until their babies are 8 weeks old as participant preference.

At 3 days, 8, 16 and 24 weeks after birth, women will be sent a text/web link which asks how they are feeding their baby. We will compare breastfeeding rates at 8-weeks between women who did/did not receive support from feeding helpers. We will interview women, feeding helpers and health care professionals about their experience of the service.

Project Details
Principal Investigator: Ms Marion Copeland
Planned end date: 31/08/2022
Local Ref: 4985

ACE ID

Many women have a very different birth experience to what they expected, which can contribute to anxiety and distress. Up to 1.5% of women experience post-traumatic stress disorder at six months following birth, and up to 50% of women suffer stress-related symptoms at two months after Caesarean section and 24% at six weeks after vaginal delivery.

Research has shown that having information about labour, birth and the postnatal period, and feeling in control during labour, are associated with positive psychological outcomes.

Some antenatal education is currently offered to women and their partners as part of routine care. However, many women do not attend these classes and the content and delivery is variable within and between areas.

ACE is a patient-focused intervention that will educate and support women to develop and use coping strategies. It will also equip the midwifery workforce at North Bristol NHS Trust to deliver interactive, skills-based education and enable them to better support patients.

The project aims to improve patient experience, psychological outcomes and staff satisfaction with care.

Focus groups will be held with women and staff to identify current expectations of labour and birth, and to understand how women would like to use coping strategies.

The two interventions (one for women; one for staff) will then be implemented in three community midwifery hubs. Around 50 women in each area will attend. Community midwives will deliver the intervention in addition to usual care. A project midwife will deliver the staff training intervention.

To find out more about this study, contact abi.merriel@bristol.ac.uk

This study is funded by The Health Foundation. Collaborators include the University of Bristol and the National Childbirth Trust.

 

Project Details
Principal Investigator: Dr Abi Merriel
Planned end date: 01/09/2022
Local Ref: 4863

AKID: Acute Kidney Injury and Gestational Diabetes in pregnancy – A prospective cohort study

The aim of this study is to help better understand kidney function throughout pregnancy and blood sugar (glucose) levels late in pregnancy.

Acute Kidney Injury (AKI) is a sudden fall in kidney function. It can happen in pregnancy, during birth and after birth. AKI can cause problems for the pregnancy and the mother and in the longer term for a mother’s health. Currently, normal kidney function in pregnancy is unknown. This study will aim to more clearly define normal kidney function levels in pregnancy, thereby allowing a more accurate diagnosis of Acute Kidney Injury in the future.

Gestational diabetes is a type of diabetes that can develop during pregnancy. Currently, gestational diabetes is diagnosed by a test called an Oral Glucose Tolerance TEST (OGTT), which is performed at around 24-28 weeks of pregnancy and is offered to mother’s who have risk factors for developing gestational diabetes. At times, whilst this result is normal, some women may go on to develop late onset of gestational diabetes and it may go undetected.    

This study aims to look at normal levels of glucose in pregnant women after 32 weeks of pregnancy, using 2 types of test, with a view of finding best way to diagnose late onset gestational diabetes.

Women can choose to take part in both parts of the study, or the AKI aspect of the study.

To find out more about the AKID study, contact 0117 414 6764 or email AKID@nbt.nhs.uk.

 

 

Project Details
Principal Investigator: Dr Christy Burden
Planned end date: 30/06/2022

Local Ref: 4586

CoCo90s

Children of the 90s is a group of around 14,500 children born in the Avon area in 1991 and 1992. Scientists have been studying them ever since and are constantly making discoveries that make a difference to lives around the world.

Some now have children of their own, and we want to follow these pregnancies, births and babies. We call this Children of the Children of the 90s, or COCO90s for short. This is the only project we know of that provides scientists with information on three generations, allowing them to study important social and health issues.

If you or your partner are in Children of the 90s and are about to become or are already a parent, we'd love you, your partner and all your children to take part in COCO90s. It doesn’t matter how much or how little you have been involved in Children of the 90s in the past -- this is a new opportunity to be involved in ground-breaking research.

For more information about this study, visit the CoCo90s website.

Project Details
Principal Investigator: Ms Mary Alvarez
Planned end date: 31/12/2021
Local Ref: 2801

Continuous Glucose Monitoring

This study aims to look at the normal levels of glucose in pregnant women after  32 weeks of pregnancy by using continuous monitoring or CGM (a small device that is placed on the skin and measures glucose in surrounding cells for 7 days) and to compare them with levels earlier in the pregnancy. The aim of the study is to find what normal levels of glucose are after 32 weeks gestation of pregnancy, to then facilitate the future plan to establish the best way to diagnose diabetes at this stage in pregnancy.

If you would like to get involved in this study, email CGM@nbt.nhs.uk.

Project Details
Principal Investigator: Dr Christy Burden
Planned end date: 31/01/2022
Local Ref: 4585

Impact Diabetes

Healthy eating and staying active during pregnancy help both the mother and baby. We know that women and their families find it hard during the first year after the baby is born to look after their own health as well as their baby’s.

We want to test whether providing women with a health coach and an interactive smartphone app will improve health in pregnancy and the first year after the baby’s birth. The health coach and smartphone app will provide help around healthy eating and exercise in pregnancy, and once the baby is born, help with feeding their baby and active ways to play with them. We are comparing this with giving women the information about healthy eating and staying active in a different way.

We are carrying out this study with colleagues from several hospitals around the world – in Ireland, Spain and Australia.

For more information about this study, visit the bump2babyandme website.

EU Emblem

This project has received funding from the European Union’s Horizon 2020 Research & Innovation programme under grant agreement No 847984

Project Details
Principal Investigator: Dr Christy Burden
Planned end date: 30/06/2023
Local Ref: 4846

MAP-A: The Medication Adherence in Pregnancy- Aspirin Study

Low-dose aspirin prophylaxis is recommended to pregnant women who have risk factors for developing pre-eclampsia. Pre-eclampsia is characterised by high blood pressure and protein in the urine and there is no cure for it except delivery of the baby. Women who have pre-eclampsia can go on to develop serious complications both for themselves and for the baby. Pregnant women are assessed for this risk at the first booking appointment in pregnancy. If they are identified as being at risk they will be recommended to take low-dose aspirin (75-150mg).

We know from talking to women that some find it difficult to, or prefer not to, take the low-dose aspirin that is recommended to them. The aim of the MAP-A study is to find out from women what the barriers and facilitators to taking it are, to inform development of future interventions to support women to take it.

To find out more about this study, contact Dr Anna Davies via anna.davies@bristol.ac.uk or anna.davies@nbt.nhs.uk.

Project Details
Principal Investigator: Dr Christy Burden
Planned end date: 31/10/2021
Local Ref: 4689

MAP-C

Research tells us that lots of people find it difficult to take medications for their long-term conditions. We know that this can become even more difficult for women when they are pregnant, and for lots of different reasons, including feeling unwell and concerns about the effect of the medications on their baby. Stopping medication in pregnancy can sometimes affect the health of mother and baby during pregnancy but also the mother's health after her baby is born. We would like to find out more about the difficulties that women with long-term conditions experience, and what help they would like from health care practitioners to support them to take their medication.

This study aims to listen to the views of women to help us find the best ways of supporting them to take their medication as recommended.

For more information about this study, please get in touch with Anna Davies via anna.davies@nbt.nhs.uk.

Project Details
Principal Investigator: Anna Davies
Planned end date: TBC
Local Ref: 4702

Orchard

Kidney disease affects about 1 in 30 (3%) women of childbearing age. Most women with kidney disease have successful pregnancies and healthy babies. However, women with kidney disease have an increased chance of more pregnancy complications including early deliveries and smaller babies.  They also may have temporary or permanent damage to kidney function.

At the moment we do not understand why some women develop damage to kidneys during pregnancy. We would like to test your blood and urine at different times during your pregnancy to get more information.  This will allow us to develop tests to predict who is going to have kidney damage and find ways to prevent damage.

Project Details
Principal Investigator: Dr Alison Armitage
Planned end date: 01/10/2022
Local Ref: 4900

Shared Decision Making

The aim of this research is to improve shared decision-making during labour and birth, with the purpose of improving women’s experiences of making these decisions. This study will form the foundation for the development of an intervention to improve shared decision making.

We want to improve women’s experience of labour and birth and part of that is for women to lead the decision making during their labour and birth.  Women are often offered interventions to ensure their and their baby’s safety and to optimise their experience of birth. Women may feel vulnerable and are often in pain, it could be considered to be a particularly difficult time at which to have to make decisions about interventions.

We want to improve experience because poor experience can be linked to stress symptoms after a baby is born and, in some studies, has been linked to low mood. Some women who have interventions during their birth describe a poorer experience of birth.

We believe that if we can improve shared decision making, it may improve women’s birth experience.

For more information about this study, visit the NHS England website.

Project Details
Principal Investigator: Dr Abi Merriel
Planned end date: 31/07/2021
Local Ref: 4656

The POOL Study

The pool study is a data collection study with the aim of answering the question about the safety of waterbirths.

Information is collected via the hospital’s maternity electronic information system form all women who labour or give birth in water until December 2020, unless a woman specifically opts out of having this data collected.

The study will determine:

  • How many women are using birth pools
  • How many women give birth in water
  • Whether mothers and their babies come to any extra harm as a result of waterbirth.

For babies that need specialist care after their birth, the study will also use the data held by the National Neonatal Research Database(NNRD).

All women who use a pool as part of their labour or birth will be given an information card about the study and they can let the midwife providing their care if they wish to opt out from this study.

Project Details
Principal Investigator: Ms Nichola Bale
Planned end date: 30/06/2022

Local Ref: 4536

NICU Studies:

AZTEC

AZTEC is a research study investigating whether 10 days of treatment with Azithromycin (a common antibiotic), can potentially improve lung outcomes for premature babies when compared to a placebo (dummy medicine).

For more information about this study, visit the AZTEC Trial website

Project Details
Principal Investigator: Dr Richard Wach
Planned end date: 28/02/2022
Local Ref: 4591

Feed-1

Around 8% of UK babies are born premature at birth and 12% of these are born between 30 and 33 weeks. Currently, most preterm babies are fed through a drip into their veins (intravenous) and given small amounts of milk by a small tube into their stomach, slowly increasing until they are fully milk fed. Doctors are wary of feeding premature babies with full milk straight after birth due to a potentially life-threatening gut condition called necrotising enterocolitis (NEC). Evidence suggests that in premature babies who aren't too poorly, larger milk feeds can be successfully given within 48 hours of birth without increasing the risk of NEC and death and could reduce the risk of severe infection.

We will compare the two different groups: the 'full milk' group will be given milk to provide all their fluid needs from the first day of life and increased over a few days unless they are struggling with this (e.g. if it makes them very sick). In the 'gradual milk' group, babies will be initially fed through their veins, increasing milk feeds slowly and reducing IV fluids until they are fully milk fed, which is current practice. Mothers will be identified at Antenatal clinic or within 3 hours of early arrival. The groups will be decided at random by a computer giving each baby an equal chance of being in either group.

We want to know if feeding babies with only milk from the first day of life can avoid babies having fluids through a drip (IV). It may be that giving milk only could reduce infections, reduce the number of days in hospital and therefore reduce the overall costs to parents and to the NHS.

Project Details
Principal Investigator: Dr Richard Wach
Planned end date: 31/07/2023
Local Ref: 4980

Fertility Studies:

BRIST-IVF

The Bristol IVF Study has been set up to investigate the success of IVF treatment.

Led by Professor Debbie Lawlor and Dr Amy Taylor at the University of Bristol and Dr Valentine Akande at the BCRM. We are recruiting women, and their partners, undergoing IVF treatment. We are inviting individuals/couples who become pregnant, following IVF treatment, to attend pregnancy clinics at the University of Bristol. This will help to understand more about the impact of IVF treatment on short and longer term outcomes.

We recruited our first couple to the study in September 2019.

Project Details
Principal Investigator: Dr Amanda Jeffreys
Planned end date: 31/03/2022

Local Ref: 4526

Gynaecology Studies:

CHANCE: CHronic endometritis ANd unexplained reCurrent miscarriage – The role of the endometrial microbiome

Background: Many people want to become parents. Unfortunately, 5% of couples experience recurrent miscarriage – defined as two or more miscarriages in a row. In more than half of these cases no cause is found.

This has a significant psychological impact on couples and uses many NHS resources. We do not know how to treat women with unexplained recurrent miscarriage and currently only offer supportive care.

A suggested cause of recurrent miscarriage is persistent inflammation of the womb lining. This is known as ‘chronic endometritis’. It may result in an unhealthy environment for an embryo. Chronic endometritis cannot be detected using regular tests; it requires examining a sample of the womb lining in a laboratory. Studies that previously investigated chronic endometritis as a potential cause of recurrent miscarriage are of poor quality and therefore National and International guidelines, The James Lind Alliance, and national miscarriage charities have prioritised this area for research.

Aim: To identify whether women with recurrent miscarriage are more likely to have chronic endometritis than women without recurrent miscarriage, and to identify any bacteria that might be responsible for chronic endometritis. Furthermore, we will investigate if chronic endometritis could cause recurrent miscarriage by changing the distribution/function of cells in the womb lining.

Methods: We will collect a sample of the womb lining from 100 women with a history of recurrent miscarriage and from 100 women who have had a successful pregnancy and no history of recurrent miscarriage (a control group). The control group (as approved by our patient advisory group) will be women undergoing planned “key hole” surgery for another reason but which allows easy sampling of their womb lining too.

If our study shows that chronic endometritis is a likely cause of recurrent miscarriage, we will carry out another study to see if treating chronic endometritis, with targeted antibiotics, increases pregnancy rates. Effective treatment would improve outcomes for our patients and save the NHS and society costs associated with recurrent miscarriage.

The study has been co-designed by women and their partners. Our patient advisory group will also be integral throughout the delivery of the study; from leading the preparation of patient facing documentation, to reviewing any changes made to the study protocol and co-dissemination of our findings through links with Tommy’s charity and The Miscarriage Association.

Sharing the results: Our findings will be presented through national miscarriage charity events and national and international medical conferences. Our results will be published in health journals and freely available to the public. We will work closely with the relevant NHS and professional organisations to ensure that our findings are meaningful and widely and appropriately disseminated.

This study is funded by the National Institute for Health Research (NIHR). Collaborators include the University of Bristol, University College London and the University of Birmingham.

Project Details
Principal Investigator: Dr Islam Gamaleldin
Planned end date: 30/09/2021
Local Ref: 4383

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Find out more about our research and how we're working to improve patient care.

Contact Research & Innovation

Research & Innovation
North Bristol NHS Trust
Floor 3, Learning & Research Centre
Southmead Hospital
Westbury-on-Trym
Bristol, BS10 5NB

Telephone: 0117 4149330
Email: research@nbt.nhs.uk