UC San Diego launches Center for Perinatal Discovery

A recently opened center at the UC San Diego School of Medicine is bringing together doctors, researchers and patients in a first-of-its-kind effort to study pregnancy, including its complications and their long-term effects, with the goal of improving the health of mothers and their children through collaborative science.

The Center for Perinatal Discovery, based at the Sanford Consortium for Regenerative Medicine, will carry out basic research projects to help understand the interactions among maternal health, environmental exposures, fertility, pregnancy and the health of children before and after birth. The center, with faculty representing nine different departments, is considered the only one of its kind in the region.

Specific research topics include detection of biomarkers for adverse pregnancy outcomes, understanding how the maternal immune response changes during pregnancy, and investigating causes of pregnancy loss, such as miscarriage and stillbirth.

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The center was launched in September and is co-directed by Dr. Louise Laurent, a professor of obstetrics, gynecology and reproductive science, and Dr. Mana Parast, a professor of pathology. The two have worked together for more than a decade as clinicians and scientists but wanted to bring together researchers from a variety of fields to expand the study of how complications during pregnancy can lead to developmental abnormalities later in life.

“We recognized early on in our careers that health outcomes are complicated,” Laurent said. “There are a lot of different factors that determine what the health of a given person is at any given point in their lives. We think some of these effects occur before birth. Part of our goal is to collect a rich set of data so we can ask these complex questions and look for associations between different risk factors.”

The center plans to recruit a large group of women, some with no predetermined risk factors and some considered at high risk, and study them throughout their pregnancies through the lens of different fields.

“These are complex questions that require teams to answer them,” Laurent said.

For example, a shared interest between Laurent and Parast is preeclampsia, a pregnancy complication characterized by high blood pressure and signs of damage to an organ system, most often the liver and kidneys. It is considered fairly common because it occurs in 5 percent to 8 percent of otherwise normal pregnancies.

“There are some that get a mild form of the disease later in their pregnancy; others get a severe form earlier in pregnancy, which means pre-term delivery,” Laurent said. “It’s one of the most consequential complications because pre-term birth is a risk factor for complications after birth. It can show up in a number of different ways, but you can have multiple organs being affected and the growth of the baby. It’s a complex thing in and of itself, and the risk factors are complicated as well. ... We don’t have great ways of predicting it. ... So there is a lot of work in looking at better ways to predict.”

Another subject the center would explore, Parast said, is how complications during pregnancy can lead to neurological changes down the line.

“It is now coming out that certain events likely during intra-uterine life can predispose a person to neurodevelopmental changes, but we don’t really understand that very well,” she said. “So having a well-characterized cohort during pregnancy with five-year follow-up will hopefully answer some of those questions. ... We see this as a chance to build something that neither one of us could build on our own.”

Parast said she sees the prospect of attracting more funding by bringing in more partners “and really start something big at the local level that will improve the health of the community right here in San Diego.”

Laurent said she hopes launching the center will help draw attention to the importance of studying pregnancy. “Part of the reason I went into OB is because I was amazed that, even though pregnancy is something we all go through [as fetuses] … pregnancy is very understudied,” she said. “[The National Institutes of Health division that] supports pregnancy and pediatric research is the smallest and least-funded institute in NIH.”

However, she said, “it’s not only important, it’s fascinating. In what other area of medicine do we get to study a human developing from one cell to a person? It’s so important from a clinical standpoint, and the more attention we can draw to significance of this area the better, and it deserves to have top-notch people from all fields of expertise.”

For more information about the Center for Perinatal Discovery, including its June 26 online symposium focusing on perinatal loss, visit medschool.ucsd.edu/som/pathology/research/Center-for-Perinatal-Discovery. ◆