Dr Fran Conti-Ramsden

MRC Clinical Research Training Fellow, O&G ST3.

[Dr Fran Conti-Ramsden @FContiRamsden]

Can genomics improve prediction of #preeclampsia? New data shows maternal ethnicity is imperfect proxy for genetic ancestry, and ancestry is independently associated with pre-eclampsia: 10.1016/j.preghy.2024.101162 @Abbasdehghan @LucyChappell2 @AdeMarvao

[Antonio de Marvao @AdeMarvao]

Our expert review on the treatment of hypertension in #pregnancy has just been published:

➡️https://t.co/jsBC5jv6iU

Systematic review of meta-analyses, when and how to treat, special scenarios, what is known and what are the knowledge gaps

@FContiRamsden @LucyChappell2

[Dr Fran Conti-Ramsden @FContiRamsden]

New paper! > 4/10 babies admitted to NNU < 34 weeks in UK experienced clinician-initiated (iatrogenic) preterm birth, with hypertensive disorders of pregnancy and associated fetal growth restriction present in 50%
@NNRDbase @LucyChappell2 @DrCBattersby https://t.co/tPYXKM0rJT

[Dr Fran Conti-Ramsden @FContiRamsden]

@kiityc Also worth noting labetalol exposure in 3rd trimester is recognised as a risk factor for infant hypoglycaemia in @BAPM_Official hypoglycaemia guidelines in term infant - so this subset of HDP infants should receive more monitoring and feeding support

[Dr Fran Conti-Ramsden @FContiRamsden]

@kiityc Agree comparing tx to non tx too confounded but several other AHA used to tx HTN in pregnancy in UK and so head to head comparison of AHA should give us answers on drug specific risks.. ideally RCT of course - see @GiantPANDATrial

[Dr Fran Conti-Ramsden @FContiRamsden]

@BJOGTweets Video abstract summary available here: https://t.co/0FO8XlBEAJ

[Dr Fran Conti-Ramsden @FContiRamsden]

@KeighleyUK @BJOGTweets Yes quite possibly! Sadly we didn't have breakdown of AHA in @NNRDbase but hoping to set up data linkage in due course that will allow us to address this Q

[Dr Fran Conti-Ramsden @FContiRamsden]

@kiityc My hunch is all these factors (+ FGR and earlier birth) are contributing (we couldnt dissect it all out in this paper). Q is what is modifiable - infant feeding/postnatal support and antihypertensive choice are best contenders IMHO. Better data on steroids after 34w needed too!

[Dr Fran Conti-Ramsden @FContiRamsden]

@drruthannharpur @BJOGTweets Yes locally definitely something we can look into - I am not sure how well powered or representative the dataset will be but worth a look.

[Dr Fran Conti-Ramsden @FContiRamsden]

@kiityc @BJOGTweets @DrCBattersby Agreed I think there is really exciting work to be done here - large potential benefits to mum and baby if we can improve BF outcomes in HDP and potential transgenerational benefits too.

[Dr Fran Conti-Ramsden @FContiRamsden]

@susan_bewley @buist_rob @BJOGTweets We did adjust for gestational age, birthweight centile and FGR and found HDP infants still more likely to receive management for hypoglycaemia alone incase of interest

[Dr Fran Conti-Ramsden @FContiRamsden]

@buist_rob @BJOGTweets Corresponding author here - yes agree we need much better data on infant side effects of Maternal AHA. We didn't have this granularity in @NNRDbase unfortunately. If AHA choice does impact infant hypoglycaemia a relatively easy thing to address and reduce admissions!

[Dr Fran Conti-Ramsden @FContiRamsden]

@placentadoc Hi corresponding author here - yes we couldn't investigate specific AHA which is a limitation. We did look at steroid data but as very high missingness (approx 50% - and couldn't distinguish missing v not given) so v difficult to draw conclusions.. thanks for reading!

[Dr Fran Conti-Ramsden @FContiRamsden]

@kiityc @BJOGTweets 👋 corresponding author here - interesting but sadly we couldn't investigate this in this dataset. Agree feeding and postnatal support really important areas to investigate and address in this context as well as medications. @DrCBattersby might add more from NNU perspective!

[Dr Fran Conti-Ramsden @FContiRamsden]

@drruthannharpur @BJOGTweets Sadly on a national scale I think unlikely. We are exploring linkage of NNRD to national maternity datasets atm and they just don't have this granularity. But absolutely agree feeding really important in this context and something we need to look at more as well as medications

[Dr Fran Conti-Ramsden @FContiRamsden]

@drruthannharpur @BJOGTweets Hi 👋 I am the corresponding author - sadly no there is only data on feeding type once admitted not prior to admission so this would need further research

[BJOG @BJOGTweets]

12% of late preterm infants admitted to UK neonatal units are born to mothers with hypertension in pregnancy. Hypoglycaemia is one of the primary pathologies driving these high admission rates. Can we modify the risk for this?

https://t.co/BveW0UazoL

[Dr Fran Conti-Ramsden @FContiRamsden]

Video abstract here: https://t.co/0FO8XlBEAJ

[Dr Fran Conti-Ramsden @FContiRamsden]

1/10 late preterm, 1/20 term UK NNU admissions ass. with maternal HDP. 1/4 HDP infants managed for hypoglycaemia alone. Could antihypertensive choice reduce separation of mothers and babies in HDP? @NNRDbase @GiantPANDATrial @LucyChappell2 @DrCBattersby. https://t.co/XMSQaYL8FL