Expert Meeting Agenda 2020

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Action on Pre-eclampsia Expert Meeting 2020 Pre-eclampsia post the pandemic Date: November 12th 2020 Location: Online via ZOOM* (*invitation following registration) Time: 13:00-17:00 GMT 12:45 REGISTRATIONS OPEN/WELCOME/SETTLING IN Prof Andrew Shennan OBE, Chair of Trustees, APEC 12:55 Welcome and Introductions Marcus Green CEO APEC Pre-eclampsia post the pandemic - CHAIR Prof Andy Shennan A showcase of UK work and research on pre-eclampsia and hypertension in pregnancy KEYNOTE TALK Professor Marian Knight Hypertension and COVID-19: what can Professor of Maternal & Child Population Health 13:05 we learn from women admitted to National Perinatal Epidemiology Unit hospital in the UK with SARS-CoV-2 in Nuffield Department of Population Health pregnancy? University of Oxford Self-monitoring of BP during Dr Katherine Tucker 13:25 hypertensive pregnancy in Academic Research Fellow the context of COVID University of Oxford Placental Imaging Dr Alison Ho 13:35 Project Research Fellow, Kings College London Dr Louise Webster James Lind Alliance 13:45 Clinical Lecturer, Department of Women and Children's Health, Kings College London 13:55 Short break/summary Kemi Badenoch MP Exchequer Secretary to the Treasury 14:05 KEYNOTE TALK Parliamentary Under-Secretary of State Minister for Equalities 14:35 Break 14:45 Sponsor presentation - Perkin Elmer Dr Alice Beardmore Gray Update on Redman Walker Prize 14:50 Research Fellow, Kings College London Dr Tanya Robins 14:55 Update on Redman Walker Prize Research Fellow, Kings College London Prof Laura Magee 15:00 Pre-eclampsia: redefined? Professor of Women’s Health, Kings College London PICk-UP: Postnatal enalapril to Improve Laura Ormesher 15:10 Cardiovascular fUnction Researcher, University of Manchester Dr Shireen Meher 15:15 CaPE update Consultant, Maternal Fetal Medicine, Birmingham Women’s and Children’s NHS Foundation Trust 15:25 Break Regional analgesia in women who were prescribed 150mg aspirin for Mr Umber Agarwal 15:30 prevention of pre-eclampsia, following Consultant in Obstetrics and Maternal-Fetal ASPRE trial and new NICE HT in Medicine Liverpool Women’s Hospital pregnancy guideline 15:40 A personal story of pre-eclampsia Khilna Shah Catch up/Q and A 15:50 16.00 Sponsor Presentation by Thermo Fisher 16:05 Pregnancy Decision Aids Rebecca Whybrow Academic Midwife, Kings College London Bereavement Support after pre- Prof Alex Heazell 16:15 eclampsia - what are we doing to address this? Professor of Obstetrics, University of Manchester 16:30 Break Prof Andrew Shennan OBE 16:35 APECI /APEC INTERNATIONAL Professor of Obstetrics, Kings College London ‘Obstetric Medicine’ - the first book in Dr Charlotte Frise 16:45 the Oxford Specialist Handbook of Consultant Obstetric Physician Obstetrics and Gynaecology series John Radcliffe Hospital, Oxford PlGF-based testing Guy Checketts 16:50 Head of Transformation and Evaluation Adoption Success and Future Plans Oxford Academic Health Science Network 16:55 Final thoughts and summary Marcus Green, CEO APEC 17:00 Meeting ends .

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Saving Lives, Improving Mothers' Care
Maternal, Newborn and Infant Clinical Outcome Review Programme Saving Lives, Improving Mothers’ Care Surveillance of maternal deaths in the UK 2011-13 and lessons learned to inform maternity care from the UK and Ireland Confidential Enquiries into Maternal Deaths and Morbidity 2009-13 December 2015 Maternal, Newborn and Infant Clinical Outcome Review Programme Saving Lives, Improving Mothers’ Care Surveillance of maternal deaths in the UK 2011-13 and lessons learned to inform maternity care from the UK and Ireland Confidential Enquiries into Maternal Deaths and Morbidity 2009-13 Marian Knight, Derek Tuffnell, Sara Kenyon, Judy Shakespeare, Ron Gray, Jennifer J Kurinczuk (Eds.) December 2015 National Perinatal Epidemiology Unit Nuffield Department of Population Health University of Oxford Old Road Campus Headington, Oxford OX3 7LF Funding: The Maternal, Newborn and Infant Clinical Outcome Review programme, delivered by MBRRACE-UK, is commissioned by the Healthcare Quality Improvement Partnership (HQIP) on behalf of NHS England, NHS Wales, the Health and Social care division of the Scottish government, the Northern Ireland Department of Health, Social Services and Public Safety (DHSSPS), the States of Jersey, Guernsey, and the Isle of Man. Design by: Sarah Chamberlain and Andy Kirk Cover artist: Tana West Printed by: Oxuniprint This report should be cited as: Knight M, Tuffnell D, Kenyon S, Shakespeare J, Gray R, Kurinczuk JJ (Eds.) on behalf of MBRRACE-UK. Saving Lives, Improving Mothers’ Care - Surveillance of maternal deaths in the UK 2011-13 and lessons learned to inform maternity care from the UK and Ireland Confidential Enquiries into Maternal Deaths and Morbidity 2009-13. Oxford: National Perinatal Epidemiology Unit, University of Oxford 2015.
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Impact of SARS-Cov-2 Variant on the Severity of Maternal Infection and Perinatal Outcomes: Data from the UK Obstetric Surveillan
medRxiv preprint doi: https://doi.org/10.1101/2021.07.22.21261000; this version posted July 25, 2021. The copyright holder for this preprint (which was not certified by peer review) is the author/funder, who has granted medRxiv a license to display the preprint in perpetuity. It is made available under a CC-BY 4.0 International license . Impact of SARS-CoV-2 variant on the severity of maternal infection and perinatal outcomes: Data from the UK Obstetric Surveillance System national cohort. Nicola Vousden PhD1, Rema Ramakrishnan PhD1, Kathryn Bunch MA1, Edward Morris MD2, Nigel Simpson MBBS3, Christopher Gale PhD4, Patrick O’Brien MBBCh,2,5, Maria Quigley MSc1, Peter Brocklehurst MSc6, Jennifer J Kurinczuk MD1, Marian Knight DPhil1 1National Perinatal Epidemiology Unit, Nuffield Department of Population Health, University of Oxford, UK 2Royal College of Obstetricians and Gynaecologists, London, UK 3Department of Women's and Children's Health, School of Medicine, University of Leeds, UK 4Neonatal Medicine, School of Public Health, Faculty of Medicine, Imperial College London, London, UK 5Institute for Women’s Health, University College London, London, UK 6Birmingham Clinical Trials Unit, Institute of Applied Health Research, University of Birmingham, UK *Corresponding author: Marian Knight National Perinatal Epidemiology Unit, Nuffield Department of Population Health, University of Oxford, UK 01865 289700 [email protected] NOTE: This preprint reports new research that has not been certified by peer review and should not be used to guide clinical practice. 1 medRxiv preprint doi: https://doi.org/10.1101/2021.07.22.21261000; this version posted July 25, 2021.
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The Incidence, Characteristics and Outcomes of Pregnant Women Hospitalized with Symptomatic And
medRxiv preprint doi: https://doi.org/10.1101/2021.01.04.21249195; this version posted January 5, 2021. The copyright holder for this preprint (which was not certified by peer review) is the author/funder, who has granted medRxiv a license to display the preprint in perpetuity. It is made available under a CC-BY 4.0 International license . 1 The incidence, characteristics and outcomes of pregnant women hospitalized with symptomatic and 2 asymptomatic SARS-CoV-2 infection in the UK from March to September 2020: a national cohort 3 study using the UK Obstetric Surveillance System (UKOSS) 4 5 Covid-19 in pregnancy 6 7 Nicola Vousden1,2 PhD, Kathryn Bunch MA1, Edward Morris MD3, Nigel Simpson MBChB4, Christopher 8 Gale PhD5, Patrick O’Brien MBBCh6, Maria Quigley MSc1, Peter Brocklehurst MSc7 9 Jennifer J Kurinczuk MD1, Marian Knight DPhil1 10 11 1National Perinatal Epidemiology Unit, Nuffield Department of Population Health, University of 12 Oxford, UK 13 2School of Population Health & Environmental Sciences, King’s College London, UK 14 3Royal College of Obstetricians and Gynaecologists, London, UK 15 4Department of Women's and Children's Health, School of Medicine, University of Leeds, UK 16 5Neonatal Medicine, School of Public Health, Faculty of Medicine, Imperial College London, London, 17 UK 18 6Institute for Women’s Health, University College London, London, UK 19 7Birmingham Clinical Trials Unit, Institute of Applied Health Research, University of Birmingham, UK 20 21 Corresponding author: 22 Marian Knight, National Perinatal Epidemiology Unit, Nuffield Department of Population Health, 23 University of Oxford, Old Rd Campus, Oxford, OX3 7LF, UK 24 Tel: 01865 289727 Email: [email protected] 25 26 Non-standard abbreviations: 27 Royal College of Obstetricians and Gynaecologists - RCOG 28 NOTE: This preprint reports new research that has not been certified by peer review and should not be used to guide clinical practice.
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Randomised Evaluation of Covid-19 Therapy (Recovery)
RANDOMISED EVALUATION OF COVID-19 THERAPY (RECOVERY) for pregnant and breastfeeding women Pregnancy lead: Prof Marian Knight With support of UK Teratology Information Service (Dr Ken Hodson, Medical Director) RECOVERY trial protocol Adaption for pregnancy Eligibility Patients are eligible if all of the following are true: Same eligibility i. Hospitalised ii. SARS-CoV-2 infection (clinically suspected or lab confirmed) iii. No medical history that might, in the opinion of the attending clinician, put the patient at significant risk if they were to participate in the trial Interventions First randomisation part A Interventions for pregnant women Dimethyl fumarate (in some sites) No interventions currently available First randomisation part D Baricitinib Not recommended in pregnancy First randomisation part F Dimethyl fumarate Empagliflozin Baricitinib Empagliflozin Follow-up/ Ascertained at the time of death or discharge or at 28 Same follow-up and outcomes, with outcomes days after randomisation (whichever is sooner): addition of UKOSS COVID-19 case Vital status (alive/ dead, with date and presumed number (for pregnancy and baby cause of death, if appropriate) information) to allow later data linkage Hospitalisation status (inpatient/ discharged, with date of discharge, if appropriate) Use of ventilation (none/ previous/ ongoing, with days of use and type, if appropriate) Use of renal dialysis or haemofiltration (none/ previous/ ongoing) Adaptions for breastfeeding The same interventions as in pregnancy should be used. UKOSS COVID-19 case number added if available. Frequently asked questions 1. Are the drugs safe in pregnancy? The pregnancy leads for the trial have reviewed the safety literature (Annex A), and experience around using these drugs for other conditions, and consider that participation in the trial is reasonable for pregnant and breastfeeding women.
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Include Pregnant Women in Research—Particularly Covid-19
EDITORIALS BMJ: first published as 10.1136/bmj.m3305 on 25 August 2020. Downloaded from 1 National Perinatal Epidemiology Unit, Include pregnant women in research—particularly covid-19 research Nuffield Department of Population Health, University of Oxford, Oxford, Adapting interventions and changing attitudes will drive scientific progress UK Marian Knight, 1 R Katie Morris, 2 Jenny Furniss, 3 Lucy C Chappell4 2 Institute of Applied Health Research, University of Birmingham, The UK Confidential Enquiries into Maternal Deaths or breastfeeding allows safety concerns to be allayed Birmingham, UK have repeatedly highlighted inequities in the medical for women, their families, and healthcare 3 UK Obstetric Surveillance System treatment of pregnant and postpartum women, noting professionals. Steering Committee, National that women are denied investigations and life Even if regulatory barriers have been overcome, Perinatal Epidemiology Unit, Oxford, preserving treatments simply because they are UK gatekeeping or inertia may occur if local ethics pregnant or breastfeeding.1 2 These inquiries committees take an overwhelming precautionary 4 School of Life Course Sciences, King’s emphasise that the default position should be to approach, overriding recognition of the potential College London, London, London, UK investigate and treat pregnant and breastfeeding benefits of including pregnant and breastfeeding Correspondence to: L C Chappell women in the same way as non-pregnant women, women. This problem can be mitigated by a strong [email protected] unless there are clear reasons not to.1 Cite this as: BMJ 2020;370:m3305 network of maternity researchers, familiar with http://dx.doi.org/10.1136/bmj.m3305 Clinical trials, particularly those of drug treatments, delivering drug trials in pregnancy, who can be Published: 25 August 2020 have typically automatically excluded pregnant or rapidly mobilised to help implement studies.
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Saving Lives, Improving Mothers' Care 2014
Maternal, Newborn and Infant Clinical Outcome Review Programme Saving Lives, Improving Mothers’ Care Lessons learned to inform future maternity care from the UK and Ireland Confidential Enquiries into Maternal Deaths and Morbidity 2009-2012 December 2014 Maternal, Newborn and Infant Clinical Outcome Review Programme Saving Lives, Improving Mothers’ Care Lessons learned to inform future maternity care from the UK and Ireland Confidential Enquiries into Maternal Deaths and Morbidity 2009-2012 Marian Knight, Sara Kenyon, Peter Brocklehurst, Jim Neilson, Judy Shakespeare, Jennifer J Kurinczuk (Eds.) December 2014 National Perinatal Epidemiology Unit Nuffield Department of Population Health University of Oxford Old Road Campus Headington, Oxford OX3 7LF Design by: Sarah Chamberlain and Andy Kirk Cover artist: Tana West Printed by: Oxuniprint This report should be cited as: Knight M, Kenyon S, Brocklehurst P, Neilson J, Shakespeare J, Kurinczuk JJ (Eds.) on behalf of MBRRACE- UK. Saving Lives, Improving Mothers’ Care - Lessons learned to inform future maternity care from the UK and Ireland Confidential Enquiries into Maternal Deaths and Morbidity 2009–12. Oxford: National Perinatal Epidemiology Unit, University of Oxford 2014. ISBN 978-0-9931267-1-0 Individual chapters from this report should be cited using the format of the following example for chapter 4: Paterson-Brown S, Bamber J on behalf of the MBRRACE-UK haemorrhage chapter writing group. Prevention and treatment of haemorrhage. In Knight M, Kenyon S, Brocklehurst P, Neilson J, Shakespeare J, Kurinczuk JJ (Eds.) on behalf of MBRRACE-UK. Saving Lives, Improving Mothers’ Care - Lessons learned to inform future maternity care from the UK and Ireland Confidential Enquiries into Maternal Deaths and Morbidity 2009–12.
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Bmj.M2107.Full.Pdf
RESEARCH Characteristics and outcomes of pregnant women admitted to BMJ: first published as 10.1136/bmj.m2107 on 8 June 2020. Downloaded from hospital with confirmed SARS-CoV-2 infection in UK: national population based cohort study Marian Knight,1 Kathryn Bunch,1 Nicola Vousden,2 Edward Morris,3 Nigel Simpson,4 Chris Gale,5 Patrick O’Brien,6 Maria Quigley,1 Peter Brocklehurst,7 Jennifer J Kurinczuk,1 On behalf of the UK Obstetric Surveillance System SARS-CoV-2 Infection in Pregnancy Collaborative Group For numbered affiliations see ABSTRACT over, and 145 (34%) had pre-existing comorbidities. end of the article. OBJECTIVES 266 (62%) women gave birth or had a pregnancy loss; Correspondence to: M Knight To describe a national cohort of pregnant women 196 (73%) gave birth at term. Forty one (10%) women [email protected] (or @Marianfknight and @NPEU_ admitted to hospital with severe acute respiratory admitted to hospital needed respiratory support, and UKOSS on Twitter: syndrome coronavirus 2 (SARS-CoV-2) infection in five (1%) women died. Twelve (5%) of 265 infants ORCID 0000-0002-1984-4575) the UK, identify factors associated with infection, tested positive for SARS-CoV-2 RNA, six of them within Additional material is published and describe outcomes, including transmission of the first 12 hours after birth. online only. To view please visit the journal online. infection, for mothers and infants. CONCLUSIONS C ite this as: BMJ2020;369:m2107 DESIGN Most pregnant women admitted to hospital with http://dx.doi.org/10.1136 bmj.m2107 Prospective national population based cohort study SARS-CoV-2 infection were in the late second or third Accepted: 27 May 2020 using the UK Obstetric Surveillance System (UKOSS).
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Confidential Maternal Death Enquiry in Ireland Report for 2009
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Study Protocol EXPRESS
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Saving Lives, Improving Mothers' Care
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1 the UK's Pandemic Influenza Research
The UK’s pandemic influenza research portfolio: a model for future research on emerging infections Professor Colin R Simpson PhD a b, *, Mr Dan Beever MPH c, Dr Kirsty Challen PhD d, Dr Daniela De Angelis PhD e, Ms Ellen Fragaszy MSc f g, Professor Steve Goodacre PhD h, Professor Andrew Hayward MD f i, Professor Wei Shen Lim DM j, Dr G James Rubin PhD k, Professor Malcolm G Semple PhD l, Professor Marian Knight DPhil m, on behalf of the NIHR hibernated influenza studies collaborative group a Usher Institute, The University of Edinburgh, Edinburgh, UK. b Faculty of Health, Victoria University of Wellington, Wellington, New Zealand. c. Clinical Trials Research Unit, School of Health and Related Research (ScHARR), University of Sheffield, Sheffield, UK d. Lancashire Teaching Hospitals NHS Trust and Honorary Senior Lecturer, Centre for Urgent and Emergency Care Research, University of Sheffield, UK e MRC Biostatistics Unit, University of Cambridge f Centre for Public Health Data Science, Institute of Health Informatics, University College London, London, UK g Department of Infectious Disease Epidemiology, London School of Hygiene and Tropical Medicine, London, UK h Centre for Urgent and Emergency Care Research, School of Health and Related Research (ScHARR), University of Sheffield i Institute of Epidemiology and Health Care, University College London, London, UK j Nottingham University Hospitals NHS Trust, Nottingham, UK k Department of Psychological Medicine, Weston Education Centre, King’s College London, London, UK l Institute of Translational Medicine, University of Liverpool, UK m National Perinatal Epidemiology Unit, University of Oxford, Oxford, UK * Corresponding author NIHR hibernated influenza studies collaborative group: Marian Knight, Colin R Simpson, Dan Beever, Kirsty Challen, Daniela De Angelis, Ellen Fragaszy, Steve Goodacre, Andrew Hayward, Wei Shen Lim, Garry Meakin, G James Rubin, Malcolm G Semple, Helen Walters.
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RESEARCH BMJ: First Published As 10.1136/Bmj.B542 on 3 March 2009
RESEARCH BMJ: first published as 10.1136/bmj.b542 on 3 March 2009. Downloaded from Inequalities in maternal health: national cohort study of ethnic variation in severe maternal morbidities Marian Knight, UKOSS clinical coordinator/honorary consultant in public health Jennifer J Kurinczuk, reader in perinatal epidemiology Patsy Spark, programmer Peter Brocklehurst, professor of perinatal epidemiology on behalf of UKOSS National Perinatal Epidemiology ABSTRACT maternity services and improved access to care for women Unit, University of Oxford, Oxford Objective To describe on a national basis ethnic from ethnic minorities. National information on the Correspondence to: M Knight ethnicity of women giving birth in the UK is needed to [email protected] differences in severe maternal morbidity in the United Kingdom. enable ongoing accurate study of these inequalities. Cite this as: BMJ 2009;338:b542 Design National cohort study using the UK Obstetric doi:10.1136/bmj.b542 Surveillance System (UKOSS). INTRODUCTION Setting All hospitals with consultant led maternity units in Recent reports from the UK Confidential Enquiry into the UK. Maternal and Child Health have highlighted inequal- Participants 686 women with severe maternal morbidity ities in rates of maternal death among different ethnic between February 2005 and February 2006. minority groups.1 A greater than fivefold difference in Main outcome measures Rates, risk ratios, and odds rates exists between the group with the lowest rate of ratios of severe maternal morbidity in different ethnic death (white) and that with the highest (black African). http://www.bmj.com/ groups. Similar differences in maternal death rates in ethnic Results 686 cases of severe maternal morbidity were minority groups have been observed in other countries 2-4 reported in an estimated 775 186 maternities, with well developed healthcare systems, and sub- representing an estimated incidence of 89 (95% standard care has been found to contribute to the 5 confidence interval 82 to 95) cases per 100 000 differences.
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