• Research

Understanding miscarriage-related pathologies

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The In Utero Care project, supported by the Bordeaux University Foundation and led by scientists from the University of Bordeaux and Bordeaux University Hospital, aims to identify factors associated with pregnancy-related pathologies with a particular focus on placental vascular abnormalities.

Photo : The In Utero Care project aims to provide better support for patients © Photographee.eu
The In Utero Care project aims to provide better support for patients © Photographee.eu

Pregnancy-related pathologies (particularly placental vascular pathologies such as intrauterine growth retardation (IUGR), pre-eclampsia and fetal death in utero (FDI), also known as intrauterine death (IUD)) are becoming increasingly common both in France and throughout the world. They are the leading cause of maternal and especially neonatal morbidity and mortality and are therefore a major public health concern. In France, 6 pregnancies in 1,000 are affected by fetal death in utero and 10.8% of children from single pregnancies are underweight for their gestational age.

The incidence of these two pathologies is becoming more and more frequent. Sadly, not only is FDI a frequent occurrence, even at term, and a major family tragedy with prolonged psychological effects, but children born with IUGR, even at term, are at a greater risk of lifelong neurodevelopmental disorders (compared with those born at a healthy weight for their gestational age), as well as metabolic disorders, obesity, diabetes, high blood pressure, and stroke, with possible transgenerational effects.

IUGR and FDI have many, often interrelated causes, including congenital and placental abnormalities, congenital infections (CMV), vascular, immunologic and environmental/toxic causes. However, 30-50% of cases of FDI/IUGR remain unexplained, making it extremely difficult to develop prevention strategies and justifying further research in this area.

The In Utero Care project

The university hospital teams (Gynecology-Obstetrics, Internal Medicine and Immunology) of Bordeaux University Hospital and the University of Bordeaux are all working hard on this project. The teams are led by scientists Estibaliz Lazaro, professor at the University of Bordeaux and hospital practitioner at the Haut-Lévêque Hospital, Patrick Blanco, professor at the University of Bordeaux, both working at the Immunology from Concept and Experiments to Translation Laboratory (Immunoconcept - CNRS and University of Bordeaux), as well as Loïc Sentilhes, university professor and obstetrician-gynecologist at Bordeaux University Hospital. The project will also rely on collaborations with the CIANE user organisation.

 

 

By studying three main areas that combine inflammatory, environmental and genetic aspects, the project aims to identify the factors associated with FDI and IUGR and to better understand the mechanisms involved in pregnancy-related pathologies in order to improve preventive measures for patients

The teams are working together to create a comprehensive university hospital structure for pregnant women.

This project has just been accepted and is currently seeking funding. For any questions, please contact the Bordeaux University Foundation.

Missions of the project

The project aims to identify the factors associated with FDI and IUGR by studying the different factors that could be involved, such as endogenous factors (inflammation, thrombophilia, autoimmunity, alloimmunisation and genetics) or exogenous factors (including environmental influences). This research is divided into three main areas:

  • Inflammation: It is likely that there are a number of immunologic and inflammatory mechanisms responsible for IUGR/FDI, yet they remain poorly identified. In some cases, analysing the placenta can provide valuable information about placental malperfusion or inflammatory abnormalities that have developed around the placenta.
  • Environment: The ARTEMIS platform is dedicated to environmental health aspects during pregnancy and benefits from extensive expertise in the widely recognised field of ultrafine particles.
  • Genetics: While autopsy analysis cannot explain the occurrence of FDI in many cases, it is possible that genetic abnormalities are involved in some cases.