Grant: Project Grant

In the era of patient-centered care, clinicians wish to identify an individual at substantially higher risk of having an adverse outcome, to enable her to receive an efficacious preventive intervention or a tailored form of surveillance that results in an improved outcome. Few methods exist to predict which pregnant women will develop preeclampsia (PE), especially early onset PE, as well as maternal admission to ICU, stillbirth, and heart disease and stroke long term. We have studied novel and conventional risk factors for these serious, often inter-related, conditions, yet, a clear limitation of our and other's prior work was lack of application of well developed & validated "clinical prediction models" (CPM) for these conditions, especially in Canada. Our current objectives are to develop/validate/disseminate four broadly applicable CPMs: 1) For PE & preterm PE. 2) For stillbirth. 3) For maternal ICU admission in pregnancy or soon after delivery. 4) For long-term premature onset of heart disease and stroke among women who had PE. Over 4 years, we will refine and expand our existing Ontario-wide population-based cohorts, to include maternal measures like body mass index, ethnicity and commonly performed blood tests before & in early pregnancy. We will develop and validate each CPM, including how it performs within Alberta. We will also implement each validated CPM with our provincial and national partners, who are positioned to advise us on CPM development and its dissemination.