Iron metabolism in pregnancy: a longitudinal study in India using the MaatHRI platform
Elizabeta Nemeth, UCLA, USA
Samira Lakhal-Littleton, Department of Physiology, Anatomy and Genetics, Oxford.
Iron demand increases dramatically during pregnancy, engendering key adaptations in maternal iron metabolism. These adaptations have intrigued scientists across many decades, and even more so recently, due to major advances in understanding the molecular basis of iron regulation, availability of new biochemical markers and improved assay methods. However, this has also led to challenges in understanding how the biochemical parameters that measure different aspects of iron metabolism vary across the different time-periods in pregnancy and postpartum. In our ongoing work in India undertaken through the MaatHRI platform [https://www.npeu.ox.ac.uk/maathri], we have collected a range of biochemical markers of iron metabolism. However, this is cross-sectional data and further work is needed with repeated measurements of the biomarkers across the duration of pregnancy and postpartum. This will facilitate the understanding of what constitutes a normal range for these parameters during pregnancy, and their inter-relationships. Recently, the WHO has also recognised the lack of evidence in what constitutes iron deficiency in pregnancy mainly due to a lack of validated physiological ranges for the new markers and the variability in assay methods used in population studies (http://apps.who.int/iris/bitstream/10665/75368/1/9789241596107_eng.pdf). Therefore, the research objectives of this project are:
- To longitudinally assess how maternal iron stores change across normal pregnancy and postpartum in a population in India.
- To longitudinally assess how iron availability for maternal erythropoiesis and feto-placental unit change across normal pregnancy and postpartum.
- To longitudinally assess how maternal iron absorption is regulated across normal pregnancy and postpartum.
- To longitudinally assess how maternal erythropoietic activity changes across normal pregnancy and postpartum.
- To examine if and how the changes in iron metabolism are related to maternal and fetal outcomes.
RESEARCH EXPERIENCE, RESEARCH METHODS AND TRAINING
The student will be able to develop skills in quantitative research methods:
- designing a longitudinal epidemiological study
- analysing data with repeated measures over time
- systematic review and meta-analysis.
Depending on their prior experience, the student will undertake the following skills training for the project:
- conducting systematic review and meta-analysis
- advance epidemiology and statistical methods.
The student will be able to gain research experience in:
- primary data collection
- undertaking research in a low-and-middle income country setting (India)
- physiology of iron metabolism in pregnancy.
FIELD WORK, SECONDMENTS, INDUSTRY PLACEMENTS AND TRAINING
As part of this project, the student will designing and conducting a cohort study, liaising with the team in India for fieldwork (and perhaps going to India), regularly monitoring the data on the MaatHRI web portal, conducting all analyses, writing publications and presenting the work at international conferences. The MaatHRI project team in India will collect the data and provide all other support required for undertaking field work for the longitudinal study.
This project will be most suitable for a student who has interest in the physiology of iron metabolism. Basic knowledge of epidemiology and statistics is required. The student should be interested in working in India and able to travel to India.