PhD Study : Health impacts of optimising folate and related B vitamins in pregnancy and early life

This project is funded by:

DSM Nutritional Products

Summary

Hypertension affects an estimated 15% of pregnancies (National Health Service, 2015) and can lead to more serious hypertensive disorders of pregnancy, including pre-eclampsia and fetal growth restriction (Srinivas et al., 2009). Hypertensive disorders during pregnancy carry risks for both the pregnant woman and the fetus. Currently, hypertension in pregnancy is treated with blood pressure medication, which not only is very costly for health systems, but is also associated with adverse side effects in pregnancy that can be detrimental to the fetus (Rosenthal and Oparil, 2002). Thus, the identification of alternative treatments and prevention strategies for hypertension would be hugely advantageous to maternal and fetal health.

Low maternal folate status has been associated with an increased risk of adverse pregnancy outcomes including gestational hypertension, while some randomised controlled trials (RCTs) have shown that improved folate status may help to prevent these conditions (Kim et al., 2014). Inconsistencies in the evidence could partly be explained by genetic differences among populations. Emerging evidence from this centre and elsewhere have associated homozygosity for the common C677T polymorphism, the TT genotype, in the gene encoding the folate-metabolising enzyme methylenetetrahydrofolate reductase (MTHFR) with hypertension in non-pregnant adults (Newton-Cheh et al., 2009; Horigan et al., 2010; Wilson et al., 2012; Wilson et al., 2013). According to unpublished research from our group, women with the TT genotype in combination with a low riboflavin biomarker status will enter pregnancy with a higher blood pressure compared to CC women and are at an increased risk of developing hypertension (O’Sullivan et al.; under review).

This MRes project builds on this evidence with an overall aim will be to investigate the role of folate and related B vitamins on blood pressure during pregnancy in relation to the MTHFR 677TT genotype and will involve conducting an RCT in a cohort of pregnant women to optimise B vitamin status with the potential to influence blood pressure, and in turn, prevent hypertension in women with the TT genotype. The project will form part of the ongoing OptiPREG study (Optimal nutrition for prevention of hypertension using a personalised approach).

Methods

Women with a singleton pregnancy who are at the start of the second trimester of pregnancy will be recruited from antenatal clinics in Letterkenny General Hospital and will be screened for MTHFR genotype.

Those with the TT genotype and age-matched CT pregnant women will be assigned to a double-blinded, RCT with B vitamin supplementation until the end of their pregnancy.

Phlebotomy training will be provided and the student will gain experience in running a human trial, recording, storing and analysing results using appropriate statistical methods and in the use of a range of relevant laboratory measures (related to B vitamin status).

The student will be required to work closely with the wider OptiPREG team and own or have access to a vehicle.

See Niche for more information

Additional Criteria

Must own or have access to a vehicle and hold a current clean driver’s licence.

Essential criteria

Applicants should hold, or expect to obtain, a First or Upper Second Class Honours Degree in a subject relevant to the proposed area of study.

We may also consider applications from those who hold equivalent qualifications, for example, a Lower Second Class Honours Degree plus a Master’s Degree with Distinction.

In exceptional circumstances, the University may consider a portfolio of evidence from applicants who have appropriate professional experience which is equivalent to the learning outcomes of an Honours degree in lieu of academic qualifications.