TY - JOUR
T1 - Advancing human health in the decade ahead
T2 - pregnancy as a key window for discovery: A Burroughs Wellcome Fund Pregnancy Think Tank
AU - Burroughs Wellcome Fund Pregnancy Think Tank Working Group
AU - Sadovsky, Yoel
AU - Mesiano, Sam
AU - Burton, Graham J.
AU - Lampl, Michelle
AU - Murray, Jeffrey C.
AU - Freathy, Rachel M.
AU - Mahadevan-Jansen, Anita
AU - Moffett, Ashley
AU - Price, Nathan D.
AU - Wise, Paul H.
AU - Wildman, Derek E.
AU - Snyderman, Ralph
AU - Paneth, Nigel
AU - Capra, John Anthony
AU - Nobrega, Marcelo A.
AU - Barak, Yaacov
AU - Muglia, Louis J.
N1 - Funding Information:
Support for convening this meeting was provided by the Burroughs Wellcome Fund. R.M.F. is funded by a Wellcome Trust and Royal Society Sir Henry Dale Fellowship (104150/Z/14/Z). J.A.C. was supported by the National Institutes of Health (grant R35GM127087 ), the Burroughs Wellcome Fund Preterm Birth Initiative, and the March of Dimes through the Prematurity Research Center Ohio Collaborative.
Publisher Copyright:
© 2020 The Author(s)
PY - 2020/9
Y1 - 2020/9
N2 - Recent revolutionary advances at the intersection of medicine, omics, data sciences, computing, epidemiology, and related technologies inspire us to ponder their impact on health. Their potential impact is particularly germane to the biology of pregnancy and perinatal medicine, where limited improvement in health outcomes for women and children has remained a global challenge. We assembled a group of experts to establish a Pregnancy Think Tank to discuss a broad spectrum of major gestational disorders and adverse pregnancy outcomes that affect maternal-infant lifelong health and should serve as targets for leveraging the many recent advances. This report reflects avenues for future effects that hold great potential in 3 major areas: developmental genomics, including the application of methodologies designed to bridge genotypes, physiology, and diseases, addressing vexing questions in early human development; gestational physiology, from immune tolerance to growth and the timing of parturition; and personalized and population medicine, focusing on amalgamating health record data and deep phenotypes to create broad knowledge that can be integrated into healthcare systems and drive discovery to address pregnancy-related disease and promote general health. We propose a series of questions reflecting development, systems biology, diseases, clinical approaches and tools, and population health, and a call for scientific action. Clearly, transdisciplinary science must advance and accelerate to address adverse pregnancy outcomes. Disciplines not traditionally involved in the reproductive sciences, such as computer science, engineering, mathematics, and pharmacology, should be engaged at the study design phase to optimize the information gathered and to identify and further evaluate potentially actionable therapeutic targets. Information sources should include noninvasive personalized sensors and monitors, alongside instructive “liquid biopsies” for noninvasive pregnancy assessment. Future research should also address the diversity of human cohorts in terms of geography, racial and ethnic distributions, and social and health disparities. Modern technologies, for both data-gathering and data-analyzing, make this possible at a scale that was previously unachievable. Finally, the psychosocial and economic environment in which pregnancy takes place must be considered to promote the health and wellness of communities worldwide.
AB - Recent revolutionary advances at the intersection of medicine, omics, data sciences, computing, epidemiology, and related technologies inspire us to ponder their impact on health. Their potential impact is particularly germane to the biology of pregnancy and perinatal medicine, where limited improvement in health outcomes for women and children has remained a global challenge. We assembled a group of experts to establish a Pregnancy Think Tank to discuss a broad spectrum of major gestational disorders and adverse pregnancy outcomes that affect maternal-infant lifelong health and should serve as targets for leveraging the many recent advances. This report reflects avenues for future effects that hold great potential in 3 major areas: developmental genomics, including the application of methodologies designed to bridge genotypes, physiology, and diseases, addressing vexing questions in early human development; gestational physiology, from immune tolerance to growth and the timing of parturition; and personalized and population medicine, focusing on amalgamating health record data and deep phenotypes to create broad knowledge that can be integrated into healthcare systems and drive discovery to address pregnancy-related disease and promote general health. We propose a series of questions reflecting development, systems biology, diseases, clinical approaches and tools, and population health, and a call for scientific action. Clearly, transdisciplinary science must advance and accelerate to address adverse pregnancy outcomes. Disciplines not traditionally involved in the reproductive sciences, such as computer science, engineering, mathematics, and pharmacology, should be engaged at the study design phase to optimize the information gathered and to identify and further evaluate potentially actionable therapeutic targets. Information sources should include noninvasive personalized sensors and monitors, alongside instructive “liquid biopsies” for noninvasive pregnancy assessment. Future research should also address the diversity of human cohorts in terms of geography, racial and ethnic distributions, and social and health disparities. Modern technologies, for both data-gathering and data-analyzing, make this possible at a scale that was previously unachievable. Finally, the psychosocial and economic environment in which pregnancy takes place must be considered to promote the health and wellness of communities worldwide.
KW - adverse outcomes
KW - artificial intelligence
KW - birthweight
KW - computational biology
KW - developmental origins of adult disease
KW - disparities
KW - drug discovery
KW - evolutionary biology
KW - fetal growth
KW - fetal growth restriction
KW - genomics
KW - gestational diabetes mellitus
KW - immune tolerance
KW - maternal health
KW - metabolomics
KW - multiomics
KW - parturition
KW - physiology
KW - population health
KW - precision medicine
KW - preeclampsia
KW - pregnancy
KW - preterm birth
KW - stillbirth
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U2 - 10.1016/j.ajog.2020.06.031
DO - 10.1016/j.ajog.2020.06.031
M3 - Article
C2 - 32565236
AN - SCOPUS:85088835905
VL - 223
SP - 312
EP - 321
JO - American Journal of Obstetrics and Gynecology
JF - American Journal of Obstetrics and Gynecology
SN - 0002-9378
IS - 3
ER -