Swedish Medical Center researcher receives NIH grants to study pregnancy complications

Michelle A. Williams, Sc.D., co-director and principal investigator at the Center for Perinatal Studies at Swedish Medical Center in Seattle and Professor of Epidemiology and Global Health at the University of Washington, has received two grants totaling $5.6 million for research into complications affecting pregnancy. Funding source is the National Institutes of Health, Eunice Kennedy Shriver National Institute of Child Health and Human Development.

"Dr. Williams worked very hard to get support for these projects and everyone at Swedish is delighted to see their importance recognized," said Jennifer Hansberry, Swedish's administrative director of Research.

Grant 1 is 'Triggers of Abruptio Placentae - A Case Crossover Study of an Ischemic Placental Disorder.' It was awarded to Swedish, in collaboration with University of Washington and Proyectos Salud & Consultores E.I.R.L. - Lima, Peru; and with UMDNJ-Robert Wood Johnson Medical School, Piscataway, NJ. Dr. Williams, Dr. Cande V. Ananth at UMDNJ-RWJMS, and Dr. Sixto E. Sanchez are lead investigators of this research project.

Abruptio placentae, which is premature separation of the placenta, is a life threatening obstetric condition that complicates roughly 1 percent to 2 percent of all pregnancies. "Though rare, abruptio placentae is of global public health importance in large part because of its association with adverse outcomes in newborns and mothers including preterm delivery, fetal death, maternal hemorrhagic shock, and renal failure," said Dr. Williams. "Using a fairly novel research design and by integrating high-throughput genomic methods into our study, we will have a very high potential for generating etiologic and clinical information that may prove to be effective in the identification of women at greatest need of specific preventive interventions and specialized clinical care. For instance, we will be able to look at risk factors that operate acutely and over time in promoting premature placental detachments."

Patient recruitment and data collection will be performed at six hospitals in Lima. The interdisciplinary/international team of investigators will work on genomic testing and statistical analysis of collected data in Seattle at Swedish's Center for Perinatal Studies, the hub of the research program, in Lima, and at the Bionomics Research and Training Center of UMDNJ-RWJMS. Funding of $2.8 million is for five years, from September 2010 to August 2015.

Dr. Williams is also principal investigator on Grant 2, 'A Cohort Study of Preterm Delivery in Relation to Partner Abuse, Mood and Anxiety Disorder.' This grant was awarded to the University of Washington in collaborations with Swedish and with Dr. Sixto E. Sanchez of Proyectos Salud & Consultores E.I.R.L in Lima, Peru. Patient recruitment and data collection will also be performed in Lima; data analysis and lab testing will be performed in Lima and Seattle at Swedish. Funding of $2.8 million is for five years, from September 2010 to August 2015.

"Among public health officials and the clinical community, violence against women has not always been considered an important variable or component of health. Now we're beginning to see exactly what role intimate partner violence, or IPV, plays," explained Dr. Williams. "As obstetricians and the medical community in general have begun to recognize the inter-relationship of mental health and physical health, there has been a greater need to document the full scope of IPV's adverse impacts."

Dr. Williams has worked in Peru for 14 years on preeclampsia (hypertension in late pregnancy). In these new grants, she and her research team will continue to look for a concordance of results across two very different populations - geographically, socio-economically, ethnically and racially. Ideally, they will be able to report findings from Seattle and Lima that reinforce each other.

"When you accumulate data across time, research methods and different populations, you can be very confident that signals are real, relevant and reproducible," said Dr. Williams. "We have excellent clinical collaborators in Peru and they are very complementary to their Seattle counterparts."

For the past 20 years, Dr. Williams' research has focused on integrating genomic sciences and epidemiological research methods to identify risk factors, diagnostic markers, treatments, and prevention targets for disorders that contribute to maternal and infant mortality. Always interested in engaging young scholars in research, Dr. Williams, her collaborators, and her cadre of pre- and post-doctoral fellows actively study cohorts of pregnant women as they work to understand the determinants of preterm delivery, preeclampsia, gestational diabetes, and placental abruption.

In her lab at the Center for Perinatal Studies - a multidisciplinary research program involving clinical scholars, basic scientists and epidemiologists - among other things Dr. Williams works with scientists to identify unique gene expression patterns that may be used to predict which pregnant women will go on to develop preeclampsia and/or deliver prematurely. She has authored or co-authored more than 225 original research papers.

Dr. Williams estimates the two research projects will take about half of her time over the next five years, but she is unfazed: "This is my life's work and the work my colleagues live to do."

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