A Proposal for the Establishment of a New Research Centre in Women’s and Children’s Health
Coordinator: Prof Mark Kilby
The University of Birmingham is a pioneer of research into the causes and best treatments of health
problems for women, children and young people today. Many researchers across several Schools in the
College of Medical and Dental Sciences undertake groundbreaking work focused from “bench to the
bedside” across the breadth of obstetric, gynaecological, paediatric, public health and primary health
disciplines. Increasingly, there are collaborations across Colleges, e.g. with colleagues in Psychology
(involved in the long-term follow-up and psychometric testing of children) and in Biosciences
(metabolomics and gamete science). However, we have no outward facing badge for research of women’s
and children’s health in the University of Birmingham and Centre status would achieve this.
The primary vision of this Centre is:
1. To develop further understanding of the pathogenesis of disease affecting women, their
pregnancies and children.
2. To critically appraise present management strategies and to lead the development of novel
strategies for the care of women and children.
3. To promote University of Birmingham’s research excellence (with its NHS stakeholders) in the
theme of Women’s and Children’s Health to a local, national and international audience.
To these ends, the central aim of the centre is:
a) To be identified as a leading world centre of research excellence in women’s, pregnancy and
children’s research (defined by winning peer-reviewed national and international research funding
and publishing seminal papers of high impact.
b) To facilitate increased collaboration between successful researchers within the University of
Birmingham in these areas. This will lead to a demonstrable improvement in our ability to obtain
prestigious peer-reviewed funding in designated successful areas (ie,
programme grants).
c) To coordinate the training, mentorship and career development for both clinical and non-clinical
researchers within Women’s and Children’s Health.
d) To engage our local NHS stakeholders and the wider community in the Centre for Women’s and
Children’s Health research activities.
e) To align our research strategy within the Centre for Women’s and Children’s Health so that they
match those outlined in the recent NIHR clinical network re-organization of early 2013.
To date, researchers across Schools and clinical disciplines of obstetrics, gynaecology, genetics and
children’s health have little unifying identity. In addition, there are no formal regular meetings, seminars or
lectures that are truly multidisciplinary across the constituent parts making up the proposed centre.
The proposed centre will add opportunities to network with professionals from allied disciplines allowing
increased understanding, collaboration and a ‘cross fertilisation’ of ideas. A similar ethos of collaboration
and understanding would also facilitate educational themes. A multidisplinary faculty embedded in a
centre would offer increased opportunities for postgraduate taught course at master level and also
postgraduate course for CPD.
By its very nature, the Centre will include researchers and research activity that focuses on women’s and
children’s health across the life course (Figure 1). The portfolio of research undertaken under the
‘umbrella’ of Women’s and Children’s Health is diverse (see Appendix 1). Research undertaken basic
laboratory based work into gamete function and fetal development, through child health to maternal and
women’s health. There is an increasing realisation that prenatal fetal health (influenced by the mother’s
health as well as in-utero environment) has influence on neonatal, childhood and adolescent outcomes.
Such prenatal programming is influenced for the genome as well as epigenetic factors. Many diseases of
childhood can be congenital (arising during pregnancy) or present de-novo in the neonatal period,
childhood or adolescence. There are strong platforms of research in paediatric endocrinology, cancer
science and immunity. Women’s health research is focused on maternity and child birth, fertility and
women’s endocrinology and gynaecological morbidity.
The major grant giving bodies in the United Kingdom have recognized the importance of research in
women’s and children’s health in their mission statements.
 The MRC has targeted calls for women’s and children’s health, the most recent of which was focused
on global health research, and allowed the successful attainment of grant funding in an area of early
pregnancy loss in developing countries.
 The Wellcome Trust outlines areas of ‘research challenge’ as being in: i) the investigation of
development, aging and chronic disease and ii) health benefits of genetics and genomics.
 A National Institute of Health Research consultation document is being discussed nationally and
feedback is anticipated by the middle of February 2013. This presents a proposal for the designation of
clinical themes. One of the proposed themes is reproduction, child health and genetics. NIHR data
indicate that the number of open funded portfolio studies in reproductive health and childbirth,
paediatrics (medicines for children and non-medicines) and genetics have increased steadily since
2011. Indeed, the total numbers of open studies in these three areas now exceed those focused upon
cardiovascular health. In addition, the total non-commercial, commercial, multi-centre and single
centre studies in this area are second only to cancer sciences in the total number of studies registered
and being performed in the United Kingdom (Figure 2).
The proposed Centre for Women’s and Children’s Health would mirror the thematic approach outlined by
the NIHR in a consultative document.
Our Centre will:

Provide a consistent model of leadership which will be transferable locally, nationally and
internationally across all areas of women’s and children’s health.

It will promote and encourage “critical mass” of research activity within the University and across the
sub-themes of obstetrics, gynaecology, paediatrics, child health, genetics and public health.

The similar designation within NIHR will allow resources to be channelled into this specific area
enabling support and will also promote engagement with research funders for studies on portfolio
themes.

It will allow championing and promoting clinical research in women’s and children’s health and
engagement with both research communities and stakeholders within the National Health Service and
in industry. It will encourage engagement with patient groups at a local, national and international
level to ensure their support and involvement.
Researchers working in women’s and children’s health are in different Schools and Colleges across the
University of Birmingham. There is close collaboration with the Birmingham Clinical Trials Unit whose
infrastructure and experience is pivotal in the successful prosecution of the many clinical research studies
already undertaken in maternal and child health. All researchers interact with the NHS stakeholders of
United Hospitals of Birmingham, The Birmingham Children’s and Birmingham Women’s Foundation Trusts.
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In the current NIHR Birmingham and Black Country CLAHRC there is a substantial focus upon maternity and
children’s health themes. The submission of CLAHRC2 will build further upon this applied NHS research and
facilitate its implementation at a clinical level.
The portfolio of research studies truly span from laboratory-based research [mainly performed within the
Institute of Biomedical Research at the University of Birmingham] to bedside translational clinical trials
supported by our clinical trials infrastructure at the University of Birmingham. These researchers (clinical
and non-clinical) cover a broad portfolio of research in the area of Women’s and Children’s Health. These
data are detailed in Appendix 1 and the current active grant funding detailed in Appendix 2.
The figure below indicates that this diversity of research activity falls into laboratory-based/hypothesis
generating research, translational research, randomised trials and evidence synthesis. A centre status
would provide an overview of this research, channelling it into these three groupings (Figure 3).
At present we have some major strength that is based on expertise of people and local environment.
We have:
1. Broad and successful research bases from the “bench to the bedside”.
2. Strong cross-School and College research collaborations.
3. A successful portfolio of research across women’s and children’s health.
4. Collaboration and highly successful working between Schools, the successful trials units and the
local NHS stakeholders (principally by interaction with the research and development department,
CRLNs and CLAHRC).
5. Excellent high profile impacts both in terms of publications and media attention.
6. Good constructive support from our local research and development and clinical research local
networks.
We need to co-ordinate the research between the different areas to allow the prosecution of ambitious
research themes such as follow-up from fetal life through to the end of childhood.
We are competing with successful and established units such as the MRC Centre for Reproductive
Health/Tommy’s Campaign Centre in Edinburgh, the Institute for Women’s Health at University College
London, the Tommy’s Campaign Women’s Health Centre at Guy’s, King’s and St Thomas’ and the National
Perinatal Epidemiological Unit at Oxford. Much of our research portfolio is at least as successful as these
institutions. In addition, we have had an excellent high profile and visible impacts both in terms of research
and media success.
We have a large local population with a high prevalence of morbidities which makes us an ideal regional
portal for studies into pathogenesis and treatment. Birmingham has a diverse cultural community. This
allows, specific advantages (particularly within clinical genetics) when investigating rare diseases with high
prevalence within specific families.
Finally, we are building a reputation for global maternity health and have a number of successful studies
which are being pursued across Africa and the Indo-Pakistan sub-continent.
A Centre therefore would allow an executive consortium to improve strategic links with academic
institutions within the United Kingdom and abroad and allow further facilitation of trials from the bench to
the bedside, working with our highly expert Birmingham Clinical Trials Unit and utilizing the infrastructure
provided within this institution to further obtain trial funding and commercial research support (Figure 4).
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The ‘critical outputs’ for the Centre for Women’s and Children’s Health would be:
i) Short term:
1. The development of a ‘taught’ postgraduate course in the area of women’s (including maternal)
health and children’s health for academics and NHS trainees, twice annually.
2. To establish a regular forum for multidisplinary groups to discuss new research ideas (Blue skies
thinking forum).
3. To allow the propagation and submission of two collaborative grant applications (project or
programme) to national bodies per annum that includes co-applicants from disciplines within the
centre.
ii) Medium / long term.
The Centre will also allow us to focus upon strategic funding bids both for:
a) Senior investigator awards (senior fellowships).
b) Programme grant acquisition.
c) NIHR bids
d) EU commercial funding.
Most of all, it would allow us a national and international badge of identity and excellence.
Areas where the Centre will initially start to facilitate collaborative working:
1.
Early pregnancy research.
2.
Global Women’s Health.
3.
Birth trauma : childbirth and the puerperium.
4.
Long term morbidity in women after child health.
5.
Tracking of perinatal morbidity into childhood and adolescence.
The Executive team would include:
1. Professor Mark Kilby. Professor of Fetal Medicine and Section lead for Reproduction, Genes &
Development in the School of Clinical and Experimental Medicine.
2. Professor Christine MacArthur. Professor of Maternal & Child Epidemiology, School of Health &
Population Studies.
3. Dr Andrew Ewer. Clinical Reader in Neonatal Paediatrics and lead in Research & Development at
Birmingham Women’s Foundation Trust.
4. Professor Tim Barrett. Professor of Paediatric Endocrinology and lead for the Wellcome Trust
Clinical Research Facility in Children’s Health.
5. Ms. Jane Daniels. Deputy Director of the Birmingham Clinical Trials Unit, University of Birmingham.
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