Rachel Craik's research while affiliated with Oxford University Hospitals NHS Trust and other places

Publications (72)

Preprint
Background: Existing reviews of pre-eclampsia determinants have focused on clinical and genetic risk factors. Objective: To evaluate social determinants for pre-eclampsia prevention. Search strategy: Systematic searches were conducted on relevant electronic databases to 31 July 2023. Selection criteria: Reviews and large cohort studies (≥1,000 part...
Article
Background Household air pollution might lead to fetal growth restriction during pregnancy. We aimed to investigate whether a liquefied petroleum gas (LPG) intervention to reduce personal exposures to household air pollution during pregnancy would alter fetal growth. Methods The Household Air Pollution Intervention Network (HAPIN) trial was an ope...
Article
Background PRECISE-DYAD is an observational cohort study of mother-child dyads running in urban and rural communities in The Gambia and Kenya. The cohort is being followed for two years and includes uncomplicated pregnancies and those that suffered pregnancy hypertension, fetal growth restriction, preterm birth, and/or stillbirth. Methods The PRECI...
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Background Seroprevalence studies are an alternative approach to estimating the extent of transmission of SARS-CoV-2 and the evolution of the pandemic in different geographical settings. We aimed to determine the SARS-CoV-2 seroprevalence from March 2020 to March 2022 in a rural and urban setting in Kilifi County, Kenya. Methods We obtained repres...
Article
( Lancet . 2023;401:447–457) In 2021, COVID-19 during pregnancy was reported to be associated with an increased risk of maternal and neonatal outcomes. The SARS-CoV-2 virus has undergone genetic mutations since then and the subsequent impact of the omicron variant on maternal and neonatal health wasunknown. This study aimed to analyze the effects o...
Article
Background: Over 250 million children are not reaching their developmental potential globally. The impact of prenatal factors then influenced by postnatal environmental factors on child neurodevelopment, is still unclear—particularly in low- and middle-income settings. This study aims to understand the impact of placental complications as well as e...
Article
Background Copper (Cu), an essential trace mineral regulating multiple actions of inflammation and oxidative stress, has been implicated in risk for preterm birth (PTB). Objectives This study aimed to determine the association of maternal Cu concentration during pregnancy with PTB risk and gestational duration in a large multicohort study includin...
Article
Objectives: SARS-CoV-2 transmission in Sub-Saharan Africa has probably been underestimated. Population-based seroprevalence studies are needed to determine the extent of transmission in the continent. Methods: Blood samples from a cohort of Gambian pregnant women were tested for SARS-CoV-2 total receptor binding domain (RBD) IgM/IgG before (Pre-...
Article
Background: Anaemia in pregnancy is a global health problem with associated maternal and neonatal morbidity and mortality. We aimed to investigate the association between maternal haemoglobin concentrations during pregnancy and the risk of adverse maternal and neonatal outcomes. Methods: In this prospective, observational, multinational, INTERBI...
Preprint
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Objectives SARS-CoV-2 transmission in Sub-Saharan Africa has probably been underestimated. Population-based seroprevalence studies are needed to determine the extent of transmission in the continent. Methods Blood samples from a cohort of Gambian pregnant women were tested for SARS-CoV-2 total IgM/IgG before (Pre-pandemic1: October-December 2019 an...
Article
Household air pollution from solid cooking fuel use during gestation has been associated with adverse pregnancy and birth outcomes. The Household Air Pollution Intervention Network (HAPIN) trial was a randomized controlled trial of free liquefied petroleum gas (LPG) stoves and fuel in Guatemala, Peru, India, and Rwanda. A primary outcome of the mai...
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Accurate estimation of gestational age is an essential component of good obstetric care and informs clinical decision-making throughout pregnancy. As the date of the last menstrual period is often unknown or uncertain, ultrasound measurement of fetal size is currently the best method for estimating gestational age. The calculation assumes an averag...
Article
Objective: Lung ultrasound (LUS) is an alternative to chest radiography to confirm a diagnosis of pneumonia. For research and disease surveillance, methods to use LUS to diagnose pneumonia are needed. Methods: In the Household Air Pollution Intervention Network (HAPIN) trial, LUS was used to confirm a clinical diagnosis of severe pneumonia in in...
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Background In 2021, we showed an increased risk associated with COVID-19 in pregnancy. Since then, the SARS-CoV-2 virus has undergone genetic mutations. We aimed to examine the effects on maternal and perinatal outcomes of COVID-19 during pregnancy, and evaluate vaccine effectiveness, when omicron (B.1.1.529) was the variant of concern. Methods IN...
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Pre-eclampsia is a serious complication of pregnancy, and maternal nutritional factors may play protective roles or exacerbate risk. The tendency to focus on single nutrients as a risk factor obscures the complexity of possible interactions, which may be important given the complex nature of pre-eclampsia. An evidence review was conducted to compil...
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Background: PRECISE-DYAD is an observational cohort study of mother-child dyads running in urban and rural communities in The Gambia and Kenya. The cohort is being followed for two years and includes uncomplicated pregnancies and those that suffered pregnancy hypertension, fetal growth restriction, preterm birth, and/or stillbirth. Methods: The PRE...
Article
Introduction: This study examined the emotional impact that parents experience when confronted with an increased genetic risk of type 1 diabetes (T1D) in their child. Population-based screening of neonates for genetic risk of chronic disease carries the risk of increased emotional burden for parents. Methods: Information was collected using a we...
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Objective INGR1D (INvestigating Genetic Risk for type 1 Diabetes) was a type 1 diabetes (T1D) genetic screening study established to identify participants for a primary prevention trial (POInT, Primary Oral Insulin Trial). Methods The majority of participants were recruited by research midwives in antenatal clinics from 18 weeks’ gestation. Using...
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Background: Pre-eclampsia is a leading cause of maternal mortality and morbidity that involves pregnancy-related stressors on the maternal cardiovascular and metabolic systems. As nutrition is important to support optimal development of the placenta and for the developing fetus, maternal diets may play a role in preventing pre-eclampsia. The purpo...
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Background The World Health Organization recommends a package of pregnancy care that includes obstetric ultrasound scans. There are significant barriers to universal access to antenatal ultrasound, particularly because of the cost and need for maintenance of ultrasound equipment and a lack of trained personnel. As low-cost, handheld ultrasound devi...
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Background: Obesity predominantly affects populations in high-income countries and those countries facing epidemiological transition. The risk of childhood obesity is increased among infants who had overweight or obesity at birth, but in low-resource settings one in five infants are born small for gestational age. We aimed to study the relationshi...
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Background The effect of COVID-19 in pregnancy on maternal outcomes and its association with preeclampsia and gestational diabetes has been reported; however, a detailed understanding of the effect of maternal positivity, delivery mode and perinatal practices on fetal and neonatal outcomes is urgently needed. Objective To evaluate the impact of CO...
Article
Background Among non-pregnant individuals, diabetes mellitus (DM) and high body mass index (BMI) increase the risk of Covid-19 and its severity. Objective To determine whether DM and high BMI are risk factors for Covid-19 in pregnancy and whether gestational diabetes mellitus (GDM) is also associated with covid-19 diagnosis. Study Design INTERCOV...
Preprint
BACKGROUND Ultrasound for gestational age (GA) assessment is not routinely available in resource-constrained settings, particularly in rural and remote locations. The TraCer device combines a handheld wireless ultrasound probe and a tablet with Artificial Intelligence (AI)-enabled software that obtains GA from videos of the fetal head by automated...
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Background Ultrasound for gestational age (GA) assessment is not routinely available in resource-constrained settings, particularly in rural and remote locations. The TraCer device combines a handheld wireless ultrasound probe and a tablet with artificial intelligence (AI)-enabled software that obtains GA from videos of the fetal head by automated...
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The Household Air Pollution Intervention Network trial is a multi-country study on the effects of a liquefied petroleum gas (LPG) stove and fuel distribution intervention on women's and children's health. There is limited data on exposure reductions achieved by switching from solid to clean cooking fuels in rural settings across multiple countries....
Preprint
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This paper presents a novel approach to automatic fetal brain biometry motivated by needs in low- and medium- income countries. Specifically, we leverage high-end (HE) ultrasound images to build a biometry solution for low-cost (LC) point-of-care ultrasound images. We propose a novel unsupervised domain adaptation approach to train deep models to b...
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Why was this study conducted? It is unclear whether the suggested association between COVID-19 during pregnancy and preeclampsia is independent of common risk factors. This study aimed to quantify any independent association between COVID-19 during pregnancy and preeclampsia and to determine key related pregnancy outcomes and maternal and neonatal...
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Ultrasound Core Laboratories (UCL) are used in multicenter trials to assess imaging biomarkers to define robust phenotypes, to reduce imaging variability and to allow blinded independent review with the purpose of optimizing endpoint measurement precision. The Household Air Pollution Intervention Network, a multicountry randomized controlled trial...
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Many observational studies and some randomized trials demonstrate how fetal growth can be influenced by environmental insults (for example, maternal infections)¹ and preventive interventions (for example, multiple-micronutrient supplementation)² that can have a long-lasting effect on health, growth, neurodevelopment and even educational attainment...
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Background Household air pollution adversely affects human health and the environment, yet more than 40% of the world still depends on solid cooking fuels. The House Air Pollution Intervention Network (HAPIN) randomized controlled trial is assessing the health effects of a liquefied petroleum gas (LPG) stove and 18-month supply of free fuel in 3,20...
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Importance: The etiologic complexities of preterm birth remain inadequately understood, which may impede the development of better preventative and treatment measures. Objective: To examine the association between specific preterm-birth phenotypes and clinical, growth, and neurodevelopmental differences among preterm newborns compared with term...
Preprint
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An increasing number of diseases can be offered treatments that are transformative if administered in a timely manner. However, many of these diseases are currently not included in the newborn screening programs because they lack sensitive and specific metabolic biomarkers and their detection relies on genetic methods. Type 1 diabetes (T1D) constit...
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Background Technological advances and high throughput biological assays can facilitate discovery science in biobanks from population cohorts, including pregnant women. Biological pathways associated with health outcomes differ depending on geography, and high-income country data may not generalise to low-resource settings. We conducted a systematic...
Chapter
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For many emerging medical image analysis problems, there is limited data and associated annotations. Traditional deep learning is not well-designed for this scenario. In addition, for deploying deep models on a consumer-grade tablet, it requires models to be efficient computationally. In this paper, we describe a framework for automatic quality ass...
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Background: Due to different social and physical environments across Africa, understanding how these environments differ in interacting with placental disorders will play an important role in developing effective interventions. Methods: A scoping review was conducted, to identify current knowledge on interactions between the physical and social...
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Background Preterm birth is a major global health challenge, the leading cause of death in children under 5 years of age, and a key measure of a population's general health and nutritional status. Current clinical methods of estimating fetal gestational age are often inaccurate. For example, between 20 and 30 weeks of gestation, the width of the 95...
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Background and objective: PRECISE is a population-based, prospective pregnancy cohort study designed for deep phenotyping of pregnancies in women with placenta-related disorders, and in healthy controls. The PRECISE Network is recruiting ~ 10,000 pregnant women in three countries (The Gambia, Kenya, and Mozambique) representing sub-Saharan Africa....
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Background: The PRECISE (PREgnancy Care Integrating translational Science, Everywhere) Network is a new and broadly-based group of research scientists and health advocates based in the UK, Africa and North America. Methods: This paper describes the protocol that underpins the clinical research activity of the Network, so that the investigators,...
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In less-resourced settings, adverse pregnancy outcome rates are unacceptably high. To effect improvement, we need accurate epidemiological data about rates of death and morbidity, as well as social determinants of health and processes of care, and from each country (or region) to contextualise strategies. The PRECISE database is a unique core infra...
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It is widely acknowledged across the global health sector that research programmes need to be designed and implemented in a way that maximise opportunities for strengthening local capacity. This paper examines how the United Kingdom Research and Innovation (UKRI) Grand Challenges Research Fund (GCRF) funded PRECISE (PREgnancy Care Integrating trans...
Article
BACKGROUND: Among nonpregnant individuals, diabetes mellitus and high body mass index increase the risk of COVID-19 and its severity. OBJECTIVE: Thisstudyaimedtodeterminewhetherdiabetesmellitusand highbodymassindexareriskfactorsforCOVID-19inpregnancyandwhether gestational diabetes mellitus is associated with COVID-19 diagnosis. STUDY DESIGN: INTERC...
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Obstetric ultrasound is a fundamental ingredient of modern prenatal care with many applications including accurate dating of a pregnancy, identifying pregnancy-related complications, and diagnosis of fetal abnormalities. However, despite its many benefits, two factors currently prevent wide-scale uptake of this technology for point-of-care clinical...
Article
Pneumonia is a leading killer of children younger than 5 years despite high vaccination coverage, improved nutrition, and widespread implementation of the Integrated Management of Childhood Illnesses algorithm. Assessing the effect of interventions on childhood pneumonia is challenging because the choice of case definition and surveillance approach...
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Background: INTERBIO-21 st is Phase II of the INTERGROWTH-21 st Project, the population-based, research initiative involving nearly 70,000 mothers and babies worldwide coordinated by Oxford University and performed by a multidisciplinary network of more than 400 healthcare professionals and scientists from 35 institutions in 21 countries worldwide....
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Background: INTERBIO-21 st is Phase II of the INTERGROWTH-21 st Project, the population-based, research initiative involving nearly 70,000 mothers and babies worldwide coordinated by Oxford University and performed by a multidisciplinary network of more than 400 healthcare professionals and scientists from 35 institutions in 21 countries worldwide....
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Background: Human genetic factors are important determinants of malaria risk. We investigated associations between multiple candidate polymorphisms-many related to the structure or function of red blood cells-and risk for severe Plasmodium falciparum malaria and its specific phenotypes, including cerebral malaria, severe malaria anaemia, and respi...
Data
Figure S2 Relationship between fetal weight and head circumference in the final model, plotted for a fixed abdominal circumference of 23 cm.
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Appendix S1 Members of the International Fetal and Newborn Growth Consortium for the 21st Century (INTERGROWTH‐21st and INTERBIO‐21st) and its Committees
Data
Figure S1 Relationship between fetal weight and abdominal circumference in the final model, plotted for a fixed head circumference of 26 cm.
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Table S1 Estimated fetal weight per completed week of gestation at 3rd, 10th, 50th, 90th and 97th centiles
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Figure S3 Bias in estimation of fetal weight as a function of time to birth, showing mean percent prediction error and 95% CI according to time between last ultrasound scan and birth.
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Figure S4 Gestational age‐specific centiles for estimated fetal weight (blue) and birth weight (red). 3rd, 10th, 50th, 90th and 97th centiles are shown.
Article
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Background: Estimated fetal weight (EFW) and fetal biometry are complementary measures to screen for fetal growth disturbances. Our aim was to provide international EFW standards to complement the INTERGROWTH-21(st) Fetal Growth Standards that are available for use worldwide. Methods: Women with an accurate gestational age assessment, who were e...
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Glucose-6-phosphate dehydrogenase (G6PD) deficiency exhibits considerable allelic heterogeneity which manifests with variable biochemical and clinical penetrance. It has long been thought that G6PD deficiency confers partial protection against severe malaria, however prior genetic association studies have disagreed with regard to the strength and s...
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The high prevalence of sickle haemoglobin in Africa shows that malaria has been a major force for human evolutionary selection, but surprisingly few other polymorphisms have been proven to confer resistance to malaria in large epidemiological studies. To address this problem, we conducted a multi-centre genome-wide association study (GWAS) of life-...
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Background: Many studies report associations between human genetic factors and immunity to malaria but few have been reliably replicated. These studies are usually country-specific, use small sample sizes and are not directly comparable due to differences in methodologies. This study brings together samples and data collected from multiple sites a...
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Many human genetic associations with resistance to malaria have been reported, but few have been reliably replicated. We collected data on 11,890 cases of severe malaria due to Plasmodium falciparum and 17,441 controls from 12 locations in Africa, Asia and Oceania. We tested 55 SNPs in 27 loci previously reported to associate with severe malaria. T...
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Background The relationship between glucose-6-phosphate dehydrogenase (G6PD) deficiency and clinical phenomena such as primaquine-sensitivity and protection from severe malaria remains poorly defined, with past association studies yielding inconsistent and conflicting results. One possibility is that examination of a single genetic variant might un...
Article
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Resistance to anti-malarial drugs is a widespread problem for control programmes for this devastating disease. Molecular tests are available for many anti-malarial drugs and are useful tools for the surveillance of drug resistance. However, the correlation of treatment outcome and molecular tests with particular parasite markers is not perfect, due...

Citations

... The severe acute respiratory syndrome coronavirus (SARS-CoV-2) has spread rapidly around the world, infecting millions of people. Although pregnant women are not more likely to contract the disease, they are more susceptible to develop a severe infection and maternal and pregnancy complications, depending on the variant [1][2][3][4][5][6][7]. ...
... www.nature.com/scientificreports/ in order to mitigate the impact of COVID-19 and any future disease threats on maternal and neonatal health. Several seroepidemiological studies from different African countries have reported significantly high SARS-CoV-2 seropositivity rates within a wider population, which confirms the underestimation of COVID-19 cases in Africa based on reported testing figures [8][9][10] . It is possible COVID-19 burden among the pregnant population in Africa might diverge from estimates in most developed countries. ...
... Recent analyses sought to evaluate the effects of reduced haemoglobin concentrations on pregnancy outcomes, and interestingly indicated an increased risk of preterm birth at haemoglobin thresholds below the statistical thresholds proposed here. 61 Our analysis builds on previous studies using chiefly US-based data to estimate fifth centiles of haemoglobin in iron-replete, non-inflamed populations 5 by using multinational datasets with the addition of clinical criteria for health, and covers a broad age range. Our findings were robust to variations in criteria for iron deficiency and inflammation, to statistical methods, and to secular health trends. ...
... Despite growing literatures linking HAP to pregnancy outcomes, only few interventions have been tested to generate evidences on effectiveness of these interventions [51][52][53][54][55]. Only two randomized controlled trial (RCT) studies in Ethiopia tested improved stoves for their impact on childhood respiratory illness or growth [56,57]. ...
... Oghli et al. [42] focused on automatic biometric parameter prediction, achieving high accuracy with the MFP-Unet model, with a Dice Similarity Coefficient (DSC) of 0.98 and 100% accuracy in achieving good contours. Lee et al. [59] estimated fetal gestational age accurately using machine learning methods and biometry measurements, achieving a mean absolute error of 3.0 days in the second trimester and 4.3 days in the third trimester. Zhu et al. [60] discussed automatic femur length measurement in ultrasound images, achieving high accuracy with random forest regression and SegNet methods, with the random forest regression model achieving an average error of 1.23 mm and the SegNet-based method achieving an average error of 0.46 mm. ...
... In contrary, the large scale multi-country household air pollution intervention network trials found that switching to liquefied petroleum gas (LPG) stoves and fuel did not significantly reduce the risk of preterm birth (PTB) or increase the duration of pregnancy in participating women [52,95]. Another interventional study, focusing on improved biomass stoves in Nepal, did not demonstrate any evidence of reducing adverse birth outcomes, including preterm births [96]. ...
... Another study conducted during the Omicron predominance period (not included in the abovementioned meta-analysis) reported 48% and 76% VE against severe COVID-19 complications after two and three doses, respectively [89]. ...
... MDPI and/or the editor(s) disclaim responsibility for any injury to people or property resulting from any ideas, methods, instructions, or products referred to in the content. 2 a variety of domains including nutrition, exercise, smoking cessation, weight management, sleep, stress, and community support. Most of the research has been directed to interventions related to diet and exercise, both of which have been recommended by international obstetric societies to promote healthy pregnancy and reduce adverse outcomes [7,8]. ...
... However, monitoring of antibodies for younger and older adults may be different from that in children and adolescents, and limited data are available on non-White populations. Preliminary data on psychological aspects of screening were gathered in previous projects (Fr1da [15], The Environmental Determinants of Diabetes in the Young [TEDDY] [16], and Global Platform for the Prevention of Autoimmune Diabetes [GPPAD] [17]). As 9 of 10 families in a population screening will have no prior knowledge of T1D, key elements to reduce anxiety and stress are information and education, about the relevance of antibody results and eventual development of T1D, that are appropriate for families and children. ...