Projects

Global collaboration to prevent pre-eclampsia with aspirin: the PEARLS cohort

Preterm pre‐eclampsia is a serious pregnancy complication that can threaten the lives of mothers and babies. Working with international partners, and collaborators in Ghana, Kenya, South Africa and India, we’re conducting a large‐scale cohort study to prevent it.

The study is evaluating new ways to identify women at risk of pre-eclampsia. It's the largest study in low- and middle-income countries identifying women at increased risk of developing pre-eclampsia later in pregnancy, to ensure these women are offered preventive medicines.

What we're doing

We're surveying more than 18,000 women in Ghana, Kenya and South Africa, as well as an additional 5,000 women in India.

By collecting information about women's health, previous pregnancy outcomes, and blood pressure early in pregnancy, we are developing and validating tools that can predict who is most likely to develop pre-eclampsia before symptoms appear.

We are also working closely with pregnant women and healthcare workers to understand the practical challenges of introducing new screening approaches into routine antenatal care.

The findings will help improve early detection of pre-eclampsia and support more timely care, with the goal of reducing maternal and newborn illness and death in settings where the burden is greatest.

Pre-eclampsia explained

Pre-eclampsia is a condition that occurs during pregnancy. It can reduce blood flow to the placenta and cause premature birth. It can cause serious illness, organ damage, seizures and death of the parent or child.

Pre-eclampsia is the leading cause of maternal and newborn deaths worldwide. It leads to an estimated 14% of maternal deaths each year. It’s also connected to around 7% of early newborn deaths.

There’s no cure for pre-eclampsia, so when parents and children don’t have access to health care the condition poses a serious risk. It’s why risk screening and prevention through aspirin is so important.

Publications

27 Oct 2025

Protocol for a prospective cohort study on pre-eclampsia risk prediction in Ghana, Kenya and South Africa

Reproductive Health

Kara Blackburn et al

Open access

24 Mar 2025

Formative research to optimize pre-eclampsia risk-screening and prevention (PEARLS): study protocol

Reproductive Health

Nicole Minckas et al

Open access

Preprints

Factors Affecting and Strategies to Improve Risk Screening and Prevention of Pre-Eclampsia: A Multi-Country, Mixed-Methods Formative Study
View preprint at SSRN
Protocol for a prospective accuracy study on an artificial intelligence-based ultrasound system for gestational age estimation among pregnant women in Ghana, Kenya and South Africa
View preprint at medRxiv

Student opportunities

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Blood pressure trajectories in pregnancy and implications for pre‑eclampsia risk assessment in Sub‑Saharan Africa

Blood pressure measurement is central to the detection and management of hypertensive disorders of pregnancy, yet current blood pressure thresholds and nomograms used in pregnancy are largely derived from high‑income country populations. There is limited evidence on normative blood pressure patterns across pregnancy in sub‑Saharan African populations, particularly in women with common comorbidities such as malaria, HIV, or sickle cell disease. In addition, variation in blood pressure measurement techniques may substantially influence risk stratification for pre‑eclampsia, with implications for both clinical care and research.

This project aims to generate context‑specific evidence to improve the interpretation and measurement of blood pressure in pregnancy in sub‑Saharan Africa, and to assess its impact on pre‑eclampsia risk screening.