The placenta is the most important organ in pregnancy that almost nobody studies in detail. PLACENTA-PATH will collect and analyse thousands of placentas from a general population, linking their structure and pathology to genetic data and lifelong health records for both mothers and children. This matters because placental problems—such as pre-eclampsia, preterm birth, and poor fetal growth—affect millions of pregnancies worldwide, yet the organ itself remains poorly understood. Large-scale studies with long-term follow-up are almost nonexistent, leaving doctors unable to predict or prevent these complications. The project fills this gap by creating a unique resource that combines standardised placental measurements with decades of health data. If successful, the research could transform how clinicians assess risk in pregnancy. Identifying distinct subtypes of placental disease based on actual pathology would allow earlier, more targeted interventions. It could also reveal how placental health influences cardiovascular and cognitive function later in life—for both mother and child. While this is fundamental science with no immediate clinical tool, similar large-scale biobank studies have already reshaped understanding of common diseases. The deeper knowledge of placental biology could eventually lead to better screening, prevention, and treatment of pregnancy complications that quietly shape lifelong health.
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The placenta connects mother and fetus, providing all essential life supporting functions to the growing fetus. Despite the placenta's vital role in pregnancy and likely effects on lifelong health, it is poorly understood and under-researched. One reason for this is a lack of large scale studies of of human placentas drawn from a general population, with follow up beyond delivery. In PLACENTA-PATH, I will capitalise on two unique and complementary collections of placentas. I will generate standardised, quantitative morphometrics and histopathology and link these with genetic data and detailed life long health information on both mothers and offspring. This will create a unique resource that will underpin an ambitious programme of work to deliver a step change in maternal and child risk stratification, and in the understanding of the causes of clinical placental syndromes (hypertensive disorders of pregnancy, preterm delivery and fetal growth restriction), and later cardiovascular and neurocognitive health. I will use the clinical information and placental morphologic and pathology data to investigate the multifactorial and heterogeneous nature of clinical placental syndromes as well as their shared genetics and pathobiology. I will identifying homogenous subtypes of clinical placental syndromes based on placental pathology. I will then investigate associations of placental pathology with lifelong maternal and offspring cardiovascular health and cognitive function. I will also exploit the rich phenotypic and genetic data available in PLACENTA-PATH to identify determinants of placental pathology using a triangulation framework by applying multivariable regression, paternal negative control and Mendelian randomization approaches. PLACENTA-PATH goes beyond the-state-of-the-art by implementing cutting-edge analytical methods to unique placenta data and unprecedented, matched genetic and life course catalogues, facilitating a rapid step change in human pregnancy research.
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