Funding for pregnancy research projects co-led by Professor Rebecca Reynolds

The Medical Research Council (MRC) and UK Research and Innovation (UKRI) have both awarded funding for major projects co-led by Professor Rebecca Reynolds to evaluate how current guidance and treatments affect pregnant women across diverse communities in the UK.

The £1.9 million Folate Study funded by MRC aims to assess how folic acid legislation from the UK government impacts maternal and child health. The UKRI Digital Research Infrastructure Fund has awarded £3.52 million across eight new projects including the FRAME trial, which is set to explore how federated health data can be used to emulate clinical trials investigating antihypertensive treatments during pregnancy.

Based at the Institute for Neuroscience and Cardiovascular Research, Professor Rebecca Reynolds and her research team are co-investigators on these projects and will use the infrastructure of the Edinburgh Pregnancy Research Team and their existing data gathering projects to support sample and data collection.

Edinburgh Pregnancy Research

Professor Rebecca Reynolds is part of the Edinburgh Pregnancy Research Team, a diverse group of research and clinical specialists from across NHS Lothian and the University of Edinburgh who promote and support perinatal research in order to improve pregnancy outcomes.

The team have created an infrastructure to enable clinical studies, data collection and use of biobank samples in research. This includes the Born in Scotland study and Edinburgh Reproductive Tissue Biobank, which are being utilised by Professor Reynolds and her research team to support the sample and data collection for the new FRAME trial and Folate study.

Born in Scotland is a research study which gathers information on a large number of pregnancies of people living in Scotland during the 2020s. By using routinely gathered data in pregnancy, such as medical histories, ultrasound scans and blood tests, the Born in Scotland study is creating a virtual bank of interlinked information which will help show the environmental and genetic factors that affect a child’s long-term health and development.

The Edinburgh Reproductive Tissue Biobank has been set up to aid medical and scientific researchers working in the field of reproductive biology and provides high quality tissue samples and matched medical data for researchers working on approved projects.

Understanding how anti-hypertensive treatment affects different ethnic groups

blood pressure check on arm

Hypertension, commonly known as high blood pressure, complicates approximately 10–15% of pregnancies and significantly increases risks for both mothers and babies. While antihypertensive medications are widely used, there is limited evidence on whether treatment effects vary across different ethnic groups or how exposure may influence long-term child development.

Co-led by Professor Rebecca Reynolds and supported by data from the Born in Scotland study and the Pregnancy Research Team, the FRAME (Federated Research on Anti-hypertensives Maternity Emulation) trial will use observational healthcare data to emulate randomised clinical trials through a federated analysis approach and evaluate treatment outcomes across diverse groups.

It aims demonstrate how emerging capabilities within and between UK Trusted Research Environments can support real-world sensitive data research.

Evaluating the impact of UK guidance across diverse communities

pregnant person chopping bread and vegetables

Folate (vitamin B9) is vital in early pregnancy and helps to prevent serious birth defects of the brain and spine, known as neural tube defects, including spina bifida. For women trying to conceive, the NHS recommends taking a folic acid supplement every day before pregnancy and up until 12 weeks of pregnancy.

However, some pregnancies are unplanned, and not all women are aware of the recommendations to take a folic acid supplement. To address this, in 2024 the UK government introduced new legislation, making it mandatory for millers and flour producers to add folic acid to non-wholemeal wheat flour during production from the end of 2026.

The three-year folate study will provide UK-specific evidence on whether adding folic acid to flour improves folate levels across different communities and whether the benefits are shared fairly, particularly among groups at higher risk of deficiency. The work will be led by King’s College London and delivered in partnership with the University of Edinburgh, University of Cambridge, Queen’s University Belfast and the Born in Bradford cohort.

The project will collect and analyse 2,000 blood samples from women in early pregnancy, covering the period before, during and after the rollout of flour fortification. The Edinburgh Pregnancy Research midwife team are recruiting women in early pregnancy and inviting them to donate a blood sample and complete a dietary questionnaire. The blood samples are processed and stored by Professor Rebecca Reynolds and her research group.

These researchers will measure red blood cell and serum folate, vitamin B12 and homocysteine levels. These are all important markers of folate metabolism and will help identify whether folate is being used effectively in early pregnancy. They will also examine links between folic acid fortification, changes in biomarkers of folate status, and maternal and infant outcomes, including neural tube defects, fetal growth, preterm birth and infant neurodevelopment.

I am delighted to be a co-investigator on this important study. We are really pleased that women from Scotland will contribute data for the analysis as we know that some groups, such as those living with obesity and/or in deprived areas, already have folate deficiency.

Whilst it is really important that women planning pregnancy continue to take recommended folic acid supplementation, we know that many pregnancies are unplanned. The study findings will be key to understand whether folate fortification impacts folate status and whether this translates to improved pregnancy outcomes for mothers and their babies.

Rebecca Reynolds Professor of Metabolic Medicine, Institute for Neuroscience and Cardiovascular Research
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