Major obstetrical syndromes related to preterm birth—including preterm pre-labor rupture of membranes, fetal growth restriction and pre-eclampsia—affect 10–15% of all pregnancies worldwide, resulting in substantial financial and human costs. Human pregnancy comprises a set of complex physiological processes, which involve most organ systems within the maternal body. There has been rapid recent growth of computational biomechanical approaches to the study of problems in pregnancy. These are particularly attractive for research that is logistically difficult and ethically challenging to execute in humans. Here, we present the history and current state-of-the-art in pregnancy bioengineering research, focusing on three case studies in which computational approaches have been used to explore the maternal-fetal dyad. First, fracture models are used to examine preterm pre-labor rupture of the fetal membranes, which is responsible for one-third of premature births. Next, models of the utero-placental interface are considered, focused on the trophoblast—the layer of fetal cells that directly contact the maternal uterus and thus form the immunological interface between two genetically different individuals. Finally, maternal cardiovascular function in pregnancy is examined in a multiscale framework considering interactions between hormonal and mechanical cues leading to heart growth. These three examples demonstrate the substantial potential for engineering approaches to pregnancy research, in which ‘experiments’ in silico can be deployed to examine complex systems that are otherwise not available for targeted research. (225 words).
|Original language||English (US)|
|Journal||Journal of the Mechanical Behavior of Biomedical Materials|
|State||Published - Apr 2022|
Bibliographical noteFunding Information:
AC is supported by the Health Research Council of New Zealand (20/926) and The Royal Society of New Zealand Te Apārangi Marsden Fund (18-UOA-135).
The field of pregnancy biomechanics can thus be considered as emerging, as documented by the search results shown in Fig. 2. There are several interesting challenges associated with the growth of research in an emerging field. There are few established funding streams for pregnancy biomechanics compared with established fields, such as bone biomechanics within Orthopaedics research. That said, there is a great deal of recent growth in the subject of Women's Health more broadly within the US National Institutes of Health. Recently, a landmark conference to address the knowledge gap in Women's Health research was hosted by the US National Institute of Health. One exciting aspect of the field is the intense interest from young women representing future growth of gender equity within bioengineering. Unlike most engineering disciplines, many undergraduate bioengineering programs have achieved gender equity in the United States (Roy et al., 2021). The field of Obstetrics has already seen a dramatic shift in the proportion of female clinicians in the last few decades, and there is growth in research within nurse midwifery and birth support (i.e., doulas) particularly but not exclusively within the US. Pregnancy research, as a subfield of Women's Health research is also a field of global interest since the preterm birth crisis exists worldwide. Global health disparities have been made especially clear in the last two years during the COVID pandemic. All these factors together with the rising interest in progress in computational modeling (Fig. 2) mean the field of computational models in pregnancy research is poised for significant growth and impact. We hope that future generations of Bioengineering and Biomechanics researchers will consider new and interesting problems that exist in pregnancy research (and Women's Health topics more generally) and apply their unique set of skills to solve these problems.AC is supported by the Health Research Council of New Zealand (20/926) and The Royal Society of New Zealand Te Ap?rangi Marsden Fund (18-UOA-135). MO thanks Ching-Theng Koh for helpful discussions related to this manuscript.
© 2022 Elsevier Ltd
- Preterm birth
PubMed: MeSH publication types
- Journal Article
- Research Support, Non-U.S. Gov't