Understanding biological mechanisms underlying adverse birth outcomes in developing countries: protocol for a prospective cohort (AMANHI bio–banking) study

Abstract

ObjectivesThe AMANHI study aims to seek for biomarkers as predictors of important pregnancy–related outcomes, and establish a biobank in developing countries for future research as new methods and technologies become available.MethodsAMANHI is using harmonised protocols to enrol 3000 women in early pregnancies (8–19 weeks of gestation) for population–based follow–up in pregnancy up to 42 days postpartum in Bangladesh, Pakistan and Tanzania, with collection taking place between August 2014 and June 2016. Urine pregnancy tests will be used to confirm reported or suspected pregnancies for screening ultrasound by trained sonographers to accurately date the pregnancy. Trained study field workers will collect very detailed phenotypic and epidemiological data from the pregnant woman and her family at scheduled home visits during pregnancy (enrolment, 24–28 weeks, 32–36 weeks & 38+ weeks) and postpartum (days 0–6 or 42–60). Trained phlebotomists will collect maternal and umbilical blood samples, centrifuge and obtain aliquots of serum, plasma and the buffy coat for storage. They will also measure HbA1C and collect a dried spot sample of whole blood. Maternal urine samples will also be collected and stored, alongside placenta, umbilical cord tissue and membrane samples, which will both be frozen and prepared for histology examination. Maternal and newborn stool (for microbiota) as well as paternal and newborn saliva samples (for DNA extraction) will also be collected. All samples will be stored at –80°C in the biobank in each of the three sites. These samples will be linked to numerous epidemiological and phenotypic data with unique study identification numbers.Importance of the studyAMANHI biobank proves that biobanking is feasible to implement in LMICs, but recognises that biobank creation is only the first step in addressing current global challenges.

Pregnancy intervals after stillbirth, neonatal death and spontaneous abortion and the risk of an adverse outcome in the next pregnancy in rural Bangladesh

“…There is also a need for additional research to identify genetic and other bio-markers that are associated with clustering of adverse outcomes within mothers as has been established in other settings [18, 58–62], and to design interventions to address them. The study authors are currently pursuing this through a bio-repository with maternal blood and urine samples collected during pregnancy and the postpartum period [63].…”

Prevalence and factors associated with hypertension among adults in rural Sylhet district of Bangladesh: a cross-sectional study

“…We recruited the study participants from the database using computer-generated random numbers. They were visited in their homes by trained community health workers (CHWs) with a minimum of 10th grade education, who were already collecting routine surveillance and other study-specific data, including BP measurement of pregnant women 22 23. Given cultural sensitivities, two male CHWs were recruited to collect data from male participants.…”

PRECISE pregnancy cohort: challenges and strategies in setting up a biorepository in sub-Saharan Africa

“…To ensure that PRECISE sites may participate in future collaborations and consortia, specimen collection has been designed to be harmonised with other similar large pregnancy cohort studies such as AMANHI [10], INTERBIO-21st [11], GAPPS [12] and HeLTI [13]. The PRECISE Network is also aligned with H3Africa goals [3] by building on existing infrastructure and resources to develop a cohort of African scientists focussed on significant global health problems that disproportionately affect women and families in sub-Saharan Africa.…”