In this week’s Holy Grail we caught up with research scientist Dr Vanessa Murphy about her work investigating the characteristics, mechanisms and consequences of asthma exacerbations during pregnancy and their health impact on both the mother and baby.

What’s the issue your research is trying to solve?

My research is trying to solve the problem of asthma exacerbations (or flare-ups) in pregnancy, which are common and associated with poor maternal and neonatal outcomes. We are trialling a novel asthma management strategy during pregnancy, to see whether this can reduce exacerbations of asthma in pregnant women, and result in improved health outcomes for both mother and baby. We are also following the children of these asthmatic mothers to see if our interventions improve their health into early childhood.

What have you discovered so far?

At least 45% of pregnant women with asthma have exacerbations which require them to seek medical advice during pregnancy. These are associated with poor perinatal outcomes including low birth weight and neonatal hospitalisation. We have discovered that adjusting asthma medication during pregnancy based on a marker of lung inflammation, rather than symptoms, reduces exacerbations in pregnancy by 50%. This approach also results in more women using inhaled corticosteroid medication but at lower doses, more women using inhaled corticosteroid / long acting beta agonist (ICS/LABA) combination therapy, fewer oral corticosteroid courses for exacerbations and less bronchiolitis in the first year of life.

What’s been your biggest hurdle?

Getting enough funding to do the clinical trials required.

How far is your work from impacting patient care?

We hope that our research will result in a change in the recommendations for asthma management in pregnancy. We are currently gathering the evidence required for this change to occur, which could be as little as 3-5 years away.

If you could discover one thing in your research, what would it be? (e.g what’s your holy grail?)

What makes some women with asthma have severe exacerbations in pregnancy (even when their asthma was previously mild), and why others have an improvement in their disease while they are pregnant.

What book are you reading at the moment?

“The Tea Chest” by Josephine Moon – an airport book purchase that I didn’t get through on the trip itself.

What two things would you save if your house was burning down?

The teddy bear my husband and I were given when our baby son died, and our wedding album (as we don’t have digital copies of these photos).