Blizard Institute - Barts and The London

Shakila Thangaratinam, PhD, MRCOG

Shakila

Professor in maternal and perinatal health

Email: s.thangaratinam@qmul.ac.uk
Telephone: 07887 775891

Profile

Joint Director, Barts Research Centre for Women’s Health (BARC), QMUL

R&D Director for Women’s Health, Barts Health NHS Trust

Joint Lead, Multidisciplinary Evidence Synthesis Hub (mEsh), QMUL

Executive Board Member: Maternal Medicine Clinical Study Group (CSG)

Chief Medical Officers’ (CMO) Working group on Physical activity in pregnancy

National Obesity Steering Group: RCOG representative

Chair of the Trial Steering Committees: SOLVE, PREVIEW, LOTUS, ALife2

Founder, Katherine Twining Research NetworkKatie’s Team (PPI group)

 

Summary

Shakila Thangaratinam is a Professor of maternal and perinatal health at Barts and the London School of Medicine and Dentistry, Queen Mary University of London (QMUL). As Consultant Obstetrician she is involved in the care of high risk mothers at Barts Health NHS Trust. 

She started her research career as a Clinical Research Fellow at Keele University in 2004, and subsequently joined University of Birmingham In 2006 as a  Clinical Lecturer in Obstetrics and Gynaecology, went on to receive her PhD in 2011. After the completion of her clinical and academic training, she was appointed by Queen Mary University of London (QMUL) to the post of Clinical Senior Lecturer in 2011. She was offered the full Professorship at QMUL in 2012.

Professor Thangaratinam has established a strong portfolio of research in maternal and perinatal health. Her work focuses on prediction, prevention and treatment of complications in mothers with pre-eclampsia, epilepsy, diabetes, and obesity. Her publications include papers in high-impact journals such as the Lancet and the BMJ, and she has accrued research income of £9 million. She leads several national and international collaborative research networks, and her work has influenced national and international guidelines.

As R and D Director for Women’s Health at Barts Health NHS Trust (2012-to date), she expanded the team, and recruited over 40,000 women into 35 studies in the last five years. She established the research support network,  Katherine Twining Network (9 NHS hospitals, 3 Universities) in North and East London to deliver women’s health research (50,000 deliveries per year). Katie’s Team, the only dedicated and funded Patient and Public Involvement group for Women’s Health in the UK thrives under her leadership.

Teaching

A significant proportion of Prof Thangaratinam's efforts is towards the development, support and supervision of junior researchers and students. She is the educational supervisor postgraduate trainees, and supervise two NIHR Academic Clinical Lecturers (ACL).  

 

Primary supervision

Completed

PhD

B Wattar - (2013-2017) - Improving health outcomes for pregnant women with metabolic risk factors

PhD

J Allotey (2014-2018)  Improving the prediction of adverse pregnancy outcomes

PhD

E Rogozinska (2014-2017)  Diet and/or physical activity based interventions for antenatal weight management

MD

S Sobhy (2015-2017)  Risks of adverse maternal and perinatal outcomes in low and middle-income countries (LMIC)

MD

F Cheong-See (2012-2017) - Predictors of adverse maternal and fetal outcomes in high risk pregnancies

MSc

M D’Amico (2016) - Clinical trials methodology

 

In progress

PhD

A Hamilton (2013-)  Views of women and healthcare professionals on lifestyle interventions in pregnancy (submitted)

PhD

Pundir J (2016-).. Interventions to improve fertility outcomes in polycystic ovary syndrome

PhD

Chiamaka E (2016-)  Prevention of gestational diabetes and type 2 diabetes in high-risk women

PhD

Bolou A (2017-)  Effects of lifestyle interventions to prevent type 2 diabetes after gestational diabetes

MD

Marleen S (2016-)  Prediction of preterm birth in twin pregnancies

 

Secondary supervision

Two (MD) completed; 1PhD in progress.


Research

Research Interests:

Prof Thangaratinam's research themes

 

1.Metabolic disorders: Obesity, diabetes and polycystic ovary syndrome

Prof Thangaratinam's work in this area involves three main streams: 

  • Evidence synthesis through NIHR and WHO funded aggregate and IPD meta-analysis to determine the effects of diet and physical activity in pregnancy. She lead the International Weight Management in Pregnancy (i-WIP) collaborative group (40 researchers, 16 countries), with the largest live repository of individual data of over 12,500 participants. 
  • The primary trial ESTEEM is the largest study of Mediterranean diet in pregnancy to prevent maternal and offspring complications.  I am currently leading three pilot/feasibility studies funded by Barts Charity and North Thames CLAHRC: EMmY trial on the effects of myo-inositol to prevent gestational diabetes; prevention of progression to type 2 diabetes in mothers with gestational diabetes with metformin OMAhA; and with Mediterranean diet (MERIT). 
  • As a member of the International guideline committee on treatment of infertility in women with polycystic ovary syndrome, in addition to making recommendations, I identified gaps to inform future research, including the promising role of myo-inositol for ovulation induction in these women. 

Outputs

High impact publications (BMJ 2017, 2012) and other papers

Chief Medical Officers’ Infographic on physical activity in pregnancy.

ESHRE Guideline on management of fertility in women with polycystic ovary syndrome

PhDs 1 completed; 1 submitted (2019); 3 ongoing

 

2. Maternal and perinatal medicine: Pre-eclampsia, epilepsy, stillbirth, fetal growth, infection

Her work in this theme involves five areas of research:

  • She  leads the prediction of pre-eclampsia IPPIC (International Prediction of Complications in Pregnancy) IPD meta-analysis project funded by NIHR HTA ,and supported by the WHO. study. The IPPIC collaborative network consists of 73 collaborators from 21 countries, and is the largest global repository of standardised IPD of over three million pregnancies (15 UK, 66 international datasets). Our primary study PREP (Prediction of complications in women with pre-eclampsia) funded by NIHR HTA led to the development of an App that is accurate to predict complications. 
  • Her evidence synthesis on association of complications in women with epilepsy (Lancet 2015) directly informed RCOG Green Top guidelines on the management of pregnant women. It was the first ever dedicated guideline for these women, and I was the lead guideline developer. She led the NIHR HTA funded EMPiRE trial, the first randomised trial involving women with epilepsy.
  • Prof Thangaratinam's work on risk of stillbirth in twin pregnancies (BMJ 2016) informs the national guidelines and garnered significant media attention. She is currently undertaking prediction model development for stillbirths (IPPIC stillbirths) funded by SANDS charity. 
  • She is funded by NIHR HTA to develop prediction models for fetal growth restriction (IPPIC FGR).
  • Maternal Group B Streptococcal infection is a major risk factor for neonatal sepsis and death. She is the Chief Investigator of the NIHR funded GBS2 study to screen for GBS2 in high risk women.

Outputs

High impact publications (BMJ 2016, Lancet 2015) and other papers

RCOG Greentop guideline Epilepsy in Pregnancy

NHMRC, Australia funding for IPPIC preterm birth prediction IPD meta-analysis

NIHR HTA funding for prediction of fetal growth restriction

SANDS Charity funding for IPPIC stillbirth prediction IPD meta-analysis

1 PhD (completed 2018); 1 MD ongoing

 

3. Global Health: Caesarean section, anaemia, nutrition,sepsis

 

The 3 main streams of our her global health research done within the WHO Collaborating Centre includes:

  • She assessed the safety of caesarean section in LMIC through large meta-analyses (Lancet Global Health 2016) undertook in collaboration with AmmaLife Charity with Prof Coomarasamy. This work was done with collaboration with our Network in India, including Fernandez hospital twinned with Barts Health in UK. 
  • The focus on anaemia in pregnancy is for effective prevention of anaemia and its complications in women and children with iron fish and also with use of intravenous iron. As part of this she has  completed a systematic review (Lancet Global Health 2017), surveys of healthcare professionals and women in India.
  • She leads the i-CIP (International calcium supplementation in pregnancy) network to determine the optimal dose of calcium supplementation for prevention of pre-eclampsia.

Outputs

High impact publications (Lancet Glob Health 2016, 2017, Lancet 2012, 2018) and other papers

1MD, 1 BSc completed

 

 4. Fertility and early pregnancy: ovulation induction, prediction

  • Her current focus is to assess the role of diet and/or myo-insoitol in women with polycystic ovary syndrome for ovulation induction. Her collaboration in this area includes Prof Teede (Australia), Prof Coomarasamy and Prof Arlt (UoB)
  • She is the CI on the TILT trial (1500 women) to determine if embryo selection with Time Lapse Imaging is superior to conventional methods for live birth rates. 

Outputs

High impact publications (BMJ 2012) and other papers

1 PhD completed, 1 PhD ongoing

Publications

High Impact Publications 

 

2014-2018

International Weight Management in Pregnancy (i-WIP) Collaborative Group (Last Author  Thangaratinam S) Effect of diet and physical activity based interventions in pregnancy on gestational weight gain and pregnancy outcomes: meta-analysis of individual participant data from randomised trials. . BMJ. 2017;358:j3119

 

Cheong-See F, Schuit E,…. Thangaratinam S; Global Obstetrics Network (GONet) Collaboration. Prospective risk of stillbirth and neonatal complications in twin pregnancies: systematic review and meta-analysis. BMJ. 2016;354:i4353.

 

Viale L, Allotey J, Cheong-See F, …… Thangaratinam S. Epilepsy in pregnancy and reproductive outcomes. The Lancet. 2015;386(10006):1845-52.

 

Sobhy S, Zamora J, Dharmarajah K,…… Thangaratinam S. Anaesthesia-related maternal mortality in low-income and middle-income countries: a systematic review and meta-analysis. Lancet Glob Health. 2016;4(5):e320-7.

 

Daru J, Zamora J, Fernández-Félix BM…..Thangaratinam S, Khan KS. Risk of maternal mortality in women with severe anaemia during pregnancy and post partum: a multilevel analysis. Lancet Glob Health. 2018;6(5):e548-e554

 

HTA Monographs 

Thangaratinam S, Allotey J, Marlin N et al. Development and validation of a prediction model for the risk of adverse outcomes in women with early onset pre-eclampsia (PREP): Prospective cohort study. Health Technol Assess. 2017;21(18):1-100.

 

Thangaratinam S, Marlin N, Newton S et al. Antiepileptic drug management in pregnancy: A double blind randomised trial on effectiveness and acceptability of monitoring strategies (EMPIRE study). Health Technol Assess. 2018 May;22(23):1-152. 

 

Rogozińska E, Marlin N….., Shakila Thangaratinam. Effects of antenatal diet and physical activity on maternal and fetal outcomes: Individual patient data (IPD) meta-analysis and health economic evaluation. Health Technol Assess. 2017;21(41):1-158

 

2000-2013

Thangaratinam S, Rogozinska E et al. Effects of interventions in pregnancy on maternal weight and obstetric outcomes: meta-analysis of randomised evidence. BMJ.2012;344:e2088.

 

Thangaratinam S, Tan A, Knox E, Kilby MD, Franklyn J, Coomarasamy A. Association of thyroid antibodies with miscarriage and preterm birth: A meta-analysis. BMJ 2011; 342:2616

 

Thangaratinam S, Brown K, Zamora J, Khan KS, Ewer AK. Pulse oximetry screening for critical congenital heart defects (CCHD) in asymptomatic newborn infants: A systematic review and meta analysis involving 229,421 babies. The Lancet 2012.379:2459-2464 

 

Wilson A, Lissauer D, Thangaratinam S, Khan KS, MacArthur C, Coomarasamy A. Clinical officers versus medical doctors for Caesarean surgery in the developing world: A meta-analysis of controlled studies. BMJ 2011; 342:2600

 

Ewer AK, Middleton LJ, Furmston AT, Bhoyar A, Daniels JP, Thangaratinam S, Deeks JJ, Khan KS; PulseOx Study Group. Pulse oximetry screening for congenital heart defects in newborn infants (PulseOx): a test accuracy study. The Lancet. 2011;378(9793):785-94.

 

Thangaratinam S, Rogozińska E, Jolly K, Glinkowski S, Duda W, Borowiack E, Roseboom T, Tomlinson J, Walczak J, Kunz R, Mol BW, Coomarasamy A, Khan KS. Interventions to reduce or prevent obesity in pregnant women: a systematic Review. Health Technol Assess. 2012 Jul;16(31):iii-iv, 1-191


View all Shakila Thangaratinam's Research Publications at: http://www.researchpublications.qmul.ac.uk