Nuffield Department of Women's & Reproductive Health
Stephen Kennedy, MA (Oxon), MD, MRCOG
Head of Department, Professor of Reproductive Medicine & Co-Director of the Oxford Maternal and Perinatal Health Institute (OMPHI).
In its field, the Nuffield Department of Women’s & Reproductive Health (NDWRH) is one of the largest academic departments in the world. NDWRH encompasses multidisciplinary research across the full spectrum of women’s health. Our work has four overarching themes: Cancer, Global Health, Maternal & Fetal Health and Reproductive Medicine & Genetics. We focus on genetic studies; the dissection of molecular, biochemical and cellular mechanisms underlying normal and aberrant reproductive tissue function; clinical studies in women’s health and pregnancy, and growth and development across the first 1000 days of life (from early pregnancy to age 2).
Our clinical and laboratory programmes are primarily based in the Women’s Centre, John Radcliffe Hospital; Weatherall Institute of Molecular Medicine; Wellcome Trust Centre for Human Genetics, and the Big Data Institute, and there are collaborations with many other University departments, as well as institutions outside Oxford.
Our staff carry out translational research in close collaboration with clinicians in The Women’s Centre. For example, Ahmed Ahmed focuses on understanding the molecular mechanisms that drive the genesis and formation of micrometastases in ovarian cancer and developing novel targeted therapies for the disease. Manu Vatish studies the mechanisms responsible for placentally-derived pregnancy complications such as gestational diabetes and preeclampsia, with a view to producing new diagnostic tools; their work with Roche Diagnostics in preeclampsia recently won the HSJ Best Healthcare Provider Partnership Award. Krina Zondervan, Cecilia Lindgren & Christian Becker work with Bayer AG to identify novel therapeutic targets for benign gynaecological diseases (endometriosis, uterine fibroids and polycystic ovarian syndrome). Antoniya Georgieva is producing innovative automated methods for interpreting the fetal heart trace in labour whilst Aris Papageorghiou, working with Oxford engineers, aims to develop low-cost technologies for fetal ultrasound scanning in low-middle income countries (LMICs).
Many of our observational and interventional studies are conducted in the Oxford Safer Pregnancy Alliance (OSPREA) Unit in the Women’s Centre established with funding from the NIHR Oxford Biomedical Research Centre as a collaboration between the Trust and NDWRH. Its mission is to encourage all pregnant women attending the hospital to contribute to research, training, audit and service development. Adding to our profile, this year, we created The Centre for the Endocrinology of Human Lactation (Director, Fadil Hannan), funded by the Family Larsson-Rosenquist Foundation. The centre will investigate the molecular endocrinology of human lactation in healthy and malnourished women; generate new molecular tools to assess lactation adequacy, and define the lactation-dependent mechanisms regulating maternal and infant health outcomes. The Foundation has also generously agreed to endow a Chair in the subject in perpetuity from 2021.
The department also delivers cutting-edge research in reproductive medicine: new techniques for preimplantation genetic diagnosis (Dagan Wells); immunology of recurrent miscarriage (Ingrid Granne); chronic pelvic pain (Katy Vincent) mitochondrial genetics (Joanna Poulton), and cryopreservation of ovarian and testicular tissue (Suzannah Williams, Kevin Coward). In addition, the Williams Group aims to save the endangered Northern White Rhino by using ovarian tissue to yield large numbers of oocytes for in vitro use.
To complement our activities in reproductive medicine, in 2008, we established an MSc Course in Clinical Embryology, a world-class programme that has won numerous University awards for teaching innovation and excellence. This 1-year taught MSc provides graduates from scientific and clinical backgrounds with advanced theoretical and practical understanding of human reproductive biology, embryology, infertility and assisted reproductive technology (ART). We place great emphasis on ‘hands-on’ practical training in laboratory techniques associated with scientific research, clinical diagnosis and ART. Amongst the 126 graduates from 42 countries, some work as clinical embryologists or for global fertility companies, others are studying for higher degrees in the UK or overseas.
The department has a particular focus on improving maternal and perinatal care globally. Working with clinicians and scientists from 18 countries worldwide, the INTERGROWTH-21st Project (Stephen Kennedy/ José Villar/Aris Papageorghiou) has produced clinical tools for standardising how human growth, nutritional status and development are monitored across the first 1000 days of life. These tools have been adopted by WHO, CDC and countries, such as Brazil, Sri Lanka and Scotland. As importantly, the project has shown that the colour of a woman’s skin plays no role in determining the variation in growth currently seen worldwide, especially in LMICs, compared to the social conditions, health and nutritional state of the population. The failure to recognise this truth is a human rights issue.
To enhance our commitment to women’s health across the world, The George Institute for Global Health (TGI) joined NDWRH in 2016. TGI is a Sydney-based research institute, employing 600+ people globally with units in India and China, and projects in approximately 50 countries. TGI is challenging the status quo in healthcare to find the best ways to prevent and treat non-communicable diseases (NCDs) and injury, and to influence policy and practice worldwide. An early example of our work together is SmartHealth Pregnancy (Jane Hirst, Robyn Norton), a tablet-based clinical decision support system in antenatal and postnatal care for use by rural healthcare workers in India.
Reflecting our broader interests in the life-course of women, in December 2017, on the 80th anniversary of our establishment as a University department, we changed our name, through an extensive democratic process, to NDWRH from the more limited Nuffield Department of Obstetrics & Gynaecology.
Together, NDWRH and TGI UK plan to establish an Institute for Global Women’s Health (IGWH) in a new, purpose-built facility (for which we need to raise £50 million) that will serve as a national and international hub for efforts to develop effective, affordable solutions for the major health issues facing women and girls worldwide, and train future leaders in the areas of research and sustainable development relating to the health of women and girls.
The IGWH will bring together world-leading biomedical, social and data scientists with complementary strengths and extensive global networks, with an initial focus on four priority areas that span the life course, which builds on our current respective strengths: 1) Transforming the management of pregnancy; 2) Earlier detection and treatment of gynaecological diseases (including cancer); 3) Enhancing the knowledge base on human lactation and its relationship to future disease, and 4) Reducing the burden of cardiometabolic diseases in women.
Lastly, the department is intensely proud of its Silver Athena SWAN Award. We have spearheaded a range of innovations, including: a) a new suggestion for improvements scheme (Brainwaves) and engagement platform (Peakon); b) refurbishment of departmental space (Project Rejuvenation), and c) most importantly, a commitment to tackle some of the challenges facing the HE sector, namely short-term contracts and limited career development opportunities for postdocs. The changes already introduced have generated greater satisfaction, as evidenced by our staff surveys, and influenced everyone’s approach to the important issues that affect both women and men, particularly gender equality, work-life balance and the working environment. As a result, the department is an exciting place to work with a clear, ambitious mission to improve the health of women and girls globally.
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