PhD Studentship: Can daily deep, slow breathing using a mobile device App reduce obstetric intervention in women with pregnancy-induced hypertension? A feasibility study.

Bournemouth University - Faculty of Health & Social Sciences

Lead Supervisor name: Alison McConnell

Pregnancy induced hypertension (PIH) affects approximately 10% of women and is a major cause of maternal morbidity and mortality worldwide. Prophylactic measures such as calcium and aspirin require further evidence to support routine use, making early detection and treatment the primary approach to managing PIH.

Dysfunctional breathing may play a role in the development of PIH and preeclampsia, by influencing autonomic nervous system balance and baroreflex sensitivity. Furthermore, daily practice of deep slow breathing (DSB) induces chronic antihypertensive effects. This studentship explores a novel method of influencing blood pressure in pregnant women, by using DSB, delivered using a bespoke mobile device App (BU App). Developed by the primary supervisor (AM), and based on fundamental physiological research into cardiorespiratory interactions, the BU App drives breathing dynamically to maximise baroreflex stimulation. It is reasonable to presume that maximising this stimulus will maximise antihypertensive effects of DSB.

This studentship will explore feasibility and efficacy of translating knowledge developed within fundamental physiological research into a clinical setting.

The main study within this PhD project will be a randomised, blinded, placebo controlled (RCT) (DSB vs. placebo).

Secondary, physiological outcomes will provide insights relating to effect size, dose-response and underlying mechanisms, addressing plausibility for sample size calculations for changes in:

  1. Systolic and diastolic blood pressures;
  2. Spontaneous breathing pattern;
  3. Indices of cardiovascular system control, such as heart rate varaibility.

Pre- and post-intervention measurements will occur in a temporary laboratory within Poole Maternity Hospital antenatal clinic (supported by both midwifery and research staff at Poole). Feasibility measures of recruitment and compliance (quantified automatically by the BU App) will be secondary outcomes. Pregnancy outcomes, such as mode of birth, induction, preeclampsia rates, and the need for antihypertensive medication will be collected from women’s records.

Preliminary estimate of effect size for dichotomous outcomes (e.g. primary outcome) will be made using logistic regression and secondary outcomes using analysis of covariance (adjusting for baseline values). Mean within participant changes in secondary outcome measures will be estimated. Associations between compliance and changes in secondary outcome variables, and between spontaneous breathing pattern and cardiovascular function will be summarised using correlation coefficients.

What does the funded studentship include?

Funded candidates will receive a maintenance grant of £14,000 per annum (unless otherwise specified), to cover their living expenses and have their fees waived for 36 months. In addition, research costs, including field work and conference attendance, will be met.

Funded Studentships are open to both UK/EU and International students unless otherwise specified.

Closing date: The first call for applications will close on 15 December 2016.

For further information on how to apply click the ‘Apply’ button below or email pgradmissions@bournemouth.ac.uk.

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Type / Role:

PhD

Location(s):

South West England