Aris Papageorghiou, Professor of Fetal Medicine and the Clinical Research Director of the Oxford Maternal and Perinatal Health Institute, has joined the BII Women’s Health Innovation Panel.
In the past 25 years, he has worked in women’s health and today, he leads research projects focused on the areas of maternal, fetal, and perinatal health. A major research interest is the use of artificial intelligence in pregnancy imaging and screening, and this has led to the co-founding of the Oxford University spin-out, Intelligent Ultrasound, which makes clinical diagnostics ultrasound easier to learn and simpler to use.
In his encounter with translational research, he found that innovations are more easily and more effectively put into practice through partnerships with commercial companies or initiatives such as the BII which is why it was an easy yes to joining the BII Women’s Health Innovation Panel.
We had a talk with Aris Papageorghiou about his work in this space.
What was your way into women’s health?
My father was a gynecologist and my mother was a pediatrician. In medical school, I was fascinated by obstetrics and how humans develop, and at the same time recognized that women are under-represented in many areas, including in what we know about predicting, diagnosing, and treating pregnancy-related conditions.
Very early on in my career, I started looking at large datasets of populations to understand how we can improve pregnancy outcomes through better screening, better diagnosis, and better treatment. Here, it became obvious to me that there is a huge data gap for the female population. I still work in this area today, and having two daughters motivates me even more.
I believe in trying to fix the problems you see, so I have used my network and connections to do so as much as I can. This includes speaking about it in various forums, becoming an editor of a scientific journal, mobilizing others to do research in women’s health, and nurturing the interest among colleagues and trainees whom I have crossed paths with.
What needs to change?
Disproportional funding and lack of funding are big issues. We shouldn’t take money away from Alzheimer’s, cancer, or diabetes, but it is important to keep in mind that research within women’s health is also very important. It is quite ‘funny’ that we even have an area called women’s health. It is half of the population!
Historically, funding within women’s health – alongside mental health and pediatrics – has been much lower than in other areas, despite the many data gaps to fill. There are data gaps for conditions that affect only women, but also huge gaps in diseases that affect both women and men, but where symptoms, care, and treatment for women are very different.
An example is that the symptoms of a heart attack are predominantly described by what happens in men, so when a woman walks into an emergency room with symptoms of cardiac problems – that are different in women – she is much less likely to be diagnosed correctly than a man is. That is just one example of a data gap that puts women at risk.
How do you experience the change?
Right now, so many things are happening in parallel, and it is not only a focus on women’s health but on other groups that in the past were not considered a priority – such as minority groups and low-income groups. When there is an overlap in these groups – for example disadvantaged pregnant women in low-income settings – data gaps are even bigger.
There is research showing that higher rates of poor pregnancy outcomes or stillbirths among women of African origin often relate to access to care rather than to biology. So apart from research in women’s health, we also need to look at what constitutes risks that can lead to adverse outcomes in e.g. pregnancy. In this case, it was less about race and more about racism. Perhaps not conscious racism but we need to improve the quality of care and provide equal access to care for women in minority groups.
What is on your mind regarding the development in women’s health?
I think we need to consider what is happening globally when planning the next steps in the development of the women’s health space. We are seeing a big shift in power on a global scale so how do we collaborate with the southern and eastern parts of the world? How do we introduce researchers from Ghana, Kenya, and India to BII in Copenhagen and to other northern or western initiatives?
Another big trend to consider is the rapid urbanization of the world. More than half of the world’s population lives in cities now. What does that mean to the rural parts of our population? How do we maintain effective healthcare in these areas? And what implications does it bring for women when we live closely together in big cities, thinking of pandemics for instance?
A third is the insecurity in access to food and water. What happens in families when there is not enough food to go around? Does it affect the children or the father? Historically, it will most likely be the mother that sacrifices food to ensure the well-being of her children; we need to dig into what that means in relation to what we are trying to achieve in women’s health.
Finally, we need to make sure that we merge the big trends in health, such as digital remote care and genomics with women’s health so that they are not only overarching.
The work we are doing at Oxford Maternal and Perinatal Health Institute is a small wave that is contributing to the ripple effect of everything that is coming together globally as a new narrative in society and in academia. Many small waves are emerging and sometimes you don’t recognize the novelty of what you are doing until years later. I think that is what we are seeing now, and I believe we are in the middle of a breakthrough, but that does not mean we can rest on our laurels.