Adaptation to fetal deprivation and the programming of cardiometabolic disease
Although developmental plasticity and fetal adaptation to in utero adversity may be beneficial for immediate survival, fetal growth restriction (FGR) in response to deprivation occurs at the expense of cardiorespiratory development and metabolic competence. Fetal hypoxia is a common factor in complicated pregnancies with placental aetiologies and pathological processes which compromise fetal blood supply, such as that seen in uteroplacental insufficiency, and has been shown to programme postnatal cardiometabolic disease. There are currently no interventions which improve clinical outcomes in the growth-restricted offspring. Increased risk of perinatal morbidity and mortality, and a predisposition to the development of chronic disease in later life suggest that the most appropriate time to intervene in order to improve the health status of the in utero growth-restricted individual is prior to the development of postnatal complications. Dr Spiroski’s expertise integrates interdisciplinary methods, from molecular biology to systems physiology, to investigate novel fetal interventions to prevent developmental programming of chronic disease.
Mitochondrial contribution to the fetal programming of cardiometabolic disease
Abnormal mitochondrial function is associated with pathophysiologic development and dismal outcomes in cardiovascular and metabolic disease. Dr Spiroski’s interest in the mitochondrial contribution to fetal programming of postnatal disease currently focusses on investigating metabolic pathways associated with mechanistic adaptation to in utero hypoxia, and intervention with novel therapies. At the cellular and molecular level Dr Spiroski investigates the regulation of energy metabolism and mitochondrial biogenesis associated with prenatally programmed cardiometabolic disease states.
Postnatal physiological function following fetal deprivation and novel prenatal therapies
Assessment of physiologic function enables the elucidation of systemic adaptations to fetal deprivation and therapeutic interventions throughout the lifespan. Dr Spiroski specialises in the in vivo assessment of postnatal physiological function in various paradigms of fetal deprivation. She currently utilises various cardiometabolic assessment techniques, and high-frequency ultrasound echocardiography with colour Doppler imaging to enable non-invasive quantitative assessment of cardiovascular function in vivo.
Spiroski AM, Oliver MH, Harding JE, Bloomfield FH, (2016), Intrauterine intervention for the treatment of fetal growth restriction, Current Pediatric Reviews, (in press)
Bay JL, Spiroski AM, Fogg-Rogers L, McCann CM, Faull RL, Barber PA, (2015), Stroke awareness and knowledge in an urban New Zealand population, Journal of Stroke and Cerebrovascular Disease, 24(6):1153-62
Bloomfield FH, Spiroski AM, Harding JE, (2013), Fetal growth factors and fetal nutrition, Seminars in Fetal and Neonatal Medicine, 18; 3: 118-123