What does a pregnant woman in Yakima have to teach a researcher at St. Louis University? How can a Seattle woman’s healthy, full-term pregnancy impact future pregnancies in Europe or Africa? The answers are closer than you might think.
Over the past seven years, the team at the Global Alliance to Prevent Prematurity and Stillbirth (GAPPS) – an initiative of Seattle Children’s – has worked to increase awareness, collaborations and research in support of their mission to improve the health of moms and babies worldwide.
One big gap (pun intended) the GAPPS team noticed early on was that a collection of widely-accessible, high-quality, pregnancy-related specimens (like cheek swabs, amniotic fluid and cord blood) for researchers didn’t exist. At the time, researchers who needed these types of specimens had to develop their own methods to collect and store them – a time-consuming and costly process.
Enter the GAPPS Repository: a biobank of pregnancy-related specimens that eligible researchers worldwide can access for their research projects.
A small but mighty team built the repository from the ground up and works tirelessly to keep it running.
The lab team, led by Donald Chaffin, GAPPS Repository laboratory manager, creates specimen collection kits, ships kits to collection sites (hospitals), and receives, processes and stores specimens. They also use questionnaires to collect data about the women who participate by providing specimens.
GAPPS Repository by the numbers
So where do these collection kits go? How many specimens are in the repository and who’s using them?
In the research world, sometimes numbers say it best. Below are some of the numbers that tell the GAPPS Repository story.
Since they started collecting specimens in 2009, over 1,600 women have given GAPPS specimens and data throughout their pregnancies.
18 collection kits
The GAPPS team creates 18 different types of kits that are tailor-made for collecting various types of specimens, from blood to placenta to urine. Each kit includes everything the participant’s physician needs to get the specimen: vials, swabs, syringes, punches and more.
Quality checks occur throughout collection kit creation to make sure each kit has all the right pieces. The final check, weighing the full kit, alerts staff that a kit may be missing something.
For example, Rohit Nariya, research associate, noted that a cord blood kit was 4 grams underweight. After carefully inspecting each of the 15 pieces in the kit, Rohit found that the sterile, wrapped syringe was missing the plunger, making the syringe useless.
Each collection kit gets a unique number and barcode that goes on every piece in the kit. Donald says that barcode is important because it tells the team which specimens go together.
For example, when a collection kit includes four vials for blood specimens, each vial is filled with the same woman’s blood. When it’s returned, the GAPPS team knows that those four vials all contain specimens from the same woman. Each item is scanned into the database before it’s sent out and again when the specimen is returned.
3 collection sites
Collection kits are routinely sent to three locations in Washington: Swedish Medical Center, University of Washington Medical Center and Yakima Valley Memorial Hospital. Coordinators at each site enroll pregnant women in the repository. If they agree to participate, the women give specimens and data to the GAPPS Repository throughout their pregnancy.
Each participant is asked to fill out lengthy questionnaires about diet, past pregnancies, environment and more throughout their pregnancy and after delivery. This data is helpful for researchers who are studying, for example, pregnancies in women who eat only vegetarian diets, or who are pregnant for the first time.
The weight capacity of a classic red Radio Flyer wagon that belongs to the GAPPS Repository team. Chaffin, Nariya and Jillian Legard, lab specialist, use the wagon to haul boxes of collection kits from their office to a nearby FedEx store. Nariya scans vials and then adds them to placenta collection kits.
1,745 data points
Chaffin estimates that for each participant, the team will collect about 1,745 data points (through questionnaires, specimens and medical record data). This data gives researchers the information they need to research pregnancy and related maternal and child health outcomes, while still protecting the participants’ identities.
The length of time a specimen can be unaccounted for after collection. After collection, specimens must be properly handled and stored in order to retain their integrity for research. If a specimen’s whereabouts or storage condition is unknown, it cannot be used for research.
15 research studies and publications
Researchers have used specimens from the GAPPS Repository for a wide range of studies – a total of 15 so far. The research must be based on maternal and infant health issues, but Donald says that’s a bigger umbrella of topics than you might think.
For example, many adult-onset diseases like heart disease may begin in utero, so eligible researchers studying adult heart disease may use the GAPPS Repository specimens. Researchers from Children’s, University of California in Los Angeles, Saint Louis University and University of Washington, to name just a few, have all used GAPPS Repository specimens for their studies.
The 1,600 participants have provided more than 50,000 specimens to the GAPPS Repository so far, and 2,000 more come in each month.
The number of collection kits the GAPPS Repository team is creating for INTERBIO-21st, a University of Oxford study that has its own repository, which Chaffin helped them build. So far the team has created and shipped 21,269 of those kits containing a total of 133,602 individual items. Using thorough processes and rigorous quality checks, there have been no errors with those kits.