Rebecca Reynolds

R.Reynolds@ed.ac.uk

My research focuses on understanding the mechanisms linking development in utero to health and disease across the lifespan. My work spans process to population eg experimental medicine studies in pregnant women and their children, detailed mechanistic studies using placental tissue, randomised controlled trials testing interventions in pregnancy to improve outcomes and epidemiological data-linkage studies using ‘big data’ in Scotland.

BIOGRAPHY

Professor Rebecca Reynolds, MA, BM, BCh, PhD, FRCP, FRCPE, studied medicine at Pembroke College, Oxford and graduated from the University of Oxford Medical School in 1992. She worked in Southampton before undertaking research in the Medical Research Council Lifecourse Epidemiology Unit as a Wellcome Trust Entry Level Training Fellow and then moving to Edinburgh as a Wellcome Trust Clinical Research Fellow in 1999. She was awarded a PhD by the University of Edinburgh in 2002 for work on the early life programming of disease. She was appointed Senior Lecturer in Endocrinology and Diabetes and Consultant Physician in 2014 and awarded a Personal Chair as Professor of Metabolic Medicine in 2013.

Rebecca’s main research interest is in the early life origins of health and she was awarded the Nick Hales Award in 2011 by the International Society for the Developmental Origins of Health and Disease and the Curt Richter Award in 2012 by the International Society of Psychoneuronendocrinology in recognition of this work. Rebecca’s clinical work includes general diabetes and endocrinology and specialist clinics in reproductive endocrinology and pregnancy. She set up the antenatal metabolic clinic in 2008 with obstetric colleagues. This clinic manages women with metabolic problems in pregnancy including obesity and gestational diabetes and many women participate in clinical research studies supported by Tommys, the baby charity. Rebecca is Clinical Director of the University of Edinburgh Undergraduate Endocrinology and Diabetes Module and Personal Tutor for Undergraduate Medical Students.

Clinics

General Diabetes
General Endocrinology
Antenatal Metabolic
Reproductive Endocrinology

Hospitals

Royal Infirmary of Edinburgh
Western General Hospital

Why do stress hormones matter in pregnancy?

by Professor Rebecca Reynolds

Stress hormones are vital for life and are particularly important in pregnancy – they are needed for normal fetal growth and development, to mature the fetal lungs. They also play a key role in the timing of labour and delivery of the baby. However the balance is important: our work has shown that either too much or too little maternal stress hormones can have adverse consequences for the baby’s growth and development. Many factors can influence the levels of stress hormones circulating in the mother during pregnancy. These include her own body composition, and her levels of anxiety and/or depressive symptoms as key examples. We have shown that the developing baby is also protected from the mother’s circulating stress hormone levels by an enzyme in the placenta ‘11β-HSD2’ which acts as a barrier, breaking down stress hormones into an inactive form. Importantly the barrier can become leaky, for example with changes in the mother’s diet and also if she experiences anxiety or depressive symptoms during pregnancy. Any leakiness of the barrier will potentially allow too many stress hormones to reach the developing baby with adverse consequences. We know that liquorice contains an active product that inhibits 11β-HSD2. Working with our collaborators in Finland we have followed up children whose mother’s consumption of liquorice in pregnancy was recorded. Liquorice is a popular confectionary in Finland but is also used as a sweetener in many foods that women may perceive as healthy in pregnancy such as herbal teas. We found that the children born to mothers who ate the most liquorice in pregnancy were at increased risk of having behavioural problems in childhood and, when entering adolescence, the girls were heavier and went into puberty earlier than those whose mothers had eaten little liquorice in pregnancy. The Finnish Government have subsequently altered their guidance for pregnant women to advise them to avoid eating liquorice in pregnancy. But are there other ways that we can help? We run a high risk pregnancy clinic and we’ve shown that by regular contact with women and good continuity of care we can improve clinical outcomes – we can speculate this is due to optimising stress levels. We are now testing an on-line intervention ‘Enjoy your Bump’ to see if we can further help women have a less stressful pregnancy and improve outcomes for them and their babies.