Projects per year
I'm a Senior Lecturer at the MRC Integrative Epidemiology Unit in the Population Health Sciences division of the Bristol Medical School. I started at this department as a postdoc in 2013, following my PhD at the MRC Centre for Reproductive Health at the University of Edinburgh (2010-2013). Prior to that, I completed an MSc in Reproduction and Development at the University of Bristol (2008-2010) and a BSc (hons) in Biology at Cardiff University (2003-2007).
I was born in Bristol and grew up a few miles south in Nailsea.
I'm on Twitter here: @ammegandchips
I'm interested in women's and reproductive health in the context of the big issues facing society. I very much enjoy working collaboratively, so please get in touch if you're also interested in any of the following:
Early life and prenatal influences on child and adult health
I'm interested in how our early environments and experiences can shape our health and wellbeing into adulthood.
Traditionally, research on the developmental origins of health and disease (DOHaD) has focused on the influence of the lifestyle of pregnant women on the health of their children. Although much of the evidence has been correlative (rather than showing robust causal effects), it has been used to back up public health policies and clinical practices that seek to change pregnant women's behaviour. Through my research, I'm trying to improve the causal evidence base in DOHaD by studying potentially causal biological mechanisms (chiefly involving epigenetics) and using genetic and statistical approaches to infer causality. I'm also trying to expand the traditional focus on pregnant women to study paternal factors and the wider social determinants of health as well.
- Through my Exploring Prenatal influences On Childhood Health (EPoCH) study, I'm studying the extent to which paternal and maternal health behaviours might affect the health of children. EPoCH is funded by an MRC New Investigator Research Grant (NIRG) and you can find out more about the study here.
- I lead the University of Bristol's involvement in the NutriPROGRAM project, which is an JPI ERA-HDHL funded project studying the effect of early life nutrition on metabolic health via epigenetic pathways.
- I'm a key member of the Pregnancy and Childhood Epigenetics (PACE) consortium, and I've led three PACE projects (on paternal BMI, maternal alcohol and maternal BMI) and contributed results to many others.
- I'm interested in uncovering, highlighting and addressing various sources of imbalance and bias in the DOHaD field to improve the evidence base and have written about this here and here.
- Some of my research has focused more specifically on particular conditions in children - exploring the early-life causes of these conditions, as well as the consequences. For example, I've led research on the epidemiology of cleft lip and/or palate, which has found that: DNA methylation (epigenetics) may play a role in causing clefts; different types of cleft (cleft lip only, cleft palate only, cleft lip with palate) are potentially caused by different factors, so they should be treated separately in research; children born with a cleft are unlikely to be genetically predisposed to do poorly at school; and children born with a cleft experienced substantial difficulties in the first UK COVID-19 lockdown.
Women's and fetal health in pregnancy
Throughout my career, I've been interested in women's reproductive health. As a masters student on the MSc in Reproduction and Development (which I now co-direct), I was surprised to learn that we still don't fully know why women go into labour when they do. Our limited understanding makes it difficult to predict and prevent pregnancy complications like preterm labour. My PhD was entitled Comprehensive data analysis to study parturition ("parturition" = childbirth). The methods I used were many and varied: through conducting a gene expression microarray study, I showed that labour was likely to be associated with inflammatory events in the myometrium (the muscle layer of the womb); I built a computer model of an inflammatory signalling pathway associated with infection-induced preterm labour; using Scottish health records data, I showed that women whose mothers or grandmothers experienced postpartum haemorrhage (PPH) were not at increased risk of PPH themselves; I conducted a Cochrane systematic review that highlighted the need for further evaluation of the efficacy of fetal assessment methods in improving maternal and neonatal outcomes following preterm prelabour rupture of membranes (PPROM).
I'm interested in the epidemiology of menstrual dysfunction and the impact of menstruation on women's health and quality of life. Current understanding in this area is severely limited, and considering the huge number of people affected, the area is under-researched.
I lead the GW4 Menstrual and Mental Health Research Community, which we established to facilitate collaborative research into how the menstrual cycle interacts with mental health. All community members are based at one of the GW4 universities: Bath, Bristol, Cardiff and Exeter. The association between menstrual and mental health is likely to be extremely complex and multidirectional, involving interactions between genetics, reproductive hormones and other physiological processes, but also environmental factors including lifestyle and social, political and structural influences on health and wellbeing.
I'm also leading several projects exploring data on menstrual experiences in the Avon Longitudinal Study of Parents and Children (ALSPAC). We are interested in identifying environmental, epigenetic and genetic factors associated with experiencing menstrual dysfunctions, as well as the impact of these conditions on women's physical and mental health and quality of life.
Women's health and climate change
My undergraduate education in ecology and zoology cemented my interest and concern for the health of the planet and its inhabitants. I have a burgeoning interest in the concepts of Planetary Health and One Health - i.e. the idea that human health interacts inextricably with the health of natural systems and animals. Climate change is a major threat to global health, but it is also an opportunity to highlight and tackle the social and environmental determinants of health. Climate change is expected to affect men and women differently due to biological, socioeconomic and cultural factors. I'm interested in how climate change can affect women's health, and in identifying co-benefits of strategies to mitigate against climate change and improve women's health. I'm a member of the Bristol Medical School Climate Emergency Action Group and I co-organise a seminar series on climate change and health. I'm also a member of the Bristol Health Partners Supporting Healthy Inclusive Neighbourhood Environments (SHINE) Health Integration Team (HIT).
I teach and lead courses on a range of topics using a variety of methods. I enjoy designing courses, sessions and assessments that are 'constructively alligned', which helps student to meet the intended learning outcomes for the teaching. My sessions are interactive and use a range of media and activities. I particularly like using a 'flipped classroom' approach where students are given some digital material to read/watch/complete in their own time before coming to a live session to participate in interactive discussions and group tasks. My teaching roles include:
- Co-director of the innovative distance learning MSc in Reproduction and Development
- Unit co-lead of Molecular Epidemiology in Non-communicable Disease, part of the MSc in Epidemiology
- Lead of a short course in Epigenetic Epidemiology (2016-2020)
- Project supervisor for the MSc in Epidemiology and the MSc in Reproduction and Development
- Personal tutor for students on the MSc in Public Health and the MSc in Reproduction and Development
Structured keywords and research groupings
- Bristol Population Health Science Institute
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1/06/21 → 30/11/21
3/06/19 → 30/09/22
Azithromycin in patients admitted to hospital with COVID-19 (RECOVERY): a randomised, controlled, open-label, platform trialRECOVERY Collaborative Group, 13 Feb 2021, In: Lancet. 397, 10274, p. 605-612 8 p.
Research output: Contribution to journal › Article (Academic Journal) › peer-reviewOpen AccessFile44 Citations (Scopus)1 Downloads (Pure)
"Environmental risk factors associated with juvenile idiopathic arthritis associated uveitis: a systematic review of the literature"Clarke, S. L. N., Mageean, K. S., Carlton, H., Simonini, G., Sharp, G. C., Relton, C. L. & Ramanan, A. V., 24 May 2021, In: Journal of ophthalmic inflammation and infection. 11, 1, 9 p., 15.
Research output: Contribution to journal › Article (Academic Journal) › peer-reviewOpen AccessFile1 Citation (Scopus)5 Downloads (Pure)
Richmond, R., Sillero Rejon, C., Khouja, J. N., Prince, C., Board, A., Sharp, G. C., Suderman, M. J., Relton, C. L., Munafo, M. R. & Gage, S., Dec 2021, In: Clinical Epigenetics. 13, 1, 13 p., 183.
Research output: Contribution to journal › Article (Academic Journal) › peer-reviewOpen AccessFile