To improve detection of fetal growth restriction (FGR)- the leading risk factor for stillbirth- our novel approach to biomarker discovery is to target proteins that are known to be *very highly expressed in placenta*. Proteins highly expressed in the placenta are more likely to have important biological roles, and thus more likely to have altered expression in placental insufficiency. These changes can then be detected with a simple maternal blood test. This approach has already proven successful: we have identified many circulating proteins that are differentially expressed in the blood of mothers carrying a baby destined to be born small. Of these, a little-known protein named SPINT1 may be the best blood marker for a small baby yet reported. We expect to discover more potential biomarkers over the next 5 years, and to bring them together in a multi-marker algorithm to improve detection of FGR. Improving detection of FGR enables closer surveillance and well-timed delivery to reduce stillbirth risk.
