My name is Dr. Erin McGillick and I am a fetal and neonatal physiology Research Fellow at the Hudson Institute of Medical Research and Monash University. I am also currently a director of the Australian Society for Medical Research.
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We Rep STEM aims to promote the work of inspiring people in the STEM community. Today, we’re featuring Dr. Erin McGillick.
Read on to learn more about Dr. McGillick and what her work entails, in her own words.
My name is Dr. Erin McGillick and I am a fetal and neonatal physiology Research Fellow at the Hudson Institute of Medical Research and Monash University. I am also currently a director of the Australian Society for Medical Research. My research is focussed at the molecular, structural and functional physiology level to understand factors that control fetal lung development and how pregnancy complications affect the transition to air-breathing at birth. The goal of my research is to find the most effective ways to help compromised babies successfully transition from fetal to newborn life.
1. The fetal lung undergoes 5 different phases of growth during pregnancy. First, the large airways develop and then branch into smaller generations like the limbs of a tree getting smaller at each series of branches. As the airways grow, the lung tissue becomes thinner and blood vessels develop to prepare for gas exchange after birth. One of the most important steps occurs late in pregnancy when specialised lung cells begin to produce a detergent-like substance called surfactant. Surfactant is a mix of proteins (10%) and an oily compound called lipids (90%) which coats the small airways to help reduce surface tension and prevent them from collapsing between breaths in the air-breathing lung. The final phase of lung development involves growth of the smallest airways, the alveoli, which look just like a bunch of grapes! Even when babies are born at term, the lung has not finished growing. There are less than 20 million alveoli present in the newborn lung and this number will continue to increase approximately 90% over the first 1-2 years of life.
2. During pregnancy, the fetal lungs are filled with liquid as the placenta plays the role of gas exchange. Inside the womb, the fetal lungs are filled with liquid which helps them to grow correctly. The liquid can be secreted from lung cells into the developing airways from early pregnancy and the amount of lung liquid increases during pregnancy to around 35-45mL per kilogram of body weight at the end of pregnancy. While the placenta plays the role of gas exchange, the fetus has breathing movements which are like practice breaths caused by rhythmic contractions of the respiratory muscles and these are important for lung development. Pregnancy complications can affect function of the placenta (reducing the amount of oxygen and nutrients delivered to a fetus) or can cause too much or too little liquid in the growing lungs. In both cases, these alterations can affect lung development at the molecular and structural level which can increase the risk of the newborn experiencing respiratory complications at birth. My research has focused on understanding how preterm birth, diabetes in pregnancy (gestational diabetes), maternal obesity, intrauterine growth restriction and lung hypoplasia (small and under-developed lungs) affect lung growth and function.
3. The transition at birth from the liquid-filled fetal environment to the air-breathing newborn is the biggest physiological challenge a person will face in their lifetime. At birth, the fetal lung liquid must be cleared and the lung must rapidly take over the role of gas exchange from the placenta when the umbilical cord is clamped. During the first phase of the transition at birth, lung liquid is rapidly cleared from the airways into the lung tissue due to the pressure generated when air enters the lungs during the first breaths. The second critical step occurs in response to the clearance of lung liquid and results in a 90% increase in blood flowing to the newborn lungs as the heart takes over the role of pumping all of the blood to the lungs to be oxygenated (rather than the placenta providing the majority of oxygenated blood). The third phase involves clearance of lung liquid from the lung tissue over the first 4-6 hours after birth. Approximately 1 in 5 newborns need some assistance to help make the transition at birth. Supportive strategies provided in the delivery room help to make the transition from the fetal to newborn life successful for babies to reduce the risk of complications that can affect their brains, heart, and lungs. As part of my research, I have had the opportunity to work in the neonatal intensive care unit as part of an international clinical trial team working to improve oxygenation to allow a quicker transition to air-breathing at birth in premature babies.
4. Biomedical imaging using a synchrotron can visualise the first breaths and see down to the smallest airways in a newborn lung. A synchrotron is a large machine that accelerates electrons close to the speed of light and produces X-rays that are a million times brighter than the sun. The X-rays can be directed using magnetic fields into beamline experimental work stations to conduct imaging. The specialised X-rays generated by a synchrotron have helped advance medical research by allowing us to see things that are smaller than any other type of imaging can visualise. The acquisition of video-speed imaging has allowed a greater understanding of biological processes that have helped improve outcomes worldwide. My team’s research involves physiologists, physicists, clinicians and synchrotron scientists working together using this technology to find ways to help make the transition from fetal to newborn life more successful. My current work is focussed on using this technology to understand how being born with a greater volume of liquid in the airways leads to respiratory distress in near-term newborns, with this new knowledge we aim to better target interventions to improve outcomes.
5. Greater understanding of fetal and newborn physiology is the key to finding the most effective ways to improve outcomes for complicated pregnancies. Advances in our understanding of physiological factors controlling the transition from fetal to newborn life have led to major advances in care for the most vulnerable babies at birth. Ongoing work is focussed on (1) understanding the normal processes and (2) how different pregnancy complications affect the transition at birth leading to poorer outcomes. This new knowledge can identify the most effective ways to provide support to newborns and intervene as early as possible. The ultimate goal of our work is towards preventing or recognising and treating the complications more quickly to improve outcomes both at birth and in later life.
As a research fellow, I have had the incredible privilege to meet and work with many wonderful people from all around the world. Celebrating and acknowledging the wonderful diversity of people, their identities and backgrounds is a strength of the research community.
It is critically important to foster an environment that promotes acceptance and inclusivity for all people, where they feel supported and can be their authentic selves, both personally as well as professionally. It is our diversity that allows us to bring together a wide variety of ideas and perspectives to answer important questions.
Connect with Dr. McGillick on Twitter (@lung_queen).
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Photos courtesy of Erin McGillick.
