How a childhood accident led to groundbreaking paediatric research

4 Jul 2018

Dr Niamh Nowlan of the Department of Bioengineering at Imperial College London. Image: John Millar

Dr Niamh Nowlan of Imperial College London has dedicated her research to finding out what a baby’s movement in the womb means for their skeletal development.

When it comes to scientific breakthroughs, they can sometimes start with a chance occurrence to spark off an idea in a person’s mind.

While Archimedes had his ‘Eureka!’ moment, Dr Niamh Nowlan of Imperial College London (ICL) was inspired to better understand the development of babies in the womb after a childhood accident.

After obtaining an engineering bachelor’s degree and PhD in bioengineering from Trinity College Dublin (TCD), she held two personal fellowships in Ireland and Spain and was a Fulbright Scholar in Boston University.

She joined the Department of Bioengineering at ICL in 2011 and has a number of awards to her name, including the 2016 Bioengineering Society UK Early Career Scientist Award.

Nowlan is set to be a speaker at the World Congress of Biomechanics 2018 event taking place in Dublin from 8 to 12 July. It will be co-hosted by the Royal College of Surgeons in Ireland and TCD in partnership with the Science Foundation Ireland-funded AMBER centre.

What inspired you to become a researcher?

When I was 11, I dislocated my hip and, due to complications, spent the following two years on crutches. I was told then that I would need a hip replacement in about 10 or 15 years, and so my interest in biomedical engineering and orthopaedics began.

Over 25 years and two pregnancies later, my hip is still holding up, so I count myself lucky.

Can you tell us about the research you’re currently working on?

The focus of my group is on how and why the movements of a baby in the womb are important for the development of their bones, joints and spine.

We use computer models, animal models and in vitro culture experimental set-ups to try to understand why babies develop skeletal conditions such as hip dysplasia and congenital scoliosis.

In recent years, we have worked on human foetal data to understand what happens when babies kick in utero, both as the baby grows and when there are factors limiting their movement; for example, when the baby is head up rather than head down.

I manage a fantastic team of PhD students and postdoctoral students from biological, mathematical and engineering backgrounds. There are eight of us including me, from eight different countries.

My research aims to improve diagnosis and ultimately treatment, or even prevention, of paediatric musculoskeletal conditions.

In your opinion, why is your research important?

Musculoskeletal conditions in babies are actually really common, and only a small number of groups are doing research to improve diagnosis or treatment. Hip instability/dysplasia, for example, affects up to one in 100 babies.

While not all of those will go on to need treatment, cases of hip instability cause huge anxiety to parents, and the rationale for treatment – or lack thereof – is not always clear.

When a case of hip dysplasia is missed – which, unfortunately, is not a rare occurrence – the child may need invasive surgery and be at high risk of poor musculoskeletal health in later life.

What commercial applications do you foresee for your research?

My collaborators and I are working on a wearable sensor for foetal movements that will be extremely valuable for monitoring pregnancies where there is some worry or concern about the health of the baby.

Otherwise, I see the main impact of my work as improving diagnosis and treatment of skeletal conditions in babies.

What are some of the biggest challenges you face as a researcher in your field?

The number of people working at the interface between developmental biology, neonatal health and engineering is very small, and this can sometimes mean it can be a bit isolating.

Furthermore, doing research at the boundaries between disciplines can lead to cases of ‘falling between stools’, particularly when it comes to funding.

However, for me, the advantages of doing something that is a bit different far outweigh the negatives.

Are there any common misconceptions about this area of research?

People might think that there is a lot of research going on with prenatal, neonatal and paediatric conditions.

However, research in areas that are related to the ageing population is much more heavily invested in. From an ethical perspective, research involving these vulnerable groups is challenging, although not impossible.

What are some of the areas of research you’d like to see tackled in the years ahead?

I’m very interested in what happens to the bones and joints of babies who are born extremely prematurely, in particular those born earlier than 28 weeks.

They are susceptible to weak bones and, currently, there are no ways to effectively diagnose it before fractures happen, or to treat it. I’m collaborating with neonatologists to address these challenges.