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Health data science to understand pregnancy intention and reduce maternity disparities (code T1.1_UCL)

Capacity Development

The Opportunity

  • International students are welcome to apply but must secure alternative funding for the difference between UK and Overseas tuition fees.

The Project

Background. Unplanned pregnancy is associated with adverse outcomes (e.g. increased
risk of preterm birth, and low birth weight), yet most evidence is cross-sectional,
retrospective and rarely uses validated measures of pregnancy intention, limiting causal
insight and actionable mitigation strategies. This PhD will use the validated London
Measure of Unplanned Pregnancy (LMUP) captured in routine care to model causal
pathways from preconception health and pregnancy intention to outcomes of
national and patient priority, including preterm birth and gestational diabetes,
thereby informing personalised prevention and support.

Data & setting. We will leverage a unique, multi-site routine dataset (UCLH, Homerton,
St Thomas’s), currently exceeding 35,000 pregnancies, with linked outcomes, and existing
NHS ethics and CAG approvals ensuring there will be no delay to the start of the PhD.
There are no health and safety considerations.

Methods. We will apply modern causal inference methods and explore the integration of
artificial intelligence (AI). This includes exploratory machine-learning models that
complement theory-driven Directed Acyclic Graphs (DAGs) to identify complex relationships
of pregnancy intention, socio-demographic factors, healthcare utilisation and outcomes.
Where free-text booking or clinical notes are available, natural language processing will
extract social/contextual risk factors (e.g., housing insecurity, support networks) not reliably
coded in structured fields, allowing richer adjustment and sensitivity analyses. All models
will incorporate fairness checks and pre-specification, with internal validation and
transparent reporting, and will be interpreted with Theme 1 public contributors and
community partners. These methods will significantly strengthen analytic power and support
future clinical decision-support applications. We will estimate the costs associated with
clinical risk decision pathways using data on secondary care utilisation to update estimates
on the costs of unplanned pregnancy, which are currently 16 years out of date.

Expected impact. This project will clarify how pregnancy intention and preconception
health contribute to adverse outcomes, moving from correlational evidence to
decision-relevant causal pathways that identify modifiable points for intervention and inform
personalisation of care. Outputs will be used to iterate the our intervention providing
targeted support in community/primary care (e.g., tailored preconception advice,
continuity of care for those at higher risk). Updated estimates of the costs of
unplanned pregnancy are vital for our economic evaluation. The harmonised dataset
can be used for additional analyses where causal machine learning can estimate how a risk
might change with intervention for future decision-support.

Contact Supervisor- Jenny Hall: jennifer.hall@ucl.ac.uk

Who is a MDC PhD studentship for? 

We welcome applications from individuals passionate about maternal health equity with particular methodology knowledge and experience. We are committed to building a supportive, inclusive, and caring research community. We particularly encourage applications from: 

Eligibility Criteria

Essential

  • First/Upper Second-Class Honours degree (2:1 or above) in a relevant subject. 
  • A Master’s degree or equivalent in a relevant field. 
  • Understanding of and commitment to tackling maternity inequalities. 
  • Relevant previous research experience – this experience may be relevant to either the research or methodological area. 
  • Excellent written and verbal communication skills. 
  • Highly motivated. 
  • Able to work both independently and as part of a team. 
  • Able to plan and manage own work. 
  • Strong quantitative research skills and experience analysing complex datasets, ideally including routinely collected data.
  • International applicants are welcome to apply for studentships, but applicants who are selected for interview must be able to provide proof of funding for international fees and immigration costs prior to their interview.   
  • English language requirement which can be found on individual university postgraduate admission web pages.

Desirable

  • Experience using statistical software such as R, Stata or Python.
  • Awareness of causal inference methods.
  • AI approaches for health research.
  • Analysis of free text clinical data.

*All students will be expected to be based at their host university and meet the individual university PhD studentship regulations. Please check individual university postgraduate admissions.

Accessibility and Support

NIHR Inequalities Challenge: Maternity Disparities Consortium

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