Southampton Academy of Research

Dr Linden Stocker is a Foetal Maternal Medicine Consultant at University Hospital Southampton (UHS) and holder of a Research Leaders Programme (RLP) award.

Her research focuses on how circadian rhythm affects reproduction and pregnancy outcomes.

Studying sleep and fertility

In her clinical role, as well as delivering babies, Linden diagnoses and manages complex problems that might affect a baby before birth. She also looks after women who have pre-existing medical problems, or ones that develop during pregnancy, who might need special plans or medications to manage their condition while pregnant.

During her specialist training, Linden split her time between her clinical work and her research. She completed a PhD and then took up an NIHR Clinical Lectureship. Following this she completed subspeciality training in Leeds and commenced an MSc in genomics.

Her research during this time focused on how the sleep-wake cycle affected early pregnancy. She found shift workers had higher rates of menstrual disruption, early miscarriage and subfertility.

She did laboratory research, investigating the womb lining. She showed women with poor sleep were more likely to have problems with implantation – the very first stage of pregnancy, where the fertilised egg sticks to the wall of the womb.

Linden has also investigated how the same genes could affect both a woman’s internal body clock, or circadian rhythm, and her chances of getting pregnant.

“Your circadian rhythm and your sleep-wake cycle is partly governed by a set of genes we all have called clock genes,” she explains. “We know that different disruptions or genetic variations in those genes cause you to have a different circadian rhythm.

“Therefore, I was looking at whether those disrupted genes, which cause poor circadian rhythm, impacted on reproductive outcomes. And I think there is a link.”

Investigating women’s body clock

For her RLP award, Linden will investigate the relationship between a woman’s circadian rhythm and the health of the mother and unborn baby, or foetus, in later pregnancy.

“Very little is known about how your circadian rhythm affects pregnancy, and very little is known about when and how circadian rhythm develops in a foetus,” she says, “These are very difficult things to study, but knowing more about how a pregnant woman’s circadian rhythm can impact on pregnancy outcomes is important to help prevent and treat pregnancy-specific conditions.”

She plans to look at what a normal circadian rhythm looks like in pregnant women, and how diverging from this might affect a woman’s ability to get pregnant.

Using big genetic datasets, she intends to investigate how variations in genes linked to sleep in the mother could affect the baby’s birthweight.

She also plans to measure changes in women’s blood pressure at different times of day, as this is known to follow our circadian rhythm. This could have important implications for the times of day that people are advised to take their medication.

Forming new collaborations

One of the main reasons Linden joined the RLP was to meet and learn from other, more experienced, researchers at the Trust.

“I’m very aware that you can’t do anything in research alone, and it involves a lot of collaboration,” she explains, “so I really want help and mentorship from the more experienced researchers at UHS.”

She was also attracted by the ring-fenced time to plan and run studies, and to apply for funding so that she can continue to pursue her valuable research in the future.

“No one thinks that going to sleep at night is important, and it is, it’s very important,” she says. “I don’t think there’s an appreciation of the fact that it’s not just something that we do.”