Dr. Fiona L R Williams

Head of Division, Reader, Developmental Epidemiology Course Director Master of Public Health

Understanding neurodevelopment, particularly in relation to thyroid function in preterm infants

Address:

Population Health Sciences
School of Medicine
The Mackenzie Building
University of Dundee
Kirsty Semple Way
Dundee DD2 4BF

Phone Number:

+(44) 01382 420117

Email Address:

f.l.r.williams@dundee.ac.uk

Biography

During her career Dr Williams has focussed on two major research themes: environmental epidemiology and developmental epidemiology.

From 1983-1999 environmental epidemiology was the major research focus, and the overall theme was monitoring the environment and evaluating the impact on health of residential exposure to point sources of airborne pollution.  During this period Dr Williams was involved in several environmental epidemiology studies within Scotland, which contributed new methodologies for assessing the impact of the environment on health. During this period Dr Williams became a member (by election) of The Royal Environmental Health Institute of Scotland, MREHIS, and an honorary Member of the Faculty of Public Health, HonMFPH.

From 1997 she has focussed on the influences of specific conditions which impact on human postnatal brain development.  Currently Dr Williams’ work is examining the impact of iodine deficiency and iodine toxicity on human brain development.

Research

Dr Williams leads the Human Brain Development group, which is focused on early brain development. The overarching research aim is to optimise neurodevelopmental outcome of infants through the development of a range of preventative approaches. The research design we have developed to support our programme of work is integrated, international, inter-disciplinary and translational, and reflects the concept that prevention of cerebral damage comes from applications of the metabolic and molecular bases of human development.

The Group’s current research is centred on one established (the Millennium) and two developing (I2S2 and I2XS) cohorts of preterm infants.  The Millennium cohort is the largest cohort worldwide for which there is substantial intrapartum and postpartum information on thyroid hormone metabolism and clinical management.  The neurodevelopmental status of this cohort was assessed in 2005-8.  The investigation of the Millennium cohort led to the hypothesis that neonatal transient hypothyroxinaemia may be exacerbated by iodine deficiency; a hypothesis which was tested by the I2S2 trial of iodine supplementation of extreme preterm infants.  This was a large, MRC/NIHR-EME funded trial which recruited 1275 neonates who were followed up at two years of age.  The trial completed in June 2015 and the data are currently being analysed and written up.

Publications

Selected publications

  1. Williams FLR, Watson J, Day C, Soe A, Somisetty SK, Jackson L, Velten E, Boelen A. Thyroid dysfunction in preterm neonates exposed to iodine.  J Perinatal Med (in press)
  2. Koh DKM, Hume R, Eisenhofer G, Watson J, Williams FLR,   Arterio-venous differences in Metabolic and hormonal responses in the regulation of neonatal blood glucose levels. J Perinatal Med 2016 (in press)
  3. Khalid R, Willatts P Williams FLRDo studies reporting infant neurodevelopment adjust for the variability of assessors? Dev Med Child Neurol: 2016;58:131–137.
  4. Koh DKM, Hume R, Eisenhofer G, Ogston SA, Watson J, Williams FLRMaternal and fetal factors which influence cord blood glucose levels in term infants delivered by caesarean section.  J Perinatal Med 2015;43:339-346. doi: 10.1515/jpm-2014-0067
  5. Williams FLR, Hume R, Ogston SA, Morgan K, Brocklehurst P, Juszczak E.  A summary of the iodine supplementation study protocol (I2S2); a UK multicentre randomised controlled trial in preterm infants.  Neonatology 2014;105:282-289 doi:10.1159/000358247
  6. Aitken J, Williams FLR.  A systematic review of thyroid function in preterm neonates exposed to topical iodine. Archives Disease Childhood Fetal and Neonatal Edition. 2014;99:F21-F28. doi:10.1136/archdischild-2013-303799
  7. Williams FLR, Delahunty C, Cheetham T.  Factors affecting neonatal thyroid function in preterm infants, NeoReviews 2013: doi: 10.1542/neo.14-4-e168
  8. Williams FLR, Watson J, Ogston SA, Visser TJ, Hume R, Willatts P. Maternal and umbilical cord levels of T4, TSH, TPOAb and TGAb in term infants and neurodevelopmental outcome at 5½ years. J Clin Endocrinol Metab  2013;98:829-838
  9. Williams FLR, Watson J, Ogston SA, Hume R, Willatts P, Visser TJ and the Scottish Preterm Thyroid Group.  Mild maternal thyroid dysfunction at delivery of infants born ≤34 weeks and neurodevelopmental outcome at 5.5 years.  J Clin Endocrinol Metab  2012: 97: 1977-1985   
  10. Williams FLR, Hume R.  The measurement, definition, aetiology and clinical consequences of neonatal transient hypothyroxinaemia.  Ann Clin Biochem 2011;48:7-22
  11. Delahunty C, Falconer S, Hume R, Jackson L, Midgley P, Mirfield M, Ogston S, Perra O, Simpson J, Watson J, Willatts P, Williams FLR and the Scottish Preterm Thyroid Group.  Levels of neonatal thyroid hormone in preterm infants and neurodevelopmental outcome at 5½ years: Millennium cohort study.  J Clin Endocrinol Metab  2010;95:4898-4908  

Teaching

Public Health has offered the Master of Public Health (MPH) for 30+years.  The degree lasts for 12 months with 8 months of taught classes and 4 months of research which leads to a dissertation.  In 2014 she developed the MPH-plus, which facilitates the support or development of additional courses based on core modules from the MPH.  The MPH-plus currently consists of:

·         Public Health Dentistry

·         Human Clinical Embryology & Assisted Conception;

·         collaborations with Tianjin Medical University and Wuhan University students, who complete a non-graduating first year followed by a second year MRes by Research. 

·         MPH (Palliative Care Research). 

·         And we host several modules as part of the MSc Stratified Medicine and Pharmacological Innovation (SMPI) programme.

All of the courses are accredited under the Scottish Credit Qualification Framework.

Between 1996 to 2016 Dr Williams was the course Director for the Master of Public Health (MPH); module leader for applied epidemiology, preparation for the dissertation, and the dissertation module; and supervised dissertations.  From 2009-2013 she was one of the external examiners for the MPH, University of Glasgow

PhD Supervision

Adel Dairi (2000) Co-supervision with Charles Florey; PhD Title “Low back pain in nurses in Bahrain”

Lesley Jackson (2003)  Co-supervision with Robert Hume; MD Title "The regulation of glucose homeostasis in infants"

Judith Simpson (2003)  Co-supervision with Robert Hume; MD Title “A multi-centre study of transient hypothyroxinaemia in the premature infant”

Caroline Delahunty (2005)  Co-supervision with Robert Hume; MD Title “A pilot study of transient hypothyroxinaemia in the premature infant”

Panos Papapreponis (2009). 1st supervisor; PhD Title “Residential exposure to low levels of air pollution from municipal waste incineration and potential subtle changes in health status”

Conferences

European Thyroid Association, ETA,  39th Annual Meeting, Copenhagen 2016 3-6 September

Verbal presentation: A randomized trial of iodide supplementation versus placebo in preterm infants (selected as a topic highlight).

Poster presentation:  A comparison of levels of T4 and TSH from whole blood on filter paper and in serum.

European Society for Paediatric Gastroenterology, Hepatology and Nutrition, ESPGHAN Conference: 49th International meeting, Athens, Greece, 2016

Verbal invited presentation: Iodide supplementation and parenteral nutrition

NEONATAL UPDATE 2015 “the science of newborn care” 30 November - 4 December 2015

Verbal invited presentation : Iodine supplementation in preterm infants

Perinatal Medicine, Harrogate 9-11th June 2014

 

Verbal presentation:  Neonatal thyroid function and the use of povidone-iodine and iodinated contrast media during labour and the postnatal period: a pilot study