Perinatal Outcomes Following Treatment For Cervical Dysplasia
Funder
National Health and Medical Research Council
Funding Amount
$98,600.00
Summary
A very high proportion of women in Australia have regular cervical screening ('pap' tests) for early detection of any early abnormal changes of the cervix. Women with abnormalities are referred for further investigation and some go on to have the areas with abnormalities treated either by surgical removal of small amounts of tissue or by other heat or laser treatments of affected areas. Many women having these treatments are of child-bearing age and may not have had children, or may seek to have ....A very high proportion of women in Australia have regular cervical screening ('pap' tests) for early detection of any early abnormal changes of the cervix. Women with abnormalities are referred for further investigation and some go on to have the areas with abnormalities treated either by surgical removal of small amounts of tissue or by other heat or laser treatments of affected areas. Many women having these treatments are of child-bearing age and may not have had children, or may seek to have more children after treatment. There are unanswered questions about the extent to which any or all of these treatments might, by changes to the cervix, lead to preterm birth in any subsequent pregnancy. In the proposed study, records relating to women referred from 1982 to 2000 for assessment and possible treatment of cervical abnormalities at a major hospital will be linked to Victorian birth records from 1983 to 2001. This will allow a comparison of preterm birth in the group of women referred with cervical abnormalities, with preterm births in the Victorian population, and comparing women who do and don't have treatment, taking into account other important factors such as the mother's age, and her previous pregnancies. The information will be of value to women themselves, to gynaecologists and to screening services.Read moreRead less
The starting point for this project is the recent finding that women who experience miscarriages or terminations of pregnancy before theuir first birth have an increased risk of having a preterm (premature) infant. These findings have prompted a re-evaluation of the relationship between the number of pregnancies a women has had and the likely outcome in later pregnancies. It will take into account the stage at which prior pregnancies ended, what the outcomes of the pregnancies were (birth, healt ....The starting point for this project is the recent finding that women who experience miscarriages or terminations of pregnancy before theuir first birth have an increased risk of having a preterm (premature) infant. These findings have prompted a re-evaluation of the relationship between the number of pregnancies a women has had and the likely outcome in later pregnancies. It will take into account the stage at which prior pregnancies ended, what the outcomes of the pregnancies were (birth, health baby, death, baby with a birth defect, termination, miscarriage etc), as well as factors such as maternal age, in relation to the risks in subsequent pregnancies. The expected outcomes and significance of the study are: * new evidence about factors causing adverse outcomes of pregnancy; * better information on the risk of recuurence of common birth defects; * more precise information on risks of adverse pregnancy outcomes for users and planners of maternity services.Read moreRead less
Antiplatelets For Prevention Of Pre-eclampsia: An Individual Patient Data Review
Funder
National Health and Medical Research Council
Funding Amount
$274,000.00
Summary
High blood pressure is a common complication of pregnancy affecting ~20,000 Australian women each year. Although most women and their babies do well, pre-eclampsia, defined as high blood pressure together with protein in the urine is a more serious problem. Severe pre-eclampsia is associated with 10-15% of maternal deaths. Fetal and newborn baby deaths are also increased. Mother and baby morbidity is high principally due to the associated complications in pregnancy, increased obstetric intervent ....High blood pressure is a common complication of pregnancy affecting ~20,000 Australian women each year. Although most women and their babies do well, pre-eclampsia, defined as high blood pressure together with protein in the urine is a more serious problem. Severe pre-eclampsia is associated with 10-15% of maternal deaths. Fetal and newborn baby deaths are also increased. Mother and baby morbidity is high principally due to the associated complications in pregnancy, increased obstetric interventions, fetal growth restriction and preterm birth. As yet we have no safe and effective way of preventing this life threatening condition. Aggregation of platelets (involved in blood clotting) is known to be part of the disease and could lead to the disturbances in the circulation of the mother and the placenta. Antiplatelet agents, low dose aspirin in particular, might prevent or delay the development of pre-eclampsia. Some trials and a Cochrane systematic review of all trials (involving over 30,000 women) suggest that pre-eclampsia, preterm birth and perinatal death could be reduced. However, it is still not clear which women will benefit, when in pregnancy the treatment should start and what dose of aspirin is both effective and safe. This proposed individual patient data review in which data on all women who have been entered in trials is gathered from the original investigators, including missing information on potential harms. This proposal represents a good investment of resources to obtain the information needed by women and health professional to make decisions about the use of aspirin. International investigators from all the primary trials have already formed a collaboration to oversee the project: the Perinatal Antiplatelet Review of International Studies (PARIS) Collaboration Furthermore, working through an international collaboration will ensure the highest quality in data availability, as well endorsement and implementation of the results in practice.Read moreRead less