DOES TREATMENT REVERSE THE NEUROCOGNITIVE AND CARDIOVASCULAR SEQUELAE OF SLEEP DISORDERED BREATHING IN CHILDREN?
Funder
National Health and Medical Research Council
Funding Amount
$519,826.00
Summary
Studies in children have shown that disruption to normal sleep patterns resulting from sleep disordered breathing (SDB) has severe consequences for both the cardiovascular system and neurocognition. To date there have been no studies in children to investigate whether treatment of SDB with adenotonsillectomy, which has been shown to reduce sleep fragmentation and neurocognition, also reduces blood pressure.
Repeated Prenatal Corticosteroids: Effects On Childhood Development, Behaviour, Growth And Health
Funder
National Health and Medical Research Council
Funding Amount
$718,055.00
Summary
Infants born preterm are at high risk of needing help with their breathing to survive. Corticosteroids given to the mother prior to preterm birth can substantially reduce these risks, although the beneficial effects of these drugs only seem to last seven days. Because of this there has been a tendancy to repeat the dose of prenatal steroids after seven days in women who remain at continued risk of very preterm birth. There has been no formal assessment of whether or not repeating the dose of pre ....Infants born preterm are at high risk of needing help with their breathing to survive. Corticosteroids given to the mother prior to preterm birth can substantially reduce these risks, although the beneficial effects of these drugs only seem to last seven days. Because of this there has been a tendancy to repeat the dose of prenatal steroids after seven days in women who remain at continued risk of very preterm birth. There has been no formal assessment of whether or not repeating the dose of prenatal corticosteroids is beneficial or harmful. In this clinical trial we will test what effect, if any, repeat doses of corticosteroids given to women who remain at risk of pretermbirth, have on children at the age of two years Women are eligible for the trial if at of less than 32 weeks of pregnancy, they have received corticosteroids seven or more days ago, and they are considered to be at continued risk of preterm birth. Women are randomised to one of the two treatment groups. Half the women will receive a weekly intramuscular injection of corticosteroids up to the time of birth or 32 weeks gestation, whichever is earlier, whilst the risk of very preterm birth remains. The other half of the women will receive a saline placebo injection. Chance will decide which treatment the women receives. In this study all children who survive to 2 years corrected age will be assessed to see if they have any problems with their health, growth and development. In particular we will assess how well they can walk, talk, understand, see and hear. The trial will be able to assess whether repeat doses of prenatal corticosteroids are helpful or not for infants at risk of being born very preterm by comparing the short term effects on infant health after birth and whilst in hospital with the effects on the child's later health, growth and development. An economic assessment of repeat doses of prenatal corticosteroids will be made in these children.Read moreRead less
DEVELOPMENT OF CARDIOVASCULAR CONTROL DURING SLEEP IN HUMAN INFANTS AFTER PRETERM BIRTH
Funder
National Health and Medical Research Council
Funding Amount
$358,537.00
Summary
Infants spend the major part of their life in sleep, and the period between birth and 6 months of age sees dramatic changes in their sleep organisation. Coincidently, there are dramatic developmental changes in the infant's heart and blood pressure control systems, and the ability to compensate for stress such as falls of blood pressure (hypotension) or in the level of oxygen in the blood (hypoxaemia). In infants born preterm, the risks of hypoxaemia, and even death are significantly greater dur ....Infants spend the major part of their life in sleep, and the period between birth and 6 months of age sees dramatic changes in their sleep organisation. Coincidently, there are dramatic developmental changes in the infant's heart and blood pressure control systems, and the ability to compensate for stress such as falls of blood pressure (hypotension) or in the level of oxygen in the blood (hypoxaemia). In infants born preterm, the risks of hypoxaemia, and even death are significantly greater during sleep than during wakefulness, but why this is so is uncertain. This study will examine the ability of infants to respond to stress during sleep. Four groups of infants will be examined: healthy infants born at normal gestation; healthy infants born prematurely (preterm); preterm infants who have experienced mild hypoxaemia soon after birth; and preterm infants who have suffered more severe hypoxaemia because of lung disease. Infants will be studied in a sleep laboratory during day-time sleep, and their ability to control blood pressure will be determined. By contrasting the effectiveness of blood pressure control between the infant groups we aim to determine whether preterm infants have lasting problems as a result of their premature birth, or their exposure to hypoxaemia. By contrasting infants in sleep and wakefulness, we aim to assess whether the risks of poorer blood pressure control are greater in sleep.Read moreRead less
Development Of A Rapid, Non-invasive And Biocompatible Bedside Sensing Method For Jaundice Embedded In A Newborn Nappy
Funder
National Health and Medical Research Council
Funding Amount
$541,744.00
Summary
Severe jaundice is a life threatening condition for which an effective screening tool in infants is currently unavailable. There is an urgent need to identify a suitable, reliable and affordable bedside test to positively impact upon the lives of millions of children worldwide by facilitating effective early intervention. This project will validate a non-invasive, affordable bedside test for neonatal jaundice, using a urine test positioned in a newborn’s nappy.
Does Placental Transfusion Prevent Death And Disability In Very Preterm Infants? Childhood Follow Up In The NHMRC Australian Placental Transfusion Study.
Funder
National Health and Medical Research Council
Funding Amount
$889,406.00
Summary
A million babies are born before 30 weeks gestation worldwide each year. Many die or face a lifetime of disability. Enhancing placental transfusion in these infants by deferred clamping of the umbilical cord (DCC) is a simple procedure that may reduce mortality and major disability in childhood. The Australian Placental Transfusion Study (APTS), the largest ever RCT of deferred clamping, will follow up 1200 children born preterm to evaluate if DCC has childhood benefits at 2 years age.
Reducing Morbidities In Preterm Growth Restricted Neonates.
Funder
National Health and Medical Research Council
Funding Amount
$687,214.00
Summary
Intrauterine growth restriction (IUGR) is a serious complication of pregnancy and occurs when fetal growth is abnormal, resulting in a fetus that is smaller than it should be for its given gestational age. IUGR babies are at much greater risk of many short and long-term adverse outcomes. This study investigates the role that adverse cardiovascular development plays in the progression of lung, heart and brain disease in preterm IUGR newborns.
Clinical Trial Of Minimally-invasive Surfactant Therapy
Funder
National Health and Medical Research Council
Funding Amount
$1,172,978.00
Summary
This proposal is for funding of a clinical trial investigating a new and less-invasive technique of giving surfactant to improve lung function in preterm babies born between 25 and 28 weeks gestation. The trial will examine whether giving surfactant using the less invasive method results in better outcomes, including a reduction in time on respiratory support, and higher survival without chronic oxygen dependency.
In What Position Should We Be Sleeping Preterm Infants In The NICU?
Funder
National Health and Medical Research Council
Funding Amount
$409,742.00
Summary
Preterm babies are at risk of brain injury caused by low cerebral blood flow and oxygenation. The prone sleeping position (lying on abdomen) has been found to decrease both cerebral oxygenation and blood pressure in healthy term babies, and is a major risk factor for Sudden Infant Death Syndrome. However, it is common practice for preterm babies to be slept in the prone position.This study will examine the effects of prone vs supine positions on brain oxygenation in the preterm babies.
Childhood Diabetes: Prediction, Prevention And Preservation Of Beta Cells
Funder
National Health and Medical Research Council
Funding Amount
$577,189.00
Summary
Childhood onset type 1 diabetes is a severe life-long disease that has a major impact on the child and their family. While studies have attempted to modify the immune system before or after diagnosis, few clinical trials have recruited young children. The overarching goal of this fellowship is to improve the lives of young people with diabetes, through a multifaceted program of ground-breaking research aimed at prediction, prevention and preservation of insulin producing ?-cells in the pancreas.