Centre For Clinical Research Excellence In Newborn Medicine
Funder
National Health and Medical Research Council
Funding Amount
$2,519,475.00
Summary
The Centre for Clinical Research Excellence in Newborn Medicine will study adverse outcomes for the brains and lungs of newborn babies; it will establish how often these occur in different types of babies (ranging from very premature babies, through to those born on time), investigate the different causes, develop treatments to either prevent or treat the adverse outcomes, determine the long-term consequences into adulthood, and continually re-evaluate the effectiveness of the various treatment ....The Centre for Clinical Research Excellence in Newborn Medicine will study adverse outcomes for the brains and lungs of newborn babies; it will establish how often these occur in different types of babies (ranging from very premature babies, through to those born on time), investigate the different causes, develop treatments to either prevent or treat the adverse outcomes, determine the long-term consequences into adulthood, and continually re-evaluate the effectiveness of the various treatment strategies designed to improve the health outcomes for newborn babies.Read moreRead less
Optimising The Motor Outcomes Of Infants With Cerebral Palsy Using Environmental And Goal Oriented Interventions
Funder
National Health and Medical Research Council
Funding Amount
$116,563.00
Summary
Cerebral palsy is the most common physical disability in childhood. Early diagnosis enables intervention when the brain is developing. Current early intervention has little impact on movement. This research tests the effectiveness of “goal-directed training” and enriched environments by: systematically reviewing literature, piloting the intervention, conducting a clinical trial and interviewing parents. Findings have the potential to improve the outcomes of the 700 new cases diagnosed each year.
The Effect Of Very Premature Birth On Brain Development
Funder
National Health and Medical Research Council
Funding Amount
$517,975.00
Summary
The neurological outcome of the premature infant is of major importance. Approximately 2,600 premature infants weighing less than 1500 grams are born annually in Australasia. Of the approximate 2,400 survivors between 5-15% will have a more major cerebral palsy, i.e. around 200 children per annum. A greater proportion of 25-50%, i.e., upto 1200 children will have a developmental disability that will adversely affect their school perfomance requiring special assistance or repeating grades. With a ....The neurological outcome of the premature infant is of major importance. Approximately 2,600 premature infants weighing less than 1500 grams are born annually in Australasia. Of the approximate 2,400 survivors between 5-15% will have a more major cerebral palsy, i.e. around 200 children per annum. A greater proportion of 25-50%, i.e., upto 1200 children will have a developmental disability that will adversely affect their school perfomance requiring special assistance or repeating grades. With an increasing number of very prematurely born infants surviving, the absolute number of affected children will continue to rise. Prevention of these disabilities will require an understanding of the cause. The educational and social implications of these high rates of neuro-developmental disability are enormous and the focus of wide international concern. Magnetic Resonance Imaging : It is a major challenge for neonatologists to be able to understand the impact of their therapies and managements on the developing brain. A window into the newborn brain can be seen utilising advanced magnetic resonance imaging techniques in-vivo to investigate these key issues: 1. What is the nature of brain injury in the prematurely born infant? 2. What are the risk factors for brain injury in the prematurely born infant - and are they able to be altered to reduce this risk - e.g. blood pressure management, steroid therapy 3. Is the brain of a prematurely born infant different from that of a full term born infant at TERM equivalent - if so, how is it different? 4. Are there certain postnatal therapies that relate to any alteration in brain structure and chemistry - e.g. postnatal nutrition, modes of ventilation, pharmacological therapies? 5. How does the brain structure relate to function on long term neuro-developmental follow up of our infants at 2 years?Read moreRead less
Improving The Outcome Of Premature Infants- A Randomised Trial Of Preventive Care At Home
Funder
National Health and Medical Research Council
Funding Amount
$633,375.00
Summary
The high rate of adverse neurodevelopmental outcomes of very premature infants is of major concern. In Australia there are approximately 2600 very low birthweight (VLBW, birthweight <1500 g) or very premature (<30 weeks' gestational age) survivors per annum. A large proportion of these infants (40%-50%) will later develop motor incoordination, cognitive impairment, attention deficits or behavioural problems (up to 1300 new cases per year). There is little research to test the efficacy of e ....The high rate of adverse neurodevelopmental outcomes of very premature infants is of major concern. In Australia there are approximately 2600 very low birthweight (VLBW, birthweight <1500 g) or very premature (<30 weeks' gestational age) survivors per annum. A large proportion of these infants (40%-50%) will later develop motor incoordination, cognitive impairment, attention deficits or behavioural problems (up to 1300 new cases per year). There is little research to test the efficacy of early preventive care programs geared to changing the infant's environment (physical management, behavioural regulation, maternal factors). In the proposed study we aim to use a low cost preventive care program at home conducted by physiotherapists and psychologists that has been shown to have utility and efficacy in pilot work, with follow up until 2 years of age. In subsequent studies we would aim to follow this cohort to school age, to determine if there are any lasting benefits of early intervention accompanied by measures of brain growth and structural development using advanced imaging techniques. Any new health care program should result not only in improvements in health, but should be affordable to implement so an economic evaluation will also be undertaken. This study will also utilise novel and advanced MRI brain imaging techniques to understand the complex interaction between brain injury and altered brain development in these infants with the risk and the repsonse to this program of care. In this way the changes in brain connectivity, structure and biochemistry can be formally defined to undertsnad the pathway of any potential benefit from this program.Read moreRead less
Does Antenatal Magnesium Sulphate Given To Women At Risk Of Preterm Birth Between 30 And 34 Weeks' Gestation Reduce The Risk Of Death Or Cerebral Palsy In Their Children? - A Randomised Controlled Trial
Funder
National Health and Medical Research Council
Funding Amount
$1,978,760.00
Summary
Antenatal magnesium sulphate is recommended prior to preterm birth at less than 30 weeks’ gestation. Whether there are benefits at later gestations is uncertain. This study is assessing whether magnesium sulphate given to women at risk of very preterm birth between 30 to 34 weeks’ gestation increases the chance of their baby surviving without cerebral palsy.
Early Identification Of Infants Who Will Benefit From Neural Rescue Treatment
Funder
National Health and Medical Research Council
Funding Amount
$206,320.00
Summary
Lack of oxygen supply before, during or immediately after birth can lead to severe disability or death. This occurs in about 1 in every 500 births and is one of the most important but unsolved problems in pediatrics. The costs (financial and other) to both the individuals involved, and the community in general, is very high. However the outlook for those affected by this condition is improving. Recent research has focused on the development of neural rescue therapies, which may decrease the exte ....Lack of oxygen supply before, during or immediately after birth can lead to severe disability or death. This occurs in about 1 in every 500 births and is one of the most important but unsolved problems in pediatrics. The costs (financial and other) to both the individuals involved, and the community in general, is very high. However the outlook for those affected by this condition is improving. Recent research has focused on the development of neural rescue therapies, which may decrease the extent of disabilities suffered by these children. The same treatments may also be helpful in children following near drowning and head trauma. Neural rescue therapies must be applied less than 24 hours following the event which has caused the reduction in oxygen supply. Thus, before these treatments can be tested, it is necessary to find a way to quickly tell which babies may benefit from the treatments. This study will trial a new method which is inexpensive and can be used without moving the baby away from its incubator. This technique involves a new application of an established technology to detect the redistribution of water within the brain one of the earliest signs of impending brain cell death. The research team consists of medical personnel from the intensive care nurseries of both the Royal Women's Hospital and the Mater Mother s Hospital, as well as scientific staff experienced in the use of this technology. If this technique is effective, it will enable babies to receive maximum benefit from new treatments and reduce long-term difficulties suffered by these children and their families.Read moreRead less
A Pre-clinical Trial Of Early Blood Transfusion For Improving Cerebral Oxygen Delivery In Very Preterm Neonates
Funder
National Health and Medical Research Council
Funding Amount
$970,603.00
Summary
Long-term disability is common in babies born prematurely. This may be due to insufficient delivery of oxygen to the brain, but currently there is no treatment that increases oxygen delivery to the brain. We will determine if blood transfusion is more effective than current treatments given to prevent brain injury in preterm babies. Transfusion has two benefits. It will increase the amount of blood going to the brain. It will also increase the amount of oxygen carried by the blood.
Efficacy And Safety Of Methylxanthines In Very Low Birth Weight Infants
Funder
National Health and Medical Research Council
Funding Amount
$221,136.00
Summary
With improving technologies and medications the numbers of very premature babies surviving to leave hospital has increased over the last two decades. However these babies are at increased risk of having brain damage in the form of mental retardation and cerebral palsy. These problems impose a major burden on the individuals, their families and society at large. This study attempts to identify whether or not a commonly used drug is safe in these babies or whether it contributes to brain damage in ....With improving technologies and medications the numbers of very premature babies surviving to leave hospital has increased over the last two decades. However these babies are at increased risk of having brain damage in the form of mental retardation and cerebral palsy. These problems impose a major burden on the individuals, their families and society at large. This study attempts to identify whether or not a commonly used drug is safe in these babies or whether it contributes to brain damage in some cases. Many premature babies have difficulty breathing by themselves because their brain does not send regular messages to their lungs telling them to expand. A class of drugs which includes caffeine has been shown to stimulate breathing in babies and has been thought to reduce the amount of support these babies require from a ventilator in the first weeks of life. The safety of these drugs has not been adequately demonstrated in premature babies and there is some evidence from animal studies that they may disrupt the developing brain. Results in human babies are inconclusive and concerns remain regarding the long term effects of caffeine. The question of whether caffeine usage increases the risk of mental retardation or cerebral palsy is a very important one given the almost universal usage of this or similar drugs in premature babies. We will find out whether babies given caffeine as newborns perform as well at 18 months of age as babies not given the drug.Read moreRead less
Neuro-protection In The Preterm Brain - A New Role For Dopamine Therapy?
Funder
National Health and Medical Research Council
Funding Amount
$183,975.00
Summary
Brain injury in premature babies leads to long term adverse outcome. Preliminary data show that dopamine improves brain oxygen. Our study will define effects of dopamine in preventing injury in the immature brain, using animal studies. In immature lambs receiving dopamine, we will test the protective effect of dopamine on brain oxygenation during hypoxia. Outcome will be measured by examining cell injury on lamb brain slices.