Early School-Age Outcomes After Exposure To Repeat Prenatal Corticosteroids - A Randomised Controlled Trial
Funder
National Health and Medical Research Council
Funding Amount
$1,083,964.00
Summary
AIMS OF THE RESEARCH We have recently concluded a large clinical trial in Australia and New Zealand of repeat dose of antenatal corticosteroids given to women who were likely to deliver their baby too early (before 34 weeks of pregnancy). We have been able to show that repeat doses of corticosteroids before birth significantly reduces the risk of the baby developing respiratory difficulties after birth from 41.4% to 32.8%. However, we are not sure if this potentially important improvement will t ....AIMS OF THE RESEARCH We have recently concluded a large clinical trial in Australia and New Zealand of repeat dose of antenatal corticosteroids given to women who were likely to deliver their baby too early (before 34 weeks of pregnancy). We have been able to show that repeat doses of corticosteroids before birth significantly reduces the risk of the baby developing respiratory difficulties after birth from 41.4% to 32.8%. However, we are not sure if this potentially important improvement will translate into better outcomes for the children as they grow older and reach school-age. As there are many examples of treatments given around the time of birth that have been shown to have some short-term benefits, but substantial long-term harms, we must be as certain as we can be that any advance in one small area of health is not counterbalanced by disadvantages in other health areas. This is particularly important to find out for repeat antenatal corticosteroids given the earlier conflicting reports from non-randomised studies. We plan to assess the 1085 survivors from our earlier clinical trial of repeat dose of prenatal corticosteroids when they are of early school age. We will assess their movement and other important areas of their brain function, as well as their school progress, blood pressure, lung function and general health and growth. EXPECTED OUTCOMES OF THE RESEARCH If we find important improvements in health outcomes at school-age in children exposed to repeat corticosteroids, without any substantial couterbalancing adverse effects, repeat steroids will be recommended standard therapy in women who are likely to give birth to their baby very early. This will lead to a reduction in the burden of ill health.Read moreRead less
Repeated Prenatal Corticosteroids: Effects On Childhood Development, Behaviour, Growth And Health
Funder
National Health and Medical Research Council
Funding Amount
$265,900.00
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 preterm birth, 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
A Population-based Longitudinal Assessment Of Early Life Vitamin D And Risk Of Food Allergy
Funder
National Health and Medical Research Council
Funding Amount
$466,086.00
Summary
There has been a dramatic and unexplained increase in food allergy over recent decades. The increase in food allergy may relate to a concordant increase in early vitamin D insufficiency, however this hypothesis has never been directly tested. This project will use existing/funded samples from two NHMRC funded studies to conduct a detailed investigation of (i) the determinant and predictors of early life vitamin D insufficiency; and (ii) the association of vitamin D insufficiency and food allergy ....There has been a dramatic and unexplained increase in food allergy over recent decades. The increase in food allergy may relate to a concordant increase in early vitamin D insufficiency, however this hypothesis has never been directly tested. This project will use existing/funded samples from two NHMRC funded studies to conduct a detailed investigation of (i) the determinant and predictors of early life vitamin D insufficiency; and (ii) the association of vitamin D insufficiency and food allergy.Read moreRead less
Discovery Early Career Researcher Award - Grant ID: DE230101053
Funder
Australian Research Council
Funding Amount
$450,556.00
Summary
Influence of parent and educator feeding practices on child self-regulation. This project aims to be the first study to investigate whether children who experience consistent and responsive feeding practices both at home and in early childhood education and care have higher levels of self-regulation, optimal eating behaviour and diet quality. The project expects to develop simple and low-cost strategies that parents and educators can use at mealtimes to enhance child self-regulation. With one mi ....Influence of parent and educator feeding practices on child self-regulation. This project aims to be the first study to investigate whether children who experience consistent and responsive feeding practices both at home and in early childhood education and care have higher levels of self-regulation, optimal eating behaviour and diet quality. The project expects to develop simple and low-cost strategies that parents and educators can use at mealtimes to enhance child self-regulation. With one million Australian children in care during their parent’s working week, outcomes of this project have widespread benefits. Higher self-regulation improves a child's health and well-being and provides short- and long-term social and economic benefits including school readiness, academic achievement and workforce participation.Read moreRead less
Reducing Vaccine Preventable Diseases In Children: Using National Active Hospital-based Surveillance To Evaluate And Improve Immunisation Program Performance
Funder
National Health and Medical Research Council
Funding Amount
$1,049,916.00
Summary
This proposal aims to evaluate and improve upon immunisation policy and programs for the prevention of severe childhood influenza and pertussis. Using our successful Paediatric Active Enhanced Disease Surveillance (PAEDS) network in 6 major children's hospitals across Australia, we will identify gaps in the evidence base needed to better control influenza and pertussis and in particular to ensure programs are delivered in such a way so as to address health inequalities.
Multi-centre, Multi-disciplinary Study Using A Systems Biology Approach To Investigate Immunomodulation In Children With Acute Wheeze
Funder
National Health and Medical Research Council
Funding Amount
$1,895,107.00
Summary
The concept that immunomodulation using naturally-occurring bacterial agents can treat asthma has reached international prominence. This is backed by strong epidemiologic and clinical trial data. However, detailed knowledge of the immunological mechanisms involved is essential to allow more focused therapeutic agents to be developed. The proposed multi-disciplinary immunomodulation study in 200 children aims to provide this essential information using an advanced systems biology approach.
Understanding The Shared Determinants And Causal Pathways Of Early Life Infection, Inflammation And Atherosclerosis.
Funder
National Health and Medical Research Council
Funding Amount
$632,803.00
Summary
Infection is the commonest reason for childhood hospitalisation, but it is unknown why infection is much more severe in some children. The long-term effects of infection on the development of atherosclerosis (hardening of the arteries), the underlying cause of cardiovascular disease, is also unknown. This research investigates these important questions with the aim of developing better prediction and prevention of severe infection and reducing its impact on adult cardiovascular disease.
Compared with normal-weight children, obese youth have a higher chance of developing diseases like Type 2 diabetes. With 1 in 4 Australian children now being overweight or obese, effective treatment programs need to be developed alongside those aimed at prevention. This program of research aims to identify which overweight/obese children are most likely to develop diabetes, with a particular focus on how infant nutrition regulates important growth factors to alter long-term diabetes risk.
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