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.
The Burden Of Late Preterm Birth On Brain Development And 2 Year Outcomes – A Prospective, Longitudinal Cohort Study
Funder
National Health and Medical Research Council
Funding Amount
$838,690.00
Summary
80% of preterm babies are born from 32-36 weeks’ gestation, and are late preterm (LPT). LPT children have more learning problems, but why this occurs is unknown. This study aims to understand the effect of LPT birth on brain development. We will do brain scans at term and assess development at 2 years of age of 200 LPT and 200 full-term children. We expect LPT babies will have subtle alterations in brain development compared with term controls which will be associated with delayed development.
A Centre For Research Excellence In Cerebral Palsy (CRE-CP)
Funder
National Health and Medical Research Council
Funding Amount
$2,622,042.00
Summary
Cerebral palsy is the most common physical disability in childhood. Our objective is to bring about a radical improvement in the treatment of individuals with cerebral palsy, both children and adults, and to determine better ways to assist their families. Emphasis will be placed on early detection of health issues and rigorous evaluation of management options. We will train more researchers and ensure that all the knowledge generated is made available to families and health care professionals.
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
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
Can Pentoxifylline Improve Long-term Outcomes In Preterm Infants With Late-onset Sepsis Or Necrotizing Enterocolitis – A Pragmatic, Randomized, Controlled Trial
Funder
National Health and Medical Research Council
Funding Amount
$2,901,130.00
Summary
Very preterm infants are at high risk of death and disability. Brain injury is often the result of inflammation caused by infection or bowel disease. To date, there is no treatment to reduce the harmful effects of inflammation. Pentoxifylline reduces inflammation and is a promising, safe and inexpensive treatment option for preterm infants. This study will determine whether Pentoxifylline in addition to antibiotics improves survival without disability in preterm infants.
We are an international team committed to clinical trials to improve survival without disability in newborn babies. We plan a randomised trial to confirm if bovine lactoferrin, an inexpensive dairy protein, reduces death or major morbidity and increases total breast milk intake in 1,500 very low birthweight babies in neonatal intensive care units
What Is The Profile, Burden And Consequences Of Cerebral Palsy (CP) Due To Congenital Cytomegalovirus (CMV) Infection?
Funder
National Health and Medical Research Council
Funding Amount
$87,130.00
Summary
Cytomegalovirus (CMV) is a virus that can be transmitted from mother to the unborn child. It is a potentially preventable cause of cerebral palsy (CP). The incidence of CP due to CMV remains unclear in Australia as screening for CMV is not routinely performed in the newborn. Our preliminary data suggests that severe CP is strongly associated with CMV. Here we will use link recorded data and test CMV in newborn screening cards to determine the burden and profile of CP due to congenital CMV in Aus ....Cytomegalovirus (CMV) is a virus that can be transmitted from mother to the unborn child. It is a potentially preventable cause of cerebral palsy (CP). The incidence of CP due to CMV remains unclear in Australia as screening for CMV is not routinely performed in the newborn. Our preliminary data suggests that severe CP is strongly associated with CMV. Here we will use link recorded data and test CMV in newborn screening cards to determine the burden and profile of CP due to congenital CMV in Australia.Read moreRead less
Prophylactic Antibiotics To Prevent Recurrent Lower Respiratory Tract Infections In Children With Neurological Impairment (PARROT) Study
Funder
National Health and Medical Research Council
Funding Amount
$1,210,224.00
Summary
We plan a randomised controlled trial to determine if 12 months of a type of antibiotics (compared to placebo) reduces hospitalisations in children with neurological impairment. Currently this group of children are recurrently hospitalised and some doctors use long term antibiotics but there is no high level evidence for this practice. The study will be undertaken in the UK and Australia and involve 474 children. The study will lead to better clinical care and inform guidelines.