Hospital Admission, Cerebral Palsy, Intellectual Disability And Birth Defects In Assisted Conception Infants.
Funder
National Health and Medical Research Council
Funding Amount
$115,110.00
Summary
We have recently completed a study examining the prevalence of birth defects in assisted conception infants born in Western Australia from 1993-1997. Contrary to reassuring claims by other researchers in this area, we found that assisted conception infants have a two-fold increased risk of being diagnosed with a major birth defect by one year of age. We now propose to examine other long-term health outcomes in these children. This study involves record linkage between the WA Reproductive Technol ....We have recently completed a study examining the prevalence of birth defects in assisted conception infants born in Western Australia from 1993-1997. Contrary to reassuring claims by other researchers in this area, we found that assisted conception infants have a two-fold increased risk of being diagnosed with a major birth defect by one year of age. We now propose to examine other long-term health outcomes in these children. This study involves record linkage between the WA Reproductive Technology Register and four other population-based databases. The prevalence of cerebral palsy, intellectual disability, hospital admission and birth defects in assisted conception children born in WA between 1993 and 2001 will be compared to that seen in all other Western Australian children born over the same time period. The collection of information on risks associated with assisted conception treatment is vital to allow adequate counselling of couples considering fertility treatment. Cerebral palsy, intellectual disability, birth defects and hospital admission are all serious adverse health outcomes and, despite the introduction of IVF to most Western countries twenty years ago, there are limited data in the literature concerning the occurrence of these conditions in assisted conception infants. Quantifying the contribution of assisted conception treatment to neonatal, infant and childhood morbidity and mortality is also important for the planning of health service provision. Although assisted conception births represent only a small proportion of total births in Australia, these infants may require a disproportionate level of health care services, such as neonatal intensive care treatment due to complications associated with preterm or multiple birth. The wide application of assisted conception treatment in Australia and the increased number of pregnancies achieved by these means reinforce the urgent need for valid data on the health of children born after these procedures.Read moreRead less
Preterm birth, a birth before the 37th week of pregnancy occurs for fewer than 8% of mothers but is associated with two-thirds of all fetal deaths and deaths of liveborn infants in the first month after birth. In the late 1990s those deaths are concentrated among very preterm births i.e. births before the 32nd week of pregnancy. Infants born very preterm are very likely to need neonatal intensive care, quite likely to have had major respiratory, infectious or other problems after birth, and to n ....Preterm birth, a birth before the 37th week of pregnancy occurs for fewer than 8% of mothers but is associated with two-thirds of all fetal deaths and deaths of liveborn infants in the first month after birth. In the late 1990s those deaths are concentrated among very preterm births i.e. births before the 32nd week of pregnancy. Infants born very preterm are very likely to need neonatal intensive care, quite likely to have had major respiratory, infectious or other problems after birth, and to need readmission to hospital in the first year after birth. Surviving infants are more likely to have major impairments, minor impairments, and school difficulties than infants born at term. There is a substantial impact on families, health services and society of very preterm birth.There has been no reduction in the proportion of births which are preterm, or very preterm in the last 20 years, though advances in treatment and care have markedly improved the survival of preterm and very preterm infants. This study will investigate the role of previous pregnancies which did not result in births (miscarriages and terminations), together with other procedures such as D and C (dilatation and curettage), in subsequent preterm birth. As these previous pregnancy losses are all fairly common experiences any associated risk is important and this particular factor has not been studied in this way before. There is preliminary evidence that they may be associated with preterm birth and the study will be able to measure the associations while taking into account all the other known risk factors. Other possible risk factors such as experiencing violence in pregnancy or social factors acting at a neighbourhood level will also be included. If it is found that previous pregnancy losses are independently associated with preterm birth it will be possible to develop and test preventive strategies.Read moreRead less
Investigating The Application Of Population Data To Improve Maternal And Child Health Services In Two Remote Communities
Funder
National Health and Medical Research Council
Funding Amount
$83,281.00
Summary
This project will contribute to the understanding of how routinely collected population health data relate to remote Aboriginal communities and how such data can be used in two field sites. Population data are widely used, but the opportunity to investigate these matters is limited. The nesting of this study within a larger project aimed at improving health services for mothers and babies provides a unique opportunity to investigate aspects of applying macro level data at a local level.
The National Survey of Adult Oral Health will interview and dentally examine 7,500 people aged 15 or more across all States and Territories of Australia. It will provide a national snap-shot of the nation's oral health, including levels of tooth loss, dental decay and gum disease. The survey, to be conducted in 2004-04, will be directed by researchers at the Australian Research Center for Population Oral Health at The University of Adelaide. It will be conducted in collaboration with the Commonw ....The National Survey of Adult Oral Health will interview and dentally examine 7,500 people aged 15 or more across all States and Territories of Australia. It will provide a national snap-shot of the nation's oral health, including levels of tooth loss, dental decay and gum disease. The survey, to be conducted in 2004-04, will be directed by researchers at the Australian Research Center for Population Oral Health at The University of Adelaide. It will be conducted in collaboration with the Commonwealth and State-Territory health departments. Occurring 17 years after the first National Oral Health Survey of Australia, this new survey will monitor changes in oral health among all Australians. The survey will identify groups at particular disadvantage in terms of oral diseases, and it will search for lifestyle and community-level hazards that increase the risk of oral disorders. The study will have a compare patterns of dental health among people born before and after the fluoride generation of adults born in the 1960s when most of Australia's capital city water supplies became fluoridated. The study has been designed to automatically capture national statistics on general health among the 7,500 study participants over the next decade. The researchers will use that information to study links that have been observed in other countries between gum disease and heart disease. Results from the survey will provide the basis for monitoring progress towards national health targets and provide information to help direct dental health services into the 21st century.Read moreRead less
Translational Public Health Research Addressing Complex Questions In Maternal, Perinatal And Indigenous Health
Funder
National Health and Medical Research Council
Funding Amount
$420,872.00
Summary
The health of women during pregnancy and the first year after giving birth is critical to the health and well-being of children. This research aims to improve understanding of the causes and consequences of poor maternal health and contribute to better informed policy and practice in maternity, early postnatal and primary care services. It focuses on 3 major themes: improving women’s health after childbirth; maternity and early postnatal care; and Indigenous women’s and children’s health.
Explaining Social Inequality In Population Oral Health Using A Multilevel Approach
Funder
National Health and Medical Research Council
Funding Amount
$103,500.00
Summary
Our preliminary research demonstrated a social gradient in the oral health of Australian adults. Adults who occupy higher positions on the social hierarchy experienced less disease and symptom experience, enhanced quality of life, and better self-rated oral health. Not only were associations made between social position and oral health, but a range of other factors such as personal control, social support, stress, life satisfaction, and workplace and childhood social environments were also assoc ....Our preliminary research demonstrated a social gradient in the oral health of Australian adults. Adults who occupy higher positions on the social hierarchy experienced less disease and symptom experience, enhanced quality of life, and better self-rated oral health. Not only were associations made between social position and oral health, but a range of other factors such as personal control, social support, stress, life satisfaction, and workplace and childhood social environments were also associated with oral wellness. This work is new Australian research and is yet to be published. In an expansion of this project, we move from describing oral health inequalities and identifying their social determinants to provide a better understanding of pathways to population oral health. In doing so we shift the focus from the individual to the social context in which individuals live. We suggest that characteristics of social environments contribute independently to the variation in oral health outcomes accounted for by the characteristics of the residents themselves. In particular, we seek to demonstrate that social cohesion (the social integration, trust, and reciprocity within an area) influences conditions linked to oral health. Previous research has demonstrated variation in health according to area. Such studies are able to demonstrate a clustering of health, but are not able to distinguish whether observed social patterns in health reflect characteristics of residents or some feature of the area itself. Such conclusions require multilevel statistical models designed to separate individual effects from contextual effects while simultaneously examining interactions between both levels. Oral health is ideally suited as a proxy for general health because of the ubiquity of dental diseases, the broad utilisation of dental services within the population, and the shared risk factors between oral disease and a wide range chronic health conditions.Read moreRead less
Reducing Maternal Depression Two Years After Birth: Follow-up Of A Cohort Within A Community Randomised Trial
Funder
National Health and Medical Research Council
Funding Amount
$359,920.00
Summary
Maternal depression following childbirth is a significant public health issue. Previous Victorian research has found that 15-17% of women experience depression 6-9 months after birth, and of those depressed then, 30% are likely still to be depressed or depressed again two years after the birth. In 1998 16 Victorian municipalities began participating in the first ever community randomised trial of prevention and early intervention in depression - PRISM (Program of Resources, Information and Suppo ....Maternal depression following childbirth is a significant public health issue. Previous Victorian research has found that 15-17% of women experience depression 6-9 months after birth, and of those depressed then, 30% are likely still to be depressed or depressed again two years after the birth. In 1998 16 Victorian municipalities began participating in the first ever community randomised trial of prevention and early intervention in depression - PRISM (Program of Resources, Information and Support for Mothers). PRISM involves eight areas participating in a range of primary care and community based strategies designed to mobilise appropriate community support for mothers and children with a view to reducing maternal depression and improving maternal physical health and recovery after birth. The other eight areas are participating as comparison communities. Evaluation in PRISM is assessing major health outcomes for mothers and wider community benefits (flow-on effects) of the intervention program. Process and impact evaluation has also been undertaken to document and assess the different program elements and enhance the reproducibility of the program if successful. All women giving birth in the 16 areas are currently being surveyed six months after birth (from August 2000-February 2002). Within PRISM it is now proposed to follow-up women again two years after birth, to assess the impact of the intervention program on: *recovery from depression among the group of mothers in both intervention and comparison areas who were depressed six months after birth; and *the overall prevalence of depression and physical ill-health in all mothers. This follow-up study has the capacity to provide infromation on the poorly documented natural history of maternal depression from birth through the next two years in a large sample, including both urban and rural residents.Read moreRead less
Burden Of Disease&cost Effectiveness Of Intervention Options:informing Policy Choices & Health System Reform In Thailand
Funder
National Health and Medical Research Council
Funding Amount
$787,978.00
Summary
This research project aims to improve the scientific basis for health services provision in Thailand by filling important gaps in knowledge about the causes of disease and the possibility of effectively intervening to reduce them. Since the accuracy of the routine death registration system in Thailand is unknown, it cannot be confidently used to guide policy. The team will evaluate how accurately causes of death are being recorded, both in urban and rural areas. It will also calculate how much d ....This research project aims to improve the scientific basis for health services provision in Thailand by filling important gaps in knowledge about the causes of disease and the possibility of effectively intervening to reduce them. Since the accuracy of the routine death registration system in Thailand is unknown, it cannot be confidently used to guide policy. The team will evaluate how accurately causes of death are being recorded, both in urban and rural areas. It will also calculate how much disease and injury in Thailand is being caused by major risk factors, such as tobacco and unsafe sex. Using this information the team will evaluate the effectiveness of the major interventions to reduces diseases and injuries from risk factors that are affordable and applicable in the Thai context.Read moreRead less