Preclinical Optimisation Of Intrauterine Transplantation Of Fetal Mesenchymal Stem Cells For Osteogenesis Imperfecta.
Funder
National Health and Medical Research Council
Funding Amount
$600,932.00
Summary
Osteogenesis imperfecta is a genetic disorder causing brittle bones and fractures. Currently there is no good treatment. Transplanting stem cells before birth should allow them to build healthy bones early in life. Despite promising effects in animals, stem cell uptake is too low to prevent all fractures and ameliorate pain and deformity. We are studying how to improve the uptake of stem cells given to the fetus and neonate, in order to develop a treatment suitable for eventual use in humans.
Understanding And Preventing Adverse Developmental Effects Of Perinatal Infection/inflammation
Funder
National Health and Medical Research Council
Funding Amount
$621,458.00
Summary
Exposure of babies to infection or inflammation within the womb is common and is associated with preterm delivery and illness in newborns. The biggest problem for these babies is lung disease due to inflammation of the lungs before birth and/or in response to lung injury after birth. We are investigating how inflammation alters lung development, and working on developing a novel cell therapy to prevent life-threatening newborn lung disease.
Intraamniotic Delivery Of Antiinflammatory Drugs And Antibiotics For The Prevention Of Preterm Birth
Funder
National Health and Medical Research Council
Funding Amount
$568,281.00
Summary
Inflammation arising from infection in the uterus is a common cause of premature (preterm) birth. Using a pregnant sheep model, plus human preterm membrane studies, we will explore the use of a combination of antibiotics and anti-inflammatory drugs given via intra-amniotic injection to prevent fetal and amniotic inflammation, while protecting mother and baby from unnecessary drug exposure. These studies will lead to the design of clinical trials aimed at preventing preterm birth.
The Alert Program: An Evidence Based Treatment Program For Aboriginal Children Living With FASD (Fetal Alcohol Spectrum Disorder)
Funder
National Health and Medical Research Council
Funding Amount
$1,196,940.00
Summary
This study will research the effectiveness of the Alert Program to improve self-regulation and executive functioning skills in primary school aged children in the Fitzroy Valley, a vast area located within the Kimberley region of Western Australia. The project also aims to document a sustainable and culturally appropriate method of implementing a theraputic intervention that supports the improvement of skills in children living with fetal alcohol spectrum disorders within these communities.
A small number of babies die unexpectedly while still in the womb: the numbers are much higher than those dying from Sudden Infant Death Syndrome (SIDS). Some of these babies slow their movements down in the days before death. It would be very helpful to be able to accurately monitor babies' movements in the womb so that we could help the few babies who need it, and so prevent poor outcomes. Mothers feel their babies moving, but it's often hard for them to pick up all the movements that do occur ....A small number of babies die unexpectedly while still in the womb: the numbers are much higher than those dying from Sudden Infant Death Syndrome (SIDS). Some of these babies slow their movements down in the days before death. It would be very helpful to be able to accurately monitor babies' movements in the womb so that we could help the few babies who need it, and so prevent poor outcomes. Mothers feel their babies moving, but it's often hard for them to pick up all the movements that do occur. The best way of measuring babies' movements is during an ultrasound. However, that's expensive and means that the pregnant mother needs to lie still for about half an hour to have this testing done. We are developing a way of recording babies' movements, which still lets the pregnant woman continue with her normal activities. We will do this using an AMBULATORY FETAL ACTIVITY MONITOR, which is an accelerometer, like an advanced pedometer. The ambulatory fetal activity monitor will measure the activity of the unborn baby during pregnancy, looking at the number of times s-he moves and how simple or complex the movements are. We expect that the unborn baby who is not getting enough nutrition during the pregnancy will have fewer movements than other unborn babies. This project involves checking that movements picked up by the ambulatory fetal activity monitor are the same as movements seen on an ultrasound. We will then monitor a large number of pregnant women with healthy and possibly unhealthy babies, to help identify the babies who need help. Once we have this information, we will be able to use it in the future to possibly prevent poor outcomes in those babies who do need help.Read moreRead less
Cardiac Function In The Growth Restricted Fetus: The Effects Of Betamethasone And Melatonin
Funder
National Health and Medical Research Council
Funding Amount
$402,872.00
Summary
I am an Obstetrician interested in the problems of growth-restricted babies. Devastatingly, many of these babies do not survive pregnancy and survivors face difficult challenges throughout their lifetime. My research uses the latest ultrasound technology to study their heart while still in the womb, evaluating if our current treatments are safe or possibly harmful, and finally testing melatonin as an antioxidant to protect their heart from damage they may sustain while still in the womb.
Differential Effects On Fetal Growth And Development Of Repeated Fetal Or Maternal Corticosteroid Treatments
Funder
National Health and Medical Research Council
Funding Amount
$356,849.00
Summary
Injections of synthetic hormones (corticosteroids) to women at risk of early preterm birth reduce the rate of respiratory illness and death in the newborn infant. It is standard clinical practice prior to early preterm birth to give corticosteroids by intramuscular injection to the mother. For many women, however, preterm birth does not occur as expected and it has become common practice to give repeated courses of corticosteroids to women in whom the risk of preterm delivery recurs or continues ....Injections of synthetic hormones (corticosteroids) to women at risk of early preterm birth reduce the rate of respiratory illness and death in the newborn infant. It is standard clinical practice prior to early preterm birth to give corticosteroids by intramuscular injection to the mother. For many women, however, preterm birth does not occur as expected and it has become common practice to give repeated courses of corticosteroids to women in whom the risk of preterm delivery recurs or continues. Using the sheep model, we have shown that repeated doses of corticosteroids, given intramuscularly to the mother, are of benefit to newborn lung function, but also reduce the rate of fetal growth and adversely affect brain development. Evidence from the Western Australian Preterm Infant Cohort Study suggests that birthweight in humans is similarly affected by repeated corticosteroids and is followed by behavioral disorders in childhood. Using sheep, we have shown that repeated injections of corticosteroids given directly to the fetus cause no reduction in birthweight although maturation is still enhanced. This finding of a differential effect of corticosteroids by different routes of administration raises several exciting opportunities and questions. First is the possibility that direct fetal treatment may be of use in humans, if current human trials show that repeated doses cause effects similar to those we have seen in sheep. Secondly, the finding challenges our current understanding of how an individual may be programmed for subsequent health or illness by prenatal events. The proposed study will attempt to explain why corticosteroids given to the mother, but not the fetus, restrict fetal growth. Our hypothesis is that these hormones, when given repeatedly to the mother, adversely affect the ability of the placenta to transfer essential nutrients to the fetus. We will test this hypothesis using pregnant sheep in which catheters have been implanted surgically.Read moreRead less
Epidemiology Of Unexplained Antepartum Fetal Death In Australia
Funder
National Health and Medical Research Council
Funding Amount
$450,350.00
Summary
The death of a baby before birth is a devastating event for the parents and families. In the vast number of these deaths, no cause can be found leaving no clues for parents and care providers struggling with decisions about future pregnancies and how the risk may be reduced for all women in pregnancy. Fetal death before the onset of labour without an apparent cause (Unexplained Antepartum Fetal Death (UAFD) constitutes the most common cause of fetal death. In Australia, the rate of UAFD is appro ....The death of a baby before birth is a devastating event for the parents and families. In the vast number of these deaths, no cause can be found leaving no clues for parents and care providers struggling with decisions about future pregnancies and how the risk may be reduced for all women in pregnancy. Fetal death before the onset of labour without an apparent cause (Unexplained Antepartum Fetal Death (UAFD) constitutes the most common cause of fetal death. In Australia, the rate of UAFD is approximately 2 per 1 000 births, contributing 30% to all fetal deaths. The rate of UAFD is over three times the current rate of Sudden Infant Death Syndrome (SIDS) in Australia. Despite this, little research has been undertaken in this area. The research which has been undertaken suggests that factors which are present during pregnancy may identify women who are at risk. However, the results of these studies are not consistent, largely due to the problems with study design, and therefore the available information is not sufficiently reliable to assist in identification of women at risk. Well designed, large scale studies are urgently needed to determine, from the reported list of risk factors, those factors which truly identify a woman at increased risk in the antenatal period where appropriate care can be provided to decrease the likelihood of fetal death. Recently, a collaborative effort involving clinicians and consumers in Australia has commenced to support and undertake research and related activities and to collaborate with international groups in reducing the risk of UAFD (ANZ Fetal Death Collaborative Group). This study forms the basis for this work within Australia. This study is designed to identify women who are at risk of unexplained antepartum fetal death. The study involves a review of 800 unexplained antepartum fetal deaths in three States of Australia and an analysis of information on all births in Australia which is routinely collected by Health Departments.Read moreRead less
Improving The Neonatal Transition In Infants With A Congenital Diaphragmatic Hernia
Funder
National Health and Medical Research Council
Funding Amount
$551,644.00
Summary
Congenital diaphragmatic hernia is a common congenital abnormality and occurs when the diaphragm fails to separate the abdominal and thoracic compartments before birth. This prevents the lung from growing properly and so at birth, the lung is unable to take over the role of gas exchange without considerable assistance. As a result, these infants are at high risk of death or significant disability and this application is focused on improving care and reducing morbidity in these infants.