DHA For The Improvement Of Neurodevelopmental Outcome In Preterm Infants: The DINO Trial
Funder
National Health and Medical Research Council
Funding Amount
$631,875.00
Summary
The incidence of neurological problems that occur in children born prematurely is higher than for those born at term. The earlier that a baby is born, the greater chance it has of having some developmental delay and general inability to cope at school. This has implications for the child, the families and the health system. One of the many dietary factors implicated in the development of neural abilities in premature infants is an omega-3 fatty acid called DHA. This compound is present in breast ....The incidence of neurological problems that occur in children born prematurely is higher than for those born at term. The earlier that a baby is born, the greater chance it has of having some developmental delay and general inability to cope at school. This has implications for the child, the families and the health system. One of the many dietary factors implicated in the development of neural abilities in premature infants is an omega-3 fatty acid called DHA. This compound is present in breast milk and most preterm formulas and is found in high concentrations in the brain and retina. In the last third of pregnancy the developing baby would normally accumulate DHA at a rapid rate. So it seems reasonable to assume that a baby outside the mother, that is born premature, would also need to accumulate DHA at this same rate. The problem is that none of the milks currently given to premature infants have DHA in high enough concentration to supply this amount of DHA to the baby. For example, breast milk and preterm formulas contain only a third of the DHA required. In order to provide this amount for the premature infant, breast milk containing DHA at about 1% of the total fat is required. Fortunately the level of DHA in breast milk can be increased to this level by supplementing the mothers diet with fish or olis like tuna oil. This study hopes to show that premature babies who receive DHA in amounts similar to that supplied in the womb will develop better than babies who receive low amounts of DHA.Read moreRead less
Which Oxygen Saturation Level Should We Use For Very Premature Infants? A Randomised Controlled Trial.
Funder
National Health and Medical Research Council
Funding Amount
$2,215,600.00
Summary
Retinopathy of prematurity (ROP) is a serious complication of premature birth, and is a major cause of preventable blindness. Babies who are born before 28 weeks gestation are at greatest risk for developing severe ROP. Oxygen is one of the most common therapies used daily to care for premature babies, but high oxygen levels are one of multiple factors that can disrupt normal eye development and contribute to ROP. The current dilemma is that doctors and nurses do not know what level of oxygenati ....Retinopathy of prematurity (ROP) is a serious complication of premature birth, and is a major cause of preventable blindness. Babies who are born before 28 weeks gestation are at greatest risk for developing severe ROP. Oxygen is one of the most common therapies used daily to care for premature babies, but high oxygen levels are one of multiple factors that can disrupt normal eye development and contribute to ROP. The current dilemma is that doctors and nurses do not know what level of oxygenation is both safe and most effective for these babies. Whilst higher oxygen levels may increase ROP and other respiratory problems, it is possible that lower oxygen levels may affect other long-term outcomes. Because there is no definitive evidence regarding appropriate oxygenation, a wide spectrum of opinion and practice currently exist. Australia is conducting The Benefits of Oxygen Saturation Targeting Trial (BOOST II), a research study to solve this dilemma. BOOST II is a randomised, double blind, clinical trial, which will study the effects of using two ranges of oxygen saturation, 85-89% versus a higher range 91-95% for infants born before 28 weeks gestation. Both of these oxygen level ranges are currently used in normal practice. Patient safety will be monitored closely, and each infant will have their development, vision and health assessed by specialists at 18-24 months of age (plus the number of weeks premature), to see whether there is difference in survival free of major disability between the two groups. 1200 Australian infants will participate. This study will answer important questions about the benefits and risks of higher versus lower oxygen levels, and will improve the care of thousands of Australian children and millions more worldwide.Read moreRead less
A Randomised Trial Of An Early Parenting Intervention To Reduce Maternal Mood Disorder And Infant Behavior Disturbance
Funder
National Health and Medical Research Council
Funding Amount
$390,503.00
Summary
Over 242,000 women give birth annually in Australia and up to 20% experience significant psychological distress in the baby's first year. Severe fatigue, worrying and depression interfere with the development of maternal confidence. If a baby does not sleep well or feed easily or cries for prolonged periods, mothers can feel ineffective and helpless. Assistance early in the baby's life is important to avoid long-term emotional and behavioral problems for mother and child. Nationally, health and ....Over 242,000 women give birth annually in Australia and up to 20% experience significant psychological distress in the baby's first year. Severe fatigue, worrying and depression interfere with the development of maternal confidence. If a baby does not sleep well or feed easily or cries for prolonged periods, mothers can feel ineffective and helpless. Assistance early in the baby's life is important to avoid long-term emotional and behavioral problems for mother and child. Nationally, health and social policy focuses on assisting families including those with parental mental health and early parenting problems and children at risk of developmental difficulties. Australia's residential early parenting services are unique, offering brief treatment to mothers with difficulties and infants with unsettled behaviour. Parents are educated in infant care and provided with emotional support and assistance to adjust to the demands of parenting. In past studies by CIA and CIB women reported marked improvements in emotional distress, maternal confidence and infant manageability after completing this treatment and six months later. The education and emotional support were rated as acceptable and very effective. This project is a randomized controlled trial that will evaluate whether brief admission to a residential early parenting service has sustainable benefits for mild to moderate maternal mental health problems and for infant behaviour disturbance. Mothers with a diagnosable mental health condition and with four-month-old infants reported to have unsettled infant behaviour will be randomly assigned to a residential treatment program at an early parenting service or to routine care. Mothers and infants will be assessed with standardized psychological measures one month after treatment and when the baby is one year old. An effective and acceptable intervention will provide an important alternative to available treatments for postnatal psychological disturbance.Read moreRead less
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
Novel Approaches To Assessing Cerebral Circulation And Oxygenation In Preterm Human Infants.
Funder
National Health and Medical Research Council
Funding Amount
$489,145.00
Summary
In the first few days after birth, some premature babies develop low blood pressure. It is thought that this meant that the amount of blood and oxygen going to the brain would also fall. If blood pressure became very low, this could injure the brain. Drugs are used to prevent low blood pressure, but their effect on blood flow and oxygen in the brain is uncertain. This study aims to develop simple cotside monitoring procedures that allow neonatologists to monitor oxygen supply and blood flow in t ....In the first few days after birth, some premature babies develop low blood pressure. It is thought that this meant that the amount of blood and oxygen going to the brain would also fall. If blood pressure became very low, this could injure the brain. Drugs are used to prevent low blood pressure, but their effect on blood flow and oxygen in the brain is uncertain. This study aims to develop simple cotside monitoring procedures that allow neonatologists to monitor oxygen supply and blood flow in the brain in tiny babies who weigh less than 1000gm, and what happens within the brain when drugs are given to raise blood pressure. We will employ a new instrument that generates low intensity near infrared light which passes safely into the brain and is absorbed according to the amount of oxygen present in very small blood vessels. As the methodology is new, we intend to first validate the measurement in immature lambs. The instrument will then be applied in studies of babies undergoing intensive care and at risk for low pressure and brain injury, as many as 5000 babies each year in Australia.Read moreRead less
Impact Of Parental Alcohol, Tobacco And Other Substance Use On Infant Development And Family Functioning
Funder
National Health and Medical Research Council
Funding Amount
$1,996,525.00
Summary
The current study will be the first large-scale Australian birth cohort study to comprehensively examine the effects of substance use in pregnant women and their partners during the prenatal period on infant developement and family functioning. Dramatically improved knowledge of these effects will provide evidence-based direction to the development of public health policy and community interventions that aim to improve the health and wellbeing of Australian children and families.