Developmental Changes In Cerebral Oxygenation After Term And Preterm Birth
Funder
National Health and Medical Research Council
Funding Amount
$445,306.00
Summary
Approximately 10% of all births are preterm and the numbers of infants surviving are increasing. We have previously found that infants born preterm have lower blood pressure over the first 6 months after term equivalent age than infants born at term. We will use new technology to examine how preterm birth affects brain oxygenation and how this is altered with gestational age, sleep states and sleeping position, to provide insights into their increased risk for SIDS.
I am a physiologist working in the area of paediatric sleep and its disorders to elucidate mechanisms involved in Sudden Infant Death Syndrome, the consequences of preterm birth for later development of cardiovascular compromise and the consequences of sleep disordered breathing in children for disturbance of the cardiovascular system.
In What Position Should We Be Sleeping Preterm Infants In The NICU?
Funder
National Health and Medical Research Council
Funding Amount
$409,742.00
Summary
Preterm babies are at risk of brain injury caused by low cerebral blood flow and oxygenation. The prone sleeping position (lying on abdomen) has been found to decrease both cerebral oxygenation and blood pressure in healthy term babies, and is a major risk factor for Sudden Infant Death Syndrome. However, it is common practice for preterm babies to be slept in the prone position.This study will examine the effects of prone vs supine positions on brain oxygenation in the preterm babies.
Previous research has shown that SIDS victims have a number of subtle abnormalities that set them apart from the normal population. These include the occurrence of upper airway obstruction in sleep, a reduced ability to awaken from sleep and abnormalities of the automatic control of heart rate and blood pressure in sleep. These body functions are controlled by a component of the brain called the autonomic nervous system which controls the heart and other internal functions by means of nerves cal ....Previous research has shown that SIDS victims have a number of subtle abnormalities that set them apart from the normal population. These include the occurrence of upper airway obstruction in sleep, a reduced ability to awaken from sleep and abnormalities of the automatic control of heart rate and blood pressure in sleep. These body functions are controlled by a component of the brain called the autonomic nervous system which controls the heart and other internal functions by means of nerves called the parasymmpathetic and sympathetic systems. The purpose of this project is to undertake studies of the autonomic system in normal infants and in those infants who are considered to be at risk for SIDS. As SIDS occurs almost exclusively in sleep it is important to study the infant?s heart rate and blood pressure responses to various challenges whilst asleep. All infants (both controls and subjects) enrolled in the protocol will therefore undergo overnight sleep studies during which their automatic responses to a variety of stimuli will be measured. Once we have established the normal response to these stimuli we can then compare them to the results of the at risk group. If, as we anticipate, there is a difference between our at risk group and the normal controls in automatic function then we will measure some of the stress hormones in the body which reflect the function of the autonomic nervous system. If there is a difference in the levels of these hormones between the normal and the at risk groups which correlates with the expected subtle abnormalities in function we may be able to devise an accessible and quantifiable measure for those infants at risk of SIDSRead moreRead less
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
DEVELOPMENT OF CARDIOVASCULAR CONTROL DURING SLEEP IN HUMAN INFANTS AFTER PRETERM BIRTH
Funder
National Health and Medical Research Council
Funding Amount
$358,537.00
Summary
Infants spend the major part of their life in sleep, and the period between birth and 6 months of age sees dramatic changes in their sleep organisation. Coincidently, there are dramatic developmental changes in the infant's heart and blood pressure control systems, and the ability to compensate for stress such as falls of blood pressure (hypotension) or in the level of oxygen in the blood (hypoxaemia). In infants born preterm, the risks of hypoxaemia, and even death are significantly greater dur ....Infants spend the major part of their life in sleep, and the period between birth and 6 months of age sees dramatic changes in their sleep organisation. Coincidently, there are dramatic developmental changes in the infant's heart and blood pressure control systems, and the ability to compensate for stress such as falls of blood pressure (hypotension) or in the level of oxygen in the blood (hypoxaemia). In infants born preterm, the risks of hypoxaemia, and even death are significantly greater during sleep than during wakefulness, but why this is so is uncertain. This study will examine the ability of infants to respond to stress during sleep. Four groups of infants will be examined: healthy infants born at normal gestation; healthy infants born prematurely (preterm); preterm infants who have experienced mild hypoxaemia soon after birth; and preterm infants who have suffered more severe hypoxaemia because of lung disease. Infants will be studied in a sleep laboratory during day-time sleep, and their ability to control blood pressure will be determined. By contrasting the effectiveness of blood pressure control between the infant groups we aim to determine whether preterm infants have lasting problems as a result of their premature birth, or their exposure to hypoxaemia. By contrasting infants in sleep and wakefulness, we aim to assess whether the risks of poorer blood pressure control are greater in sleep.Read moreRead less
Alternatives To Polysomnography For Children With Suspected Obstructive Sleep Apnoea.
Funder
National Health and Medical Research Council
Funding Amount
$357,613.00
Summary
Snoring is the cardinal symptom of obstructive sleep apnoea (OSA), a major health issue in childhood with significant impacts on cognition, behaviour and cardiovascular health. Approximately 35% of children snore but only about 10% of those have OSA. Defining OSA in a snoring child requires polysomnography, a technically challenging and expensive test. In this study we will examine a number of simple tests for their predictive power for OSA, developing a tool that will enable clinicians to diagn ....Snoring is the cardinal symptom of obstructive sleep apnoea (OSA), a major health issue in childhood with significant impacts on cognition, behaviour and cardiovascular health. Approximately 35% of children snore but only about 10% of those have OSA. Defining OSA in a snoring child requires polysomnography, a technically challenging and expensive test. In this study we will examine a number of simple tests for their predictive power for OSA, developing a tool that will enable clinicians to diagnose OSA without the need for polysomnography.Read moreRead less
A Randomised Controlled Trial Of Enhanced Parenting Capacity To Improve Developmental Outcomes In Preterm Infants
Funder
National Health and Medical Research Council
Funding Amount
$1,045,141.00
Summary
In Australia there are 2, 600 very preterm survivors each year. 50% will have education/behavioural difficulties and 10% major disability. We aim to optimise the development of infants born very preterm through a tailored Positive Parenting Program. We predict reductions in child behavioural and emotional problems at 2 years corrected age.