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
Mortality And Survival Among Clients Of The Aboriginal Medical Service At Redfern
Funder
National Health and Medical Research Council
Funding Amount
$483,290.00
Summary
The aims of the mortality study are to: (a) document current age-sex specific and cause-specific Indigenous mortality; (b) establish trends in age-sex specific and cause-specific Indigenous mortality over time; (c) compare age-sex-cause specific mortality in the AMS Redfern cohort with patterns documented in other Aboriginal populations, and in the general Australian population. The null hypotheses for general and cause-specific mortality (age-adjusted) are that: (a) there has been no decline in ....The aims of the mortality study are to: (a) document current age-sex specific and cause-specific Indigenous mortality; (b) establish trends in age-sex specific and cause-specific Indigenous mortality over time; (c) compare age-sex-cause specific mortality in the AMS Redfern cohort with patterns documented in other Aboriginal populations, and in the general Australian population. The null hypotheses for general and cause-specific mortality (age-adjusted) are that: (a) there has been no decline in mortality in Aboriginal people attending AMS Redfern over 30 years covering 1972-2001; (b) survival in the AMS cohort is similar to that recorded in Aboriginal people from NT and WA (mostly rural) for similar time periods; (c) comparisons of the AMS cohort mortality with overall NSW mortality are similar to previously published comparisons of NT-WA Aboriginal mortality compared to overall Australian mortality data. Major causes of mortality will centre on endocrine (mainly diabetes), cardio- and cerebro-vascular diseases, and on external causes, including suicide-violence and accidental death. The mortality study will be extended back to the inception of the AMS, and will rely on computerisation of name(s), sex, date of birth and date of first and last AMS attendance for the whole AMS patient data base, to provide information for matching of patient records with the National Death Index (for deaths from 1980) and for matching with the NSW mortality data for 1971-79 (as there is no nationwide mortality data available from a single source prior to 1980).Read moreRead less
Regulation Of Prostaglandin Endoperoxide Synthase-2 In The Human Fetal Membranes At Birth
Funder
National Health and Medical Research Council
Funding Amount
$249,750.00
Summary
Preterm birth with the resulting immaturity of babies is the leading cause of death and disease among newborns. Early birth occurs in 6 to 11% of pregnancies, and its rate is slowly increasing in industrialized countries. We need a much better knowledge of the regulation of the parturition process to find ways to reverse this trend. Prostaglandins are hormonal substances that stimulate uterine contractions, cervical dilatation and membrane rupture. Intrauterine tissues produce prostaglandins, an ....Preterm birth with the resulting immaturity of babies is the leading cause of death and disease among newborns. Early birth occurs in 6 to 11% of pregnancies, and its rate is slowly increasing in industrialized countries. We need a much better knowledge of the regulation of the parturition process to find ways to reverse this trend. Prostaglandins are hormonal substances that stimulate uterine contractions, cervical dilatation and membrane rupture. Intrauterine tissues produce prostaglandins, and an increase of prostaglandin levels in the uterus is likely responsible for inducing labour both normally and preterm. We have previously identified an enzyme protein in the fetal membranes, called prostaglandin synthase-2, that has a key role in the synthesis of intrauterine prostaglandins during pregnancy. This enzyme is increasingly expressed before labour onset. In the present application, we propose studies to determine what causes the increased expression. We hypothesize that the gene encoding this enzyme is specifically activated in the fetal membranes in preparation for labour. We will define the mechanism of regulation by determining the activity of the gene in tissues from women who deliver either spontaneously or without labour at term and preterm. Further, we will determine the interaction of regulatory proteins with the prostaglandin synthase-2 gene in these pregnancies in order to understand the mechanisms of regulation at the molecular level. Finally, we will conduct cell culture studies to experimentally manipulate prostaglandin synthase-2 gene activity in fetal membrane cells. As an overall outcome of this work, new targets may be identified for drugs to disrupt prostaglandin synthase-2 gene activation specifically in the fetal membranes. The long term perspective is to block prostaglandin synthesis in the uterus in order to suppress preterm labour and prevent preterm birth.Read moreRead less
Should Very Premature Babies Receive A Placental Transfusion At Birth? A Randomised Controlled Trial.
Funder
National Health and Medical Research Council
Funding Amount
$2,875,774.00
Summary
Premature babies under 30 weeks gestation are up to a hundred times more likely than full term babies to die or survive with major disability, often from brain damage due to poor blood flow after birth. This randomised study will find out if giving them more placental blood at birth, by means of a delay in clamping the umbilical cord, then milking it, reduces anemia, blood transfusions, brain damage, infection, death and disability. The results may benefit millions of premature babies worldwide.
Evaluating Neonatal And Child Health Interventions For Evidence Based Planning And Practice In Low Resourced Countries
Funder
National Health and Medical Research Council
Funding Amount
$410,512.00
Summary
The overall aim is to develop a neonatal and child health research programme responding to the various needs of resource poor country governments and provide an evidence base for public and clinical interventions and health programming. One neonatal study is outlined evaluating alternative phototherapy treatment for neonatal jaundice.
Antagonist Of Corticotrophin Releasing Hormone As Therapeutic Agents For The Prevention Of Premature Birth In Humans
Funder
National Health and Medical Research Council
Funding Amount
$376,650.00
Summary
In developed countries the most common cause of the death of a newborn baby is premature delivery. Pre-term delivery remains the greatest cause of neonatal mortality in the western world and a major consumer of health dollars (approx. $5-7B per year in the US alone). However, a delay in the onset of labour from 20 to 25 weeks has been shown to result in a 55% greater probability of infant survival (550 fewer deaths per 1000). This project will allow: The development of new drugs that will allow ....In developed countries the most common cause of the death of a newborn baby is premature delivery. Pre-term delivery remains the greatest cause of neonatal mortality in the western world and a major consumer of health dollars (approx. $5-7B per year in the US alone). However, a delay in the onset of labour from 20 to 25 weeks has been shown to result in a 55% greater probability of infant survival (550 fewer deaths per 1000). This project will allow: The development of new drugs that will allow the extension of pregnancy term The development of protocols that will in turn reduce neonatal mortality. Additionally we believe that these new agents will be useful in preventing the onset of labour after fetal surgery. Currently there are no effective treatments capable of substantially changing delivery dates. Available therapeutics delay the onset of labour, at best, 24 hours. However, recent exciting results from our laboratories show that rising concentrations of the placental peptide Corticotrophin Releasing Hormone (CRH) are associated with the onset of labour. Further, we have also delayed the onset of labour in pregnant sheep by infusing a relatively insoluble CRH antagonist into the sheep fetus. Labour commenced ONLY AFTER the drug was withdrawn from the mother. This project builds upon an interdisciplinary team: medicinal chemists, molecular modellers, pharmacologists and endocrinologists, to further develop an exciting Australian discovery. Successful completeion of this research will, for the first time, allow the control of pregnancy duration MAXIMISING the benefits to mother and child, reducing mortality and later life morbidities typically associated with premature birth.Read moreRead less
A Community-based Cluster Randomized Controlled Trial In Rural Bangladesh To Evaluate The Impact Of The Use Of Iron/folic Acid Supplements Early In Pregnancy On The Risk Of Neonatal MortalityBACKGROUND An Effective Program Of Antenatal Iron/folic Ac
Funder
National Health and Medical Research Council
Funding Amount
$2,564,922.00
Summary
This community-based trial in rural Bangladesh will determine if iron/folic acid supplementation commencing in the first trimester of pregnancy significantly reduces newborn deaths, and whether this approach is cost-effective. This trial has the potential to inform international public health policy about the importance of starting antenatal iron/folic acid supplementation early to improve neonatal survival, and to help countries reach their child survival Millennium Development Goal