School-Age Outcomes Of Very Preterm Infants And Antenatal Magnesium Sulphate Therapy - A Randomised Controlled Trial
Funder
National Health and Medical Research Council
Funding Amount
$675,050.00
Summary
Despite recent major advances in care around the time of birth that have led to large increases in the survival rates for very preterm babies, the rate of adverse long-term health problems has not diminished in survivors, and remains too high compared with children not born very preterm. In particular they have higher rates of substantial problems with the way their brain works, particularly affecting their movement, vision, hearing, thinking and talking. We have just concluded a large clinical ....Despite recent major advances in care around the time of birth that have led to large increases in the survival rates for very preterm babies, the rate of adverse long-term health problems has not diminished in survivors, and remains too high compared with children not born very preterm. In particular they have higher rates of substantial problems with the way their brain works, particularly affecting their movement, vision, hearing, thinking and talking. We have just concluded a large clinical trial in Australia and New Zealand of magnesium sulphate which was given to mothers who were likely to deliver their baby too early (before 30 weeks of pregnancy). We have been able to show, for the first time, that magnesium sulphate was able to halve the rate of substantial problems with movement in 2 year old survivors, from 6% to 3%. However, we are not sure if this potentially important improvement will translate into better outcomes for the children as they grow older and reach school-age. As there are many examples of treatments given around the time of birth that have been shown to have some short-term benefits, but substantial long-term harms, we must be as certain as we can be that any advance in one small area of health is not counterbalanced by disadvantages in other health areas. We plan to assess the 1061 survivors from our earlier clinical trial of magnesium sulphate therapy at ages from 7-8 years, when they are at school. We will assess their movement and other important areas of their brain function, as well as their school progress and general health and growth. If we find important improvements in health at school-age of these children caused by magnesium sulphate therapy, without any substantial counterbalancing side-effects, magnesium sulphate will probably become standard therapy in mothers who are likely to deliver their baby very early. This will lead to a reduction in the burden of illness in the community caused by being born too early.Read moreRead less
SCHOOL-AGE OUTCOME FOR VERY TINY/PRETERM CHILDREN BORN IN VICTORIA IN 1991-92
Funder
National Health and Medical Research Council
Funding Amount
$252,956.00
Summary
The survival rate for tiny or very premature babies has improved dramatically in recent times, from below 10% in the 1960s to greater than 70% in the 1990s. Several new treatments have helped to improve their survival rate, but some have the potential to cause long-term harm to the developing baby's brain or lung, and may cause lifelong problems with thinking, walking, talking, seeing, hearing, growth or breathing. Babies who are very tiny (born weighing less than 1000 g), or born very early (bo ....The survival rate for tiny or very premature babies has improved dramatically in recent times, from below 10% in the 1960s to greater than 70% in the 1990s. Several new treatments have helped to improve their survival rate, but some have the potential to cause long-term harm to the developing baby's brain or lung, and may cause lifelong problems with thinking, walking, talking, seeing, hearing, growth or breathing. Babies who are very tiny (born weighing less than 1000 g), or born very early (born before 28 weeks of pregnancy, or more than 12 weeks premature) will be assessed long term (to 8-9 years of age), as broadly as possible, and in comparison with normal birthweight (NBW, birthweight >2499 g) children. Outcomes will encompass academic progress and behaviour, brain function, general health, growth, and respiratory health. We will compare the outcomes for very tiny-preterm children who were treated with several of these new therapies with those who were not so treated. We will assess whether alternative measures of long term outcome that assess the quality of life are applicable to very tiny-preterm children. If so, these measures could be used much more widely, since they are cheaper and less time-consuming.Read moreRead less
Optimising The Motor Outcomes Of Infants With Cerebral Palsy Using Environmental And Goal Oriented Interventions
Funder
National Health and Medical Research Council
Funding Amount
$116,563.00
Summary
Cerebral palsy is the most common physical disability in childhood. Early diagnosis enables intervention when the brain is developing. Current early intervention has little impact on movement. This research tests the effectiveness of “goal-directed training” and enriched environments by: systematically reviewing literature, piloting the intervention, conducting a clinical trial and interviewing parents. Findings have the potential to improve the outcomes of the 700 new cases diagnosed each year.
Evaluation Of The Incorporation Of WHO Guidelines Into Post-graduate Medical Curriculum; The Impact On Quality Of Care
Funder
National Health and Medical Research Council
Funding Amount
$130,704.00
Summary
There is abundant evidence that many patients do not receive medical treatments of proven effectiveness. This is even more apparent in developing countries. Strategies to improve use of proven treatments is needed. Our research aims to evaluate an educational program for doctors in Lao PDR, based on World Health Organisation guidelines for the care of sick children in hospitals, including the impact on the knowledge of doctors and on the quality of care in the hospitals in which they work.
Implementing, Evaluating And Translating Pragmatic Strategies To Prevent Prenatal Alcohol Exposure (PAE), And Treat Fetal Alcohol Spectrum Disorders (FASD)
Funder
National Health and Medical Research Council
Funding Amount
$340,038.00
Summary
Drinking alcohol when pregnant places the unborn child at risk of lifelong brain damage, that we call Fetal Alcohol Spectrum Disorders (FASD). We can prevent FASD by raising awareness of the harms of drinking in pregnancy, and supporting women not to drink. For those with FASD, treatment programs can help reduce learning and behavioural problems. Our research team work with communities and service providers to implement FASD Prevention and Treatment strategies, and raise awareness of FASD.
Long Term Outcomes Of Infant Lung Function In Cystic Fibrosis
Funder
National Health and Medical Research Council
Funding Amount
$509,456.00
Summary
We have shown that babies with cystic fibrosis (CF) who are apparently well can still have lung problems. As lung disease is the major cause of death in CF we need ways to monitor the condition in babies, identify those at greatest risk of lung changes and predict which children should receive newer treatments. We have developed a unique program for the measurement of lung function in babies. We now aim to find out the long term consequences of lung function changes detected in infants with CF.
Improving The Long-term Quality Of Life For Preterm Children
Funder
National Health and Medical Research Council
Funding Amount
$638,517.00
Summary
My vision is to improve the long-term quality of life of preterm children (<37 weeks’ gestation), with a specific focus on those born very preterm (VP; <32 weeks’ gestation). To achieve this goal my research has two broad and related aims: 1) Determine the neurological and socio-environmental mechanisms leading to impairments in preterm children; and 2) Develop and assess the efficacy of perinatal and early intervention programs for preterm children.