Repeated Prenatal Corticosteroids: Effects On Childhood Development, Behaviour, Growth And Health
Funder
National Health and Medical Research Council
Funding Amount
$718,055.00
Summary
Infants born preterm are at high risk of needing help with their breathing to survive. Corticosteroids given to the mother prior to preterm birth can substantially reduce these risks, although the beneficial effects of these drugs only seem to last seven days. Because of this there has been a tendancy to repeat the dose of prenatal steroids after seven days in women who remain at continued risk of very preterm birth. There has been no formal assessment of whether or not repeating the dose of pre ....Infants born preterm are at high risk of needing help with their breathing to survive. Corticosteroids given to the mother prior to preterm birth can substantially reduce these risks, although the beneficial effects of these drugs only seem to last seven days. Because of this there has been a tendancy to repeat the dose of prenatal steroids after seven days in women who remain at continued risk of very preterm birth. There has been no formal assessment of whether or not repeating the dose of prenatal corticosteroids is beneficial or harmful. In this clinical trial we will test what effect, if any, repeat doses of corticosteroids given to women who remain at risk of pretermbirth, have on children at the age of two years Women are eligible for the trial if at of less than 32 weeks of pregnancy, they have received corticosteroids seven or more days ago, and they are considered to be at continued risk of preterm birth. Women are randomised to one of the two treatment groups. Half the women will receive a weekly intramuscular injection of corticosteroids up to the time of birth or 32 weeks gestation, whichever is earlier, whilst the risk of very preterm birth remains. The other half of the women will receive a saline placebo injection. Chance will decide which treatment the women receives. In this study all children who survive to 2 years corrected age will be assessed to see if they have any problems with their health, growth and development. In particular we will assess how well they can walk, talk, understand, see and hear. The trial will be able to assess whether repeat doses of prenatal corticosteroids are helpful or not for infants at risk of being born very preterm by comparing the short term effects on infant health after birth and whilst in hospital with the effects on the child's later health, growth and development. An economic assessment of repeat doses of prenatal corticosteroids will be made in these children.Read moreRead less
The Impact Of Strength Training On Calf Muscle Structure And Function In Youth And Adolescents With Cerebral Palsy
Funder
National Health and Medical Research Council
Funding Amount
$89,857.00
Summary
Muscle spasticity is a primary cause of disability in individuals with cerebral palsy; however their muscles also do not develop properly: they are weak and resistant to stretch. Strength training causes muscle adaptations that increase strength and decrease stiffness. This study will examine the impact of a strength training intervention on muscle structure and function using innovative imaging techniques, motion analysis and measures of muscle strength and stretch, translating into better cons ....Muscle spasticity is a primary cause of disability in individuals with cerebral palsy; however their muscles also do not develop properly: they are weak and resistant to stretch. Strength training causes muscle adaptations that increase strength and decrease stiffness. This study will examine the impact of a strength training intervention on muscle structure and function using innovative imaging techniques, motion analysis and measures of muscle strength and stretch, translating into better conservative intervention planning.Read moreRead less
Factor V Leiden Mutation: A Contributory Factor For Cerebral Palsy?
Funder
National Health and Medical Research Council
Funding Amount
$72,595.00
Summary
Cerebral palsy is the commonest physical disability in childhood. It has a major impact on individuals and families. In a significant proportion of cases, the cause is unknown so further research is essential to define the reasons for this condition, and thereby develop preventative strategies. Two mutations have been identified that predispose carriers to develop blood clots (called thrombosis). These mutations are the Factor V Leiden mutation and the coagulation gene for prothrombin (also know ....Cerebral palsy is the commonest physical disability in childhood. It has a major impact on individuals and families. In a significant proportion of cases, the cause is unknown so further research is essential to define the reasons for this condition, and thereby develop preventative strategies. Two mutations have been identified that predispose carriers to develop blood clots (called thrombosis). These mutations are the Factor V Leiden mutation and the coagulation gene for prothrombin (also known as the G20210A mutation). If blood clots form in, or travel to the brain (embolism), they can obstruct the blood supply causing damage that may result in cerebral palsy in young children. Our research will investigate both mothers of children with cerebral palsy, and the children themselves. The study of the mothers will determine whether those that are carriers of these mutations are at an increased risk of having children with cerebral palsy. Factors that may precipitate the development of blood clots, such as smoking during pregnancy, will be investigated. The children with cerebral palsy will be studied to determine whether they carry the mutations, and if so, whether they have brain scan evidence of previous blood clots. Children will be tested for the mutation using the blood spot taken routinely early in life. These blood spots are stored on cards (Guthrie cards) and are available for research following parental consent. The mothers will be tested for the mutation by using a saliva sample and will also be interviewed to obtain details of their pregnancies. As a result of this project, useful information will be provided for families and health care providers. It will be established whether these mutations play a role in the genesis of cerebral palsy. In addition, data about possible factors which may increase the risk in carrier mothers, such as smoking, will be provided.Read moreRead less
A Centre For Research Excellence In Cerebral Palsy (CRE-CP)
Funder
National Health and Medical Research Council
Funding Amount
$2,622,042.00
Summary
Cerebral palsy is the most common physical disability in childhood. Our objective is to bring about a radical improvement in the treatment of individuals with cerebral palsy, both children and adults, and to determine better ways to assist their families. Emphasis will be placed on early detection of health issues and rigorous evaluation of management options. We will train more researchers and ensure that all the knowledge generated is made available to families and health care professionals.
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.
Preventing Adverse Outcomes Of Neonatal Hypoxic Ischaemic Encephalopathy With Erythropoietin: A Randomised Controlled Multicentre Australian Trial
Funder
National Health and Medical Research Council
Funding Amount
$2,103,844.00
Summary
One in five babies die worldwide from Hypoxic Ischaemic Encephalopathy caused by low oxygen or blood supply to the brain around birth. Survivors often have low IQ, cerebral palsy, epilepsy or autism. Cooling the baby after birth (hypothermia) reduces the severity of brain damage, but half still die or are disabled. This randomised, controlled trial will test whether Erythropoietin (a natural hormone) can further protect and repair these babies' brains, saving lives and preventing disability.
Efficacy Of Interventions For Equinus Gait In Children With Cerebral Palsy
Funder
National Health and Medical Research Council
Funding Amount
$316,449.00
Summary
Muscle spasticity is a primary cause of disability in children with cerebral palsy; however their muscles also do not develop properly: they are weak and resistant to stretch. This study will examine the precise muscle adaptations that occur due to spasticity using innovative ultrasound techniques and motion analysis. The influence of BOTOX treatment and orthopaedic surgery on muscle structure and function will be evaluated. This research will translate into better intervention planning.