Can Esomeprazole Improve Outcomes In Women At High Risk Of Pre-eclampsia? A Phase II Placebo-controlled Randomised, Multi-centre Clinical Trial.
Funder
National Health and Medical Research Council
Funding Amount
$1,597,125.00
Summary
Pre-eclampsia, recognised through the development of high blood pressure in pregnancy, causes death and/or injury to mothers and babies. An improved understanding of the development of pre-eclampsia has provided opportunities for early prediction and prevention of disease. We will use a powerful predictive model to identify pregnancies at high risk of pre-eclampsia then observe the effect of a novel treatment (esomeprazole) on maternal blood pressure and the development of this disease.
Reducing Childbirth Related Fear And Preference For Caesarean Section: A RCT Of A Midwife-led Psycho-education Intervention (APRIME)
Funder
National Health and Medical Research Council
Funding Amount
$487,116.00
Summary
In 2008 34% of mothers had a caesarean section in Queensland. Women who are fearful are more likely to want and have a surgical delivery. We will recruit and train midwives to provide counselling and education about birth choices to fearful women during pregnancy. Our program (APRIME) enables women to work through fearful elements of childbirth, review their expectations/ experiences and develop a realistic plan. We predict that women receiving APRIME will report less fear and prefer a normal bi ....In 2008 34% of mothers had a caesarean section in Queensland. Women who are fearful are more likely to want and have a surgical delivery. We will recruit and train midwives to provide counselling and education about birth choices to fearful women during pregnancy. Our program (APRIME) enables women to work through fearful elements of childbirth, review their expectations/ experiences and develop a realistic plan. We predict that women receiving APRIME will report less fear and prefer a normal birth.Read moreRead less
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
Neuroprotective Role Of Sulphate Among Preterm Babies (SuPreme Study)
Funder
National Health and Medical Research Council
Funding Amount
$749,338.00
Summary
Magnesium sulphate administered to mothers shortly before preterm birth, reduces the risk of cerebral palsy. The mechanism of its neuroprotective effect is unknown, and our studies suggest sulphate is the protective element. Preterm babies rapidly become sulphate deficient, and magnesium sulphate mitigates this deficiency in most infants. In this study we will investigate whether low blood sulphate levels at 1 week of age correlate with cerebral palsy.
Antenatal Insulin-like Growth Factor-I And Perinatal Growth, Survival And Function Of The Growth Restricted Fetus.
Funder
National Health and Medical Research Council
Funding Amount
$150,370.00
Summary
Poor growth before birth or intrauterine growth restriction (IUGR), as indicated by being light, short or thin for stage of pregnancy, greatly increases the risk of illness and death before and after birth and in infancy. IUGR has increased risks of asphyxia, poor glucose control, hypothermia, respiratory difficulties, neurological problems and poor immune function, many of which persist. IUGR is one of the most common clinical problems in obstetrics and neonatology, with ~6% of infants born IUG ....Poor growth before birth or intrauterine growth restriction (IUGR), as indicated by being light, short or thin for stage of pregnancy, greatly increases the risk of illness and death before and after birth and in infancy. IUGR has increased risks of asphyxia, poor glucose control, hypothermia, respiratory difficulties, neurological problems and poor immune function, many of which persist. IUGR is one of the most common clinical problems in obstetrics and neonatology, with ~6% of infants born IUGR in Australia in non-Aboriginal communities and between 7 to 17% in Aboriginal communities. Despite these adverse consequences for health of the individual throughout life, we do not currently have any effective therapies to treat IUGR. Small infants are mostly a result of an inadequate supply of oxygen and nutrients before birth, due to an impaired capacity of the mother to acquire these for the placenta to deliver them to the growing fetus or due to poor functioning of the placenta itself. This intrauterine malnutrition not only slows growth, but impairs the development of a range of body functions leading to the increased risk of illness and death in IUGR. Therapies to be used before birth to treat IUGR need to either restore supply of oxygen and nutrients or to promote growth and functional development. We have discovered that administration of a major growth promoting hormone, insulin-like growth factor-I (IGF-I), to the IUGR fetus, which has low levels of IGF-I, increases its growth. This project will therefore determine if directly giving this hormone in the IUGR fetus will restore development as well as growth before birth, improving function and hence survival and health after birth. If successful, the first effective approach to the antenatal treatment of IUGR will have been identified and would provide the essential knowledge for the design of a range of therapies to best restore the abundance of IGF within the IUGR fetus to improve perinatal and later outcomes.Read moreRead less
Investigating The Relationship Between Depression, Anxiety And Nausea And Vomiting During Pregnancy: Causation Or Shared Liability?
Funder
National Health and Medical Research Council
Funding Amount
$600,874.00
Summary
Recent studies showing women who experience severe Nausea and vomiting during pregnancy (NVP) have higher rates of Anxiety and Depression prior to pregnancy have revived earlier hypotheses that NVP may have a psychogenic component. We hypothesize that Anxiety and Depression do not play a causal role in NVP but rather, the relationship is due to shared risk from genetic effects that influence both traits. We will test this hypothesis using genetic and epidemiological approaches.
Improving Primary Care For Aboriginal Mothers And Babies In The Kimberley Region Of Western Australia: A Population And Region Based Cluster Randomised Trial Driven By Local Health Service Providers
Funder
National Health and Medical Research Council
Funding Amount
$2,043,581.00
Summary
Over 50% of remote area Aboriginal mothers and 60% of breastfed infants have micronutrient malnutrition and other severe morbidities. A population based trial of a new locally driven model to improve the quality of maternal primary care will be undertaken. The primary outcome measure is improved iron deficiency anaemia in infants aged 6 months. The results will be used to develop improved primary care models and to improve health outcomes for all Aboriginal mothers and infants.