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Preterm birth, a birth before the 37th week of pregnancy occurs for fewer than 8% of mothers but is associated with two-thirds of all fetal deaths and deaths of liveborn infants in the first month after birth. In the late 1990s those deaths are concentrated among very preterm births i.e. births before the 32nd week of pregnancy. Infants born very preterm are very likely to need neonatal intensive care, quite likely to have had major respiratory, infectious or other problems after birth, and to n ....Preterm birth, a birth before the 37th week of pregnancy occurs for fewer than 8% of mothers but is associated with two-thirds of all fetal deaths and deaths of liveborn infants in the first month after birth. In the late 1990s those deaths are concentrated among very preterm births i.e. births before the 32nd week of pregnancy. Infants born very preterm are very likely to need neonatal intensive care, quite likely to have had major respiratory, infectious or other problems after birth, and to need readmission to hospital in the first year after birth. Surviving infants are more likely to have major impairments, minor impairments, and school difficulties than infants born at term. There is a substantial impact on families, health services and society of very preterm birth.There has been no reduction in the proportion of births which are preterm, or very preterm in the last 20 years, though advances in treatment and care have markedly improved the survival of preterm and very preterm infants. This study will investigate the role of previous pregnancies which did not result in births (miscarriages and terminations), together with other procedures such as D and C (dilatation and curettage), in subsequent preterm birth. As these previous pregnancy losses are all fairly common experiences any associated risk is important and this particular factor has not been studied in this way before. There is preliminary evidence that they may be associated with preterm birth and the study will be able to measure the associations while taking into account all the other known risk factors. Other possible risk factors such as experiencing violence in pregnancy or social factors acting at a neighbourhood level will also be included. If it is found that previous pregnancy losses are independently associated with preterm birth it will be possible to develop and test preventive strategies.Read moreRead less
Molecular Mechanisms Regulating Spontaneous Onset Of Human Labour
Funder
National Health and Medical Research Council
Funding Amount
$481,156.00
Summary
The single most important complication contributing to poor pregnancy and neonatal outcome is premature birth. If we are to provide the best possible start to life, improve perinatal health and reduce the risk of developing adult disease . A better understanding of labour is requisite to improving health care delivery during pregnancy and outcomes for both mother and baby. This reserach project will investigate the how labour-associated events are reguluated by nuclear proteins.
The Mechanisms That Regulate The Onset Of Human Labour And Delivery
Funder
National Health and Medical Research Council
Funding Amount
$528,170.00
Summary
Reproductive biologists still cannot explain the molecular mechanisms that govern human birth. This lack of knowledge prevents the development of better moitoring and treament of complications of labour and delivery. If we are to provide the best possible start to life and improve newborn health care delivery then we must: (1) better understand what triggers labour; (2) determine whether there are biomarkers that we can use to identify women at risk of early birth; and (3) identify new ways to d ....Reproductive biologists still cannot explain the molecular mechanisms that govern human birth. This lack of knowledge prevents the development of better moitoring and treament of complications of labour and delivery. If we are to provide the best possible start to life and improve newborn health care delivery then we must: (1) better understand what triggers labour; (2) determine whether there are biomarkers that we can use to identify women at risk of early birth; and (3) identify new ways to delay birth. This is the overall objective of this research project. In particular, this project focuses on how the multiple events needed to achieve a successful outcome to pregnancy are coordinated at the time of birth.Read moreRead less
Investigating The Association Between Incarceration While Pregnant And Maternal And Infant Outcomes
Funder
National Health and Medical Research Council
Funding Amount
$307,500.00
Summary
The number of women incarcerated within Australian prisons has doubled over the last ten years. Prisons contain large numbers of women from Indigenous backgrounds, women with a mental illness, women with violent partners and women with substance abuse problems. As such they constitute one of the most disadvantaged groups within Australian society and their children are unlikely to experience a healthy start to life. At any one time around 5-10% of women inside Australian prisons are pregnant. Th ....The number of women incarcerated within Australian prisons has doubled over the last ten years. Prisons contain large numbers of women from Indigenous backgrounds, women with a mental illness, women with violent partners and women with substance abuse problems. As such they constitute one of the most disadvantaged groups within Australian society and their children are unlikely to experience a healthy start to life. At any one time around 5-10% of women inside Australian prisons are pregnant. There has been no Australian research into the effect incarceration has upon pregnant women or their babies. Some believe that women who are incarcerated during their pregnancy may have better outcomes as they are outside their normal milieu with restricted access to alcohol and illicit drugs and separated from abusive partners. Others argue that the stress of incarceration and separation from family and friends could result in poorer pregnancy outcomes. This study will investigate whether being imprisoned while pregnant results in better or worse pregnancy and birth outcomes for Australian women and their babies.Read moreRead less
Metabolic And Molecular Determinants Of Embryo Viability
Funder
National Health and Medical Research Council
Funding Amount
$551,321.00
Summary
We know that our health as adults is influenced by the lifestyle of our mothers during pregnancy. In particular, increased risk of adult-onset diseases such as diabetes and cardiovascular disease occurs when small and lean infants at birth are raised in conditions where nutrient intake is not restricted and obesity occurs. This concept of fetal programming is now widely accepted. Our laboratory is leading research in a new concept, that of embryonic programming. We have extensive animal data dem ....We know that our health as adults is influenced by the lifestyle of our mothers during pregnancy. In particular, increased risk of adult-onset diseases such as diabetes and cardiovascular disease occurs when small and lean infants at birth are raised in conditions where nutrient intake is not restricted and obesity occurs. This concept of fetal programming is now widely accepted. Our laboratory is leading research in a new concept, that of embryonic programming. We have extensive animal data demonstrating that exposure of embryos to physiological perturbations alters fetal development, similarly to that occurring in nutrient restriction during pregnancy. Furthermore, there is data from IVF-derived children that their birth-weight is lower than expected, possibly due to the conditions used for conception in the laboratory. How does the response by eggs and embryos, at the time of conception, affect subsequent development? There has been some focus on changes to DNA that are not related to mutations, but structural changes in the DNA that alters gene expression. We call this epigenetics and epigenetic changes are found in embryos, including human embryos following IVF. However, no one knows how such epigenetic changes occur as a result of this stress response by the egg or embryo. Our proposal is to determine the mechanism of how epigenetic alterations take place in eggs and embryos. Our theory is that the mitochondria, the energy producing packages within all cells, are sending signals to the embryo's nucleus. When the egg or embryo finds itself in adverse conditions, the signals change as a result of changes in the energy balance. This in turn changes the activity of enzymes in the nucleus that regulates DNA structure. If we can prove that this relationship occurs, then we can assess these changes in human embryos that are excess to a patient's requirements and learn if programming takes place in human embryos.Read moreRead less
Heart-lung Interactions Determine Right Ventricular Function In The Perinatal Period.
Funder
National Health and Medical Research Council
Funding Amount
$421,980.00
Summary
Birth, and the ensuing stress of newborn life, requires the heart to dramatically increase its level of functioning. Understanding how this process occurs remains a key problem as the heart lacks any ability to increase its level of functioning immediately before birth. Failure to effect this increase in heart function promptly at birth has serious implications for the well being of the newborn and represents a major problem in newborn medicine. Of the 250,000 babies born each year in Australia, ....Birth, and the ensuing stress of newborn life, requires the heart to dramatically increase its level of functioning. Understanding how this process occurs remains a key problem as the heart lacks any ability to increase its level of functioning immediately before birth. Failure to effect this increase in heart function promptly at birth has serious implications for the well being of the newborn and represents a major problem in newborn medicine. Of the 250,000 babies born each year in Australia, as many as 5,000 require intensive care primarily for cardiorespiratory complications. Accurate diagnosis and effective treatment of these infants demands knowledge of the normal heart adaptations that accompany birth, adaptations that are critically linked to the way in which the heart and the lungs interact. This project investigates how interactions between the heart and the lungs determines heart function throughout life. By understanding this process we will provide essential information that will aid the diagnosis and treatment of sick neonates undergoing intensive care.Read moreRead less
Mechanisms Of Escape From Progesterone-induced Suppression: Role In Normal And Preterm Birth
Funder
National Health and Medical Research Council
Funding Amount
$547,970.00
Summary
Prematurity caused by preterm birth is the leading cause of death and disease among newborns in Australia. Here we will define how the length of pregnancy is determined by the opposing actions of progesterone, which maintains pregnancy, and prostaglandins, which induce labour. We will demonstrate the mechanism by which the actions of the two hormones are balanced in normal pregnancy and disrupted in preterm labour. We will show that preterm birth can be prevented by correcting the disorder.