Evaluating Neonatal Intensive Care For Tiny Babies In The 2000s - Is It Still Effective, Efficient And Available?
Funder
National Health and Medical Research Council
Funding Amount
$246,333.00
Summary
Most extremely tiny babies, those of birthweight less than 1000 g, need intensive care to survive. However some survivors have substantial problems with their long-term health. Since intensive care is costly we must be sure that it is money well spent. From the late 1970s until the late 1990s in the state of Victoria neonatal intensive care has been increasingly effective, with large increases in the long-term survival rate, from 25% in 1979-80, to 73% in 1997. Its efficiency has been relatively ....Most extremely tiny babies, those of birthweight less than 1000 g, need intensive care to survive. However some survivors have substantial problems with their long-term health. Since intensive care is costly we must be sure that it is money well spent. From the late 1970s until the late 1990s in the state of Victoria neonatal intensive care has been increasingly effective, with large increases in the long-term survival rate, from 25% in 1979-80, to 73% in 1997. Its efficiency has been relatively high and stable over time, comparing favorably with many other health care programmes, both intensive and non-intensive. It has been increasingly available, with fewer than 10% of ELBW infants born outside major hospitals with intensive care nurseries, and more tiny babies offered intensive care. We now need to know if these benefits have been maintained for tiny babies born in the 2000s. Hence we need to assess the long-term health of tiny babies born in Victoria in 2005.Read moreRead less
Perinatal Outcomes Following Treatment For Cervical Dysplasia
Funder
National Health and Medical Research Council
Funding Amount
$98,600.00
Summary
A very high proportion of women in Australia have regular cervical screening ('pap' tests) for early detection of any early abnormal changes of the cervix. Women with abnormalities are referred for further investigation and some go on to have the areas with abnormalities treated either by surgical removal of small amounts of tissue or by other heat or laser treatments of affected areas. Many women having these treatments are of child-bearing age and may not have had children, or may seek to have ....A very high proportion of women in Australia have regular cervical screening ('pap' tests) for early detection of any early abnormal changes of the cervix. Women with abnormalities are referred for further investigation and some go on to have the areas with abnormalities treated either by surgical removal of small amounts of tissue or by other heat or laser treatments of affected areas. Many women having these treatments are of child-bearing age and may not have had children, or may seek to have more children after treatment. There are unanswered questions about the extent to which any or all of these treatments might, by changes to the cervix, lead to preterm birth in any subsequent pregnancy. In the proposed study, records relating to women referred from 1982 to 2000 for assessment and possible treatment of cervical abnormalities at a major hospital will be linked to Victorian birth records from 1983 to 2001. This will allow a comparison of preterm birth in the group of women referred with cervical abnormalities, with preterm births in the Victorian population, and comparing women who do and don't have treatment, taking into account other important factors such as the mother's age, and her previous pregnancies. The information will be of value to women themselves, to gynaecologists and to screening services.Read moreRead less
Postnatal Dexamethasone In Tiny Babies: Does It Do More Good Than Harm?
Funder
National Health and Medical Research Council
Funding Amount
$394,688.00
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. However, some of these babies require prolonged periods of help with breathing and oxygen treatment to survive, and many develop a form of chronic lung disease in the newborn period. A powerful group of drugs, known as corticosteroids, have been used to treat or prevent this chronic lung disease in newborn babies, with some success in shorte ....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. However, some of these babies require prolonged periods of help with breathing and oxygen treatment to survive, and many develop a form of chronic lung disease in the newborn period. A powerful group of drugs, known as corticosteroids, have been used to treat or prevent this chronic lung disease in newborn babies, with some success in shortening the time that the babies need help with breathing. However, corticosteroids have the potential to cause long-term harm to the developing baby's brain, and may cause lifelong problems with thinking, walking, talking, seeing or hearing. We want to test in a clinical trial if corticosteroids, specifically dexamethasone, can reduce the need for help with breathing and the rate of chronic lung disease without causing long-term problems to the developing baby's brain. 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 eligible for this study if they still need help with their breathing after one week of age from a machine called a respirator, and their doctor considers that corticosteroids might be helpful to the baby's breathing. Some babies will receive dexamethasone and other babies will be treated with a harmless placebo - chance will decide which treatment the baby receives. All other aspects of the babies' care will continue as normally. Children who survive to 2 years of age will be assessed fully to determine if they have any problems with their health, including problems with their thinking, walking, talking, seeing or hearing. We will determine if dexamethasone is helpful or not for very tiny or very premature babies who have breathing problems after the first week of life. We will also measure the economic impact of dexamethasone treatment in these babies.Read moreRead less