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Mental Health Across Generations: Pre-and Post Conception Predicators Of Early Life Risks
Funder
National Health and Medical Research Council
Funding Amount
$666,231.00
Summary
In 2003, mental illnesses were among the ten leading causes of disease burden in Australia, accounting for 13% of the total burden of disease, according to the Australian Institute of Health and Welfare. Mental health problems and mental illness are among the greatest causes of disability, diminished quality of life, and reduced productivity. People affected by mental health problems often have high levels of morbidity and mortality, experiencing poorer general health and higher rates of death f ....In 2003, mental illnesses were among the ten leading causes of disease burden in Australia, accounting for 13% of the total burden of disease, according to the Australian Institute of Health and Welfare. Mental health problems and mental illness are among the greatest causes of disability, diminished quality of life, and reduced productivity. People affected by mental health problems often have high levels of morbidity and mortality, experiencing poorer general health and higher rates of death from a range of causes, including suicide. These conditions are significant in terms of prevalence and disease burden, and have far-reaching impacts for families, carers and others in the community. Mental health problems commonly cluster in families. However, few studies have previously been able to investigate the range of ways in which mental disorders may pass from one generation to another. Further, evidence suggests that influences that arise prior to conception may have major effects on early life risks such as development in utero, birth outcomes and early maternal infant bonding. Mental Health across Generations: Pre- and post-conception predictors of early life risks is a unique study that will examine antenatal maternal mental health and risk behaviours during pregnancy. The study will also examine the links between prior maternal mental health and later birth outcomes, and post natal maternal infant bonding. The risk processes to be tested will include genetic, epigenetic (changes in gene expression), physiological and psycho-social parameters.Read moreRead less
Planned Vaginal Birth Or Planned Elective Repeat Caesarean For Women At Term With A Single Previous Caesarean Section
Funder
National Health and Medical Research Council
Funding Amount
$741,750.00
Summary
In Australia over 1 in 5 women give birth by caesarean section. The largest contribution to the total number of caesareans is from women having a repeat caesarean; who have previously had a caesarean. Two care policies are standard for women who have had a previous caesarean; either a planned trial of vaginal birth or a planned elective repeat caesarean. This prospective cohort study will compare the risks and benefits of these two forms of care. The results will help provide better evidence fro ....In Australia over 1 in 5 women give birth by caesarean section. The largest contribution to the total number of caesareans is from women having a repeat caesarean; who have previously had a caesarean. Two care policies are standard for women who have had a previous caesarean; either a planned trial of vaginal birth or a planned elective repeat caesarean. This prospective cohort study will compare the risks and benefits of these two forms of care. The results will help provide better evidence from which to develop health advice that will guide clinical practice, for the optimal care of women who have had a previous caesarean and their infants.Read moreRead less
Does Place Of Birth Influence A Healthy Start To Life?
Funder
National Health and Medical Research Council
Funding Amount
$343,050.00
Summary
There are over 255,000 births in Australia each year and a major challenge in terms of planning and provision is to ensure that these babies are born in hospitals with the appropriate facilities to care for them. International studies suggest that transferring the mother before birth results in better infant outcomes than transferring the baby after birth. In Australia births occur in a range of hospitals, from small rural hospitals to tertiary obstetric and neonatal centres. However, few Austra ....There are over 255,000 births in Australia each year and a major challenge in terms of planning and provision is to ensure that these babies are born in hospitals with the appropriate facilities to care for them. International studies suggest that transferring the mother before birth results in better infant outcomes than transferring the baby after birth. In Australia births occur in a range of hospitals, from small rural hospitals to tertiary obstetric and neonatal centres. However, few Australian studies have looked at infant outcomes based on place of birth. This study will use existing population health data sets to evaluate the provision of care prior to and at birth and the impact it has on infant outcomes up to one year of age. It will also describe for the first time the hospital care utilisation associated with birth and infant health. Information will be obtained from routinely-collected birth, death and birth defect registers, and hospital, midwives and perinatal death review data. Variations in health outcomes for babies may be due to factors that occur before or during pregnancy, or may be due to differences in the care provided at birth. We need to take account of maternal factors to comprehensively assess the role of level of care at birth. We will use statistical techniques to 'predict' infant health outcomes and see if differences between places of birth are real or not. If variations are explained by different levels of care then there is enormous potential for improvement in the provision of pregnancy and newborn services. We will also compare the benefits and consequences of maternal versus neonatal transfer, and assess hospital costs. The results of this study could be applied to direct health services policy and organisational changes to improve pregnancy care and optimise infant outcomes for a healthy start to life.Read moreRead less
A Randomised Controlled Trial Of Immediate Delivery Versus Expectant Care In Women With Ruptured Membranes Close To Term
Funder
National Health and Medical Research Council
Funding Amount
$768,900.00
Summary
Preterm premature rupture of the membranes (PPROM) complicates 1-2% of all pregnancies and is the cause of 40% of all preterm births . At gestations remote from term expectant management is appropriate to allow fetal maturation. When PPROM complicates pregnancies closer to term the risks of prematurity are lower and the risk to the infant of sepsis becomes of greater significance. This trial will provide level 1 evidence from which to determine the optimum management of these women. If it can be ....Preterm premature rupture of the membranes (PPROM) complicates 1-2% of all pregnancies and is the cause of 40% of all preterm births . At gestations remote from term expectant management is appropriate to allow fetal maturation. When PPROM complicates pregnancies closer to term the risks of prematurity are lower and the risk to the infant of sepsis becomes of greater significance. This trial will provide level 1 evidence from which to determine the optimum management of these women. If it can be demonstrated that early planned delivery in this clinical situation is associated with less maternal and neonatal morbidity this will change current national practice. The findings of the study will also have significant resource implications as PPROM close to term is a frequent indication for antenatal admission. The study also allows for a detailed assessment of the costs associated with the care of the neonate from two different management strategies. Analysis of the clinical and economic sequelae of immediate delivery as opposed to expectant management will enable informed decisions and guidelines to be formulated.Read moreRead less
1+1- A Healthy Start To Life:Targeting The Year Before And The Year After Birth In Aboriginal Children In Remote Areas
Funder
National Health and Medical Research Council
Funding Amount
$587,272.00
Summary
Indigenous Australians in remote communities are less healthy and more socially disadvantaged than other Australians. This influences the quality of the intrauterine environment. Babies often suffer malnutrition and recurring infections during infancy which are exacerbated by their less than optimal birth status and contribute to chronic conditions (diabetes, cardiovascular disease, renal failure) in adulthood. Existing health services are costly to Government and do not achieve their potential ....Indigenous Australians in remote communities are less healthy and more socially disadvantaged than other Australians. This influences the quality of the intrauterine environment. Babies often suffer malnutrition and recurring infections during infancy which are exacerbated by their less than optimal birth status and contribute to chronic conditions (diabetes, cardiovascular disease, renal failure) in adulthood. Existing health services are costly to Government and do not achieve their potential for promoting health and providing quality care. Evidence suggests redesigned models based on continuity of care, focused, proactive family support and workload reform will improve maternal and infant outcomes. New models need to be developed, costed, implemented and evaluated providing governments with the evidence base to initiate service improvement. Such models will have applicability elsewhere in Australia. Professor Lesley Barclay and her team of researchers from Charles Darwin University will conduct research into developing such a model. The project aims to improve the quality of care for remote dwelling Aboriginal women and infants in the year before, during and the year after birth by providing evidence for, and facilitating changes to, service delivery. This will enhance the potential for the development of resilience and well-being of their children. It will also test if service improvements can improve the health of women and reduce childhood disease and therefore reduce the impact of health conditions occurring in adulthood which have their origins in the early stages of life.Read moreRead less