ORCID Profile
0000-0002-8981-6385
Current Organisations
Monash University
,
University of Adelaide
,
CBT Australia
Does something not look right? The information on this page has been harvested from data sources that may not be up to date. We continue to work with information providers to improve coverage and quality. To report an issue, use the Feedback Form.
Publisher: Cambridge University Press (CUP)
Date: 28-08-2020
DOI: 10.1017/S204017442000080X
Abstract: Donor-conceived neonates have poorer birth outcomes, including low birth weight and preterm delivery that are associated with poorer long-term health in adulthood through the developmental origins of health and disease (DOHaD) theory. The aim of this study was to conduct the first investigation of the adult health outcomes of donor-conceived people. An online health survey was completed by 272 donor sperm-conceived adults and 877 spontaneously conceived adults from around the world. Donor and spontaneously conceived groups were matched for age, sex, height, smoking, alcohol consumption, exercise, own fertility and maternal smoking. Donor sperm-conceived adults had significantly higher reports of being diagnosed with type 1 diabetes ( P = 0.031), thyroid disease ( P = 0.031), acute bronchitis ( P = 0.008), environmental allergies ( P = 0.046), sleep apnoea ( P = 0.037) and having ear tubes/grommets surgically implanted ( P = 0.046). This is the first study to investigate the health outcomes of adult donor sperm-conceived people. Donor sperm-conceived adults self-reported elevated frequencies of various health conditions. The outcomes are consistent with birth defect data from donor sperm treatment and are consistent with the DOHaD linking perturbed early growth and chronic disease in adulthood.
Publisher: Oxford University Press (OUP)
Date: 02-09-2016
Abstract: There is ongoing interest in immune-suppressant corticosteroid drugs such as prednisolone to treat infertility in women with repeated IVF failure and recurrent miscarriage. The rationale draws on the pervasive but flawed view that immune activation is inconsistent with normal pregnancy. This ignores clear evidence that controlled inflammation and activation of the immune response is essential for embryo implantation. Generally, the immune response actively promotes reproductive success - by facilitating endometrial receptivity and tolerance of the foreign embryo, and promoting vascular adaptation to support placental morphogenesis. The peri-conception immune response also establishes developmental trajectories that can impact on fetal growth and gestational age at birth. Here, we describe immune changes accompanying conception that could be impeded by inappropriate corticosteroid administration. While women with specific clinical conditions may benefit from the anti-inflammatory and immune-deviating actions of prednisolone and related drugs, it is incorrect to assume a 'one-size-fits-all' approach. Better diagnostics and more preclinical studies are essential to define patient groups, build evidence for efficacy and fine-tune treatments so as not to inhibit essential actions of immune cells. We argue that unless overt immune pathology is evident, utilization of corticosteroids is not warranted and may be harmful. In most women, perturbing immune adaptation at implantation is expected to adversely influence placental development and impair immune-mediated quality control mechanisms, potentially elevating risk of altered fetal growth and developmental programming, congenital anomalies and preterm birth.
Publisher: Wiley
Date: 17-10-2016
Abstract: To assess the contribution of maternal factors to major birth defects after in vitro fertilisation (IVF), intracytoplasmic sperm injection (ICSI), and natural conception. Retrospective cohort study in South Australia for the period January 1986 to December 2002. A whole of population study. A census of all IVF and ICSI linked to registries for births, pregnancy terminations, and birth defects (diagnosed before a child's fifth birthday). Odds ratios (ORs) for birth defects were calculated among IVF, ICSI, and natural conceptions for maternal age, parity, pre-pregnancy BMI, smoking, pre-existing diseases, and conditions in pregnancy, with adjustment for confounding factors. Birth defects classified by International Classification of Diseases (ninth revision) and British Paediatric Association (ICD9-BPA) codes. There were 2211 IVF, 1399 ICSI, and 301 060 naturally conceived births. The unadjusted prevalence of any birth defect was 7.1, 9.9, and 5.7% in the IVF, ICSI, and natural conception groups, respectively. As expected, the risk of birth defects increased with maternal age among the natural conceptions. In contrast, for IVF and ICSI combined, relative to natural conceptions, births to women aged ≤29 years had a higher risk (adjusted odds ratio, aOR 1.42 95% confidence interval, 95% CI 1.04-1.94), births to women aged 35-39 years had no difference in risk (aOR 1.01 95% CI 0.74-1.37), and births to women aged ≥40 years had a lower risk of defects (aOR 0.45 95% CI 0.22-0.92). Defects were also elevated for nulliparity, anaemia, and urinary tract infection in births after ICSI, but not after IVF. The usual age-birth defect relationship is reversed in births after IVF and ICSI, and the associations for other maternal factors and defects vary between IVF and ICSI. Risk of birth defects in women over 40 years is lower after infertility treatment than for natural conceptions.
Publisher: Springer Science and Business Media LLC
Date: 08-01-2014
Abstract: Pregnancy presents a unique situation for the management of asthma as it can alter the course of asthma severity and its treatment, which in turn can affect pregnancy outcomes. Despite awareness of the substantial adverse effects associated with asthma during pregnancy, little has been done to improve its management and reduce associated perinatal morbidity and mortality. The aim of this randomized controlled trial is to evaluate the clinical and cost effectiveness of an Antenatal Asthma Management Service. Design: Multicentre, randomized controlled trial. Inclusion criteria: Women with physician diagnosed asthma, which is not currently in remission, who are less than 20 weeks gestation with a singleton pregnancy and do not have a chronic medical condition. Trial entry and randomization: Eligible women with asthma, stratified by treatment site, disease severity and parity, will be randomized into either the ‘Standard Care Group’ or the ‘Intervention Group’. Study groups: Both groups will be followed prospectively throughout pregnancy. Women in the ‘Standard Care Group’ will receive routine obstetric care reflecting current clinical practice in Australian hospitals. Women in the ‘Intervention Group’ will receive additional care through the nurse-led Antenatal Asthma Management Service, based in the antenatal outpatient clinic. Women will receive asthma education with a full assessment of their asthma at 18, 24, 30 and 36 weeks gestation. Each antenatal visit will include a 60 min session where asthma management skills are assessed including: medication adherence and knowledge, inhaler device technique, recognition of asthma deterioration and possession of a written asthma action plan. Furthermore, subjects will receive education about asthma control and management skills including trigger avoidance and smoking cessation counseling when appropriate. Primary study outcome: Asthma exacerbations during pregnancy. S le size: A s le size of 378 women will be sufficient to show an absolute reduction in asthma exacerbations during pregnancy of 20% (alpha 0.05 two-tailed, 90% power, 5% loss to follow-up). The integration of an asthma education program within the antenatal clinic setting has the significant potential to improve the participation of pregnant women in the self-management of their asthma, reduce asthma exacerbations and improve perinatal health outcomes. ACTRN12613000244707
Publisher: Wiley
Date: 06-07-2004
Publisher: Cambridge University Press (CUP)
Date: 30-08-2016
DOI: 10.1017/S2040174416000489
Abstract: Although the use of donor sperm as a treatment modality for male infertility has become common place, the health outcomes for those conceived has been poorly studied. A structured search of the literature using PubMed, EMBASE and Cochrane Reviews was performed to investigate the health outcomes of offspring conceived from donor sperm. Eight studies were eligible and included in the review, and of these, three were included in a meta-analysis. Meta-analysis of clinical outcomes showed that donor sperm neonates are not at increased risk of being born of low birth weight ( g), preterm ( weeks) or with increased incidences of birth defects, than spontaneously conceived neonates.
Publisher: Public Library of Science (PLoS)
Date: 04-10-2011
Publisher: Elsevier BV
Date: 08-2021
Publisher: Elsevier BV
Date: 07-1990
DOI: 10.1016/0091-7435(90)90040-Q
Abstract: An important issue for public health approaches to smoking control is determining smokers' preferences for the different types of services available to assist with smoking cessation. In a population survey in the state of South Australia, smokers were asked to nominate the forms of assistance that they thought would help them to stop: a stop-smoking group a lecture a telephone counseling service a book, a p hlet, or a quit kit a television program or a video program conducted through the mail a program through their doctor a program through another health professional or none of these options. Forty-six percent of current smokers stated that they were interested in none of the options. Among the preferences that were expressed for the different forms of assistance, 67% were for services from a medical practitioner or other health professional 12.4% for a stop-smoking group 23.1% for a book, a p hlet, or a quit kit and 2.9% for mail or telephone services. The strong preferences for indirect methods that an earlier study and recent commentators have identified did not emerge in this survey. Preferences for personalized, as opposed to indirect forms of assistance, were more likely to be expressed by heavy smokers, those with less confidence of success at stopping, those with greater perceived difficulty of stopping, and those who had reported shorter periods of previous abstinence from smoking.
Publisher: Oxford University Press (OUP)
Date: 11-11-2011
Abstract: In Australia, fertility treatment is partly or wholly reimbursable under federal benefits schemes, without restrictions on age, number of treatment cycles or existing family size. In this study, we aimed to characterize the potential need for and use of fertility treatments in a population-based cohort of young Australian women. We conducted structured interviews with 974 members of a cohort constructed by tracing all female infants born at a single general hospital in Adelaide between 1973 and 1975. The main outcome measures were pregnancy history, difficulty becoming pregnant and assistance sought to become pregnant. Of 657 women aged 30-32 who had sought pregnancy, 24% reported difficulty becoming pregnant and 26% had lost at least one pregnancy. Ovulatory problems (16%) and male fertility problems (13%) were common among those with difficulty. Over half of the women who had difficulty conceiving (58%) sought assistance, largely from specialists (53%). Consultations, tests and education only were common (22%), as were IVF/ICSI (17%). Close to a third (28%) of those seeking assistance were treated only with clomiphene, as were two-thirds (67%) of women with ovulatory problems. In this study, almost a quarter of women in their early 30s reported difficulty conceiving, and over a quarter reported pregnancy loss. This suggests that a significant proportion of young women experience substantial difficulties becoming pregnant. Our findings highlight the need to continue to document the range of women's reproductive experiences and to monitor fertility and treatment-seeking trends.
Publisher: Hindawi Limited
Date: 2012
DOI: 10.1155/2012/741613
Abstract: Maternal asthma is a common disease to complicate human pregnancy. Epidemiological studies have identified that asthma during pregnancy increases the risk of a number of poor outcomes for the neonate including growth restriction, lower birthweight, preterm delivery, neonatal resuscitation, and stillbirth. Asthma therefore represents a significant health burden to society and could have an impact on the lifelong health of the children of women with asthma. Our research has identified that maternal asthma in pregnancy induces placental dysfunction and developmental perturbation in the fetus in a sex specific manner. These alterations in development could increase the risk of metabolic disease in adulthood of children of asthmatic mothers, especially females. In this paper, we will discuss the evidence currently available that supports the hypothesis that children of mothers with asthma may be at risk of lifelong health complications which include diabetes and hypertension.
Publisher: Elsevier BV
Date: 03-1999
Abstract: P-Glycoproteins are transmembrane proteins associated with acquired multidrug resistance in mammalian cells and some protozoan parasites by a process of active drug export. P-glycoproteins contain two nucleotide binding domains which couple ATP to the drug transport process. The region between the nucleotide binding domains of P-glycoproteins, termed the internucleotide binding domain (IBD), was PCR- lified from adult and larval cDNA libraries using degenerate primers. The 11 clones isolated by this method fall into several distinct groups, with one group of alleles displaying between 82 and 99% identity at the nucleotide level. This sets a baseline for sequence variation of transcribed alleles from a parasitic nematode. Northern blotting showed that P-glycoprotein genes are transcribed in a developmentally regulated fashion in Haemonchus contortus. Southern blots of H. contortus drug-resistant isolates with an IBD probe revealed a pattern consistent with the involvement of P-glycoprotein in resistance to avermectin/milbemycin anthelmintics.
Publisher: Cambridge University Press (CUP)
Date: 27-11-2015
DOI: 10.1017/S2040174415007898
Abstract: Donated oocytes are a treatment modality for female infertility which is also associated with increased risks of preecl sia. Subsequently it is important to evaluate if there is concomitant increased risks for adverse neonatal events in donated oocyte neonates. A structured search of the literature using PubMed, EMBASE and Cochrane Reviews was performed to investigate the perinatal health outcomes of offspring conceived from donor oocytes compared with autologous oocytes. Meta-analysis was performed on comparable outcomes data. Twenty-eight studies were eligible and included in the review, and of these, 23 were included in a meta-analysis. Donor oocyte neonates are at increased risk of being born with low birth weight ( g) [risk ratio (RR): 1.18, 95% confidence interval (CI): 1.14–1.22, P -value ( P ) .00001], very low birth weight ( g) (RR: 1.24, CI: 1.15–1.35, P .00001), preterm ( weeks) (RR: 1.26, CI: 1.23–1.30, P .00001), of lower gestational age (mean difference −0.3 weeks, CI: −0.35 weeks to −0.25 weeks, P .00001), and preterm with low birth weight (RR: 1.24, CI: 1.19–1.29, P .00001), when compared with autologous oocyte neonates. Conversely, low birth weight outcomes were improved in term donor oocyte neonates (RR: 0.86, CI: 0.8–0.93, P =0.0003). These negative outcomes remained significant when controlling for multiple deliveries. The donor oocyte risk rates are higher than those found in general ART outcomes, are important considerations for the counselling of infertile patients and may also influence the long term health of the offspring.
Publisher: Elsevier BV
Date: 10-1999
Publisher: Wiley
Date: 17-08-2017
DOI: 10.1111/JOG.13449
Abstract: To compare perinatal outcomes for neonates conceived with donated sperm with those for neonates conceived spontaneously in an Australian population cohort. Perinatal outcomes for all births in South Australia for the period January 1986-December 2002 were linked with assisted reproductive treatment records to determine those conceived from donated sperm. Birth outcome measures were analyzed using Student's t-test and logistic regression using generalized estimating equations to determine statistical significance. Donor sperm neonates were not significantly different from their spontaneously conceived counterparts in terms of mean birthweight, low birthweight, preterm delivery, small for gestational age, or large for gestational age. They were, however, significantly more likely to be born at lower mean gestational age (P = 0.012), and to have preterm delivery with low birthweight (P = 0.008), when controlling for maternal age, parity, ethnicity, socioeconomic quartile and baby's sex. These associations were not apparent when singletons and twins were considered separately. There was some evidence of compromised perinatal outcomes for donor sperm neonates compared with their spontaneously conceived counterparts, which appeared to be partly attributable to multiplicity.
Publisher: Public Library of Science (PLoS)
Date: 08-01-2014
Publisher: Georg Thieme Verlag KG
Date: 08-02-2016
Abstract: This review summarizes the evidence concerning effects of night shift work on women's reproductive health, specifically difficulty in conceiving and miscarriage. We distinguish between fixed night shift and rotating night shift, as the population subgroups exposed, the social and biological mechanisms, and the magnitude of effects are likely to differ of note, women working fixed night shift are known to have high tolerance for this schedule. We identified two relevant systematic reviews with meta-analyses and five additional studies. Night shift work may give rise to menstrual cycle disturbances, but effect sizes are imprecise. Endometriosis may be elevated in night shift workers, but evidence is only preliminary. Adequate data are lacking to assess associations between night shift work and infertility or time to pregnancy. The weight of evidence begins to point to working at night, whether in fixed or rotating shifts, as a risk factor for miscarriage. There are many methodological problems with this literature, with substantial variation in the definitions of night shift and schedule types making comparisons between studies difficult and pooling across studies questionable. Nevertheless, there appears to be grounds for caution and counselling where women have concerns about night shift work and their reproductive health.
Publisher: BMJ
Date: 06-08-2014
DOI: 10.1136/OEMED-2014-102101
Abstract: To develop a job-exposure matrix (JEM) that estimates exposure to eight variables representing different aspects of shiftwork among female workers. Occupational history and shiftwork exposure data were obtained from a population-based breast cancer case-control study. Exposure to light at night, phase shift, sleep disturbances, poor diet, lack of physical activity, lack of vitamin D, and graveyard and early morning shifts, was calculated by occupational code. Three threshold values based on the frequency of exposure were considered (10%, 30% and 50%) for use as cut-offs in determining exposure for each occupational code. JEM-based exposure classification was compared with that from the OccIDEAS application (job-specific questionnaires and assessment by rules) by assessing the effect on the OR for phase shift and breast cancer. Using data from the Australian Workplace Exposure Study, the specificity and sensitivity of the threshold values were calculated for each exposure variable. 127 of 413 occupational codes involved exposure to one or more shiftwork variables. Occupations with the highest probability of exposure shiftwork included nurses and midwives. Using the 30% threshold, the OR for the association between phase shift exposure and breast cancer was decreased and no longer statistically significant (OR=1.14, 95% CI 0.92 to 1.42). The 30% cut-off point demonstrated best specificity and sensitivity, although results varied between exposure variables. This JEM provides a set of indicators reflecting biologically plausible mechanisms for the potential impact of shiftwork on health and may provide an alternative method of exposure assessment in the absence of detailed job history and exposure data.
Publisher: Springer Science and Business Media LLC
Date: 25-11-2021
Publisher: Springer Science and Business Media LLC
Date: 24-09-2020
Publisher: Research Square Platform LLC
Date: 18-10-2023
Start Date: 2007
End Date: 2011
Funder: National Health and Medical Research Council
View Funded ActivityStart Date: 2006
End Date: 2008
Funder: National Health and Medical Research Council
View Funded Activity