Vitamin D In Pregnancy And Growth Of The Offspring.
Funder
National Health and Medical Research Council
Funding Amount
$168,550.00
Summary
Vitamin D is a potent steroid hormone required for bone growth and mineralisation, and there is evidence that it regulates cell proliferation. Insufficiency in pregnant women is a cause for concern. The role of vitamin D in human fetal development has been little investigated. At the severe end of the maternal vitamin D insufficiency spectrum, a very small number of deficient neonates have congenital rickets. Low maternal vitamin D status has also been associated with neonatal hypocalcaemia and ....Vitamin D is a potent steroid hormone required for bone growth and mineralisation, and there is evidence that it regulates cell proliferation. Insufficiency in pregnant women is a cause for concern. The role of vitamin D in human fetal development has been little investigated. At the severe end of the maternal vitamin D insufficiency spectrum, a very small number of deficient neonates have congenital rickets. Low maternal vitamin D status has also been associated with neonatal hypocalcaemia and defective tooth enamel. Randomised trials have shown that giving vitamin D to deficient women significantly improves their offspring's birth size and length at a year of age, in one study even though all infants were given vitamin D supplements post-natally. We do not understand the nature of the relationship between maternal vitamin D status and offspring growth. There could be a continuous association, or a threshold vitamin D level below which offspring growth is impaired. If the latter is the case, that threshold value needs to be known. Furthermore, we do not know whether maternal vitamin D level in early or late gestation is most influential in terms of fetal and infant growth. Raised maternal parathyroid hormone (PTH) level is a marker of disturbed vitamin D metabolism. There is evidence that offspring are shorter with increasing level of maternal PTH. In a study in Geelong, 63% of 20-45 year old women tested in winter, and 32% tested in summer, had vitamin D levels in the range where PTH rises. Thus a significant proportion of women may have insufficient vitamin D, in early or late pregnancy, to sustain optimal fetal growth. These issues are important for the health of mothers and their offspring, and there are public health implications, in terms of maternal health and possibly later health of the offspring. These issues have not been investigated in Australia or elsewhere, and this is a novel and important study.Read moreRead less
Characterisation Of Abnormal Placental Stem Cells In A Human Pregnancy Disorder
Funder
National Health and Medical Research Council
Funding Amount
$487,969.00
Summary
The placenta is a rich source of stem cells. We have discovered that stem cells from placentae affected by fetal growth restriction (FGR), a clinically significant pregnancy disorder, are morphologically and functionally different to normal placental stem cells. We predict that abnormal stem cells contribute to FGR. We will carry out gene expression and functional studies to further characterise the abnormal stem cells. The work may lead to new types of treatments for FGR in future.
An Evaluation Of Inhibin And Activin As Early Markers Of Pre-eclampsia And Fetal Growth Restriction.
Funder
National Health and Medical Research Council
Funding Amount
$96,921.00
Summary
Pre-eclampsia and fetal growth problems are among the major causes of maternal and perinatal death in Australia. One of the most pressing difficulties in the management of these conditions is our present inability to accurately predict those women who are destined to have one or other of these serious complications. Unfortunately, this means that the conditions are often detected late with little or no time to offer effective treatments. This project builds on exciting preliminary evidence that ....Pre-eclampsia and fetal growth problems are among the major causes of maternal and perinatal death in Australia. One of the most pressing difficulties in the management of these conditions is our present inability to accurately predict those women who are destined to have one or other of these serious complications. Unfortunately, this means that the conditions are often detected late with little or no time to offer effective treatments. This project builds on exciting preliminary evidence that suggests that a simple blood test from the mother in early pregnancy may be able to identify the women who will subsequently develop high blood pressure in late pregnancy, or the babies that will suffer impaired growth before delivery. In the future, such knowledge might then allow these women to receive more effective care, thereby improving their chance of a successful pregnancy. The project will also define the best time in pregnancy to perform the blood test and, if successful, could alter the very way women are currently looked after during their pregnancy.Read moreRead less
Fetal Intrapartum Pulse Oximetry: A Multicentre Randomised Controlled Trial
Funder
National Health and Medical Research Council
Funding Amount
$246,001.00
Summary
Current methods of monitoring the well-being of the unborn baby during labour often result in concern about the unborn baby's health. This leads to delivery by caesarean section, forceps, or vacuum. These babies are usually found to be healthy once born, meaning that the operation was unnecessary. In this study, when an unborn baby appears to be distressed, half of the study participants will be allocated to continue with the current monitoring of the baby's heartbeat. The other half will have a ....Current methods of monitoring the well-being of the unborn baby during labour often result in concern about the unborn baby's health. This leads to delivery by caesarean section, forceps, or vacuum. These babies are usually found to be healthy once born, meaning that the operation was unnecessary. In this study, when an unborn baby appears to be distressed, half of the study participants will be allocated to continue with the current monitoring of the baby's heartbeat. The other half will have a new form of monitoring in labour, fetal oxygen saturation monitoring, added. We will then determine whether the new form of monitoring makes a difference in the number of times women need to have a caesarean section, forceps, or vacuum delivery. It is important to do this research BEFORE the new form of monitoring becomes used routinely. This Australian research is leading the world in letting the health consumer (women) know whether the now monitoring method is effective in practice and ensuring that there are no unforeseen adverse events.Read moreRead less
Fetal Intrapartum Pulse Oximetry: A Multicentre Randomised Controlled Trial (the FOREMOST Trial)
Funder
National Health and Medical Research Council
Funding Amount
$146,950.00
Summary
Current methods of monitoring the well-being of the unborn baby during labour often result in concern about the unborn baby's health. This leads to delivery by caesarean section, forceps , or vacuum. These babies are usually found to be healthy once born, meaning that the operation was unnecessry. In this study, when an unborn baby appears to be distressed, half of the study participants will be allocated to continue with the current monitororing of the baby's heartbeat. The other half will have ....Current methods of monitoring the well-being of the unborn baby during labour often result in concern about the unborn baby's health. This leads to delivery by caesarean section, forceps , or vacuum. These babies are usually found to be healthy once born, meaning that the operation was unnecessry. In this study, when an unborn baby appears to be distressed, half of the study participants will be allocated to continue with the current monitororing of the baby's heartbeat. The other half will have a new form of monitoring in labour, fetal oxgyen saturation monitoring, added. We will then determine whether the new form of monitoring makes a differnce in the number of times women need to have a caesarean section, forceps, or vacuum delivery. It is important to do this research BEFORE the new form of monitoring becomes used routinely. This Australian research is leading the world in letting the health consumer (women) know whether the new monitoring method is effective in practice and ensuring that there are no unforeseen adverse events.Read moreRead less
The Effect Of Asthma During Pregnancy On Placental Function And Fetal Development
Funder
National Health and Medical Research Council
Funding Amount
$378,600.00
Summary
Asthma affects 12% of the Australian population and is expected to increase to 20% over the next 10 years. This rise will result in an increase in the number of women who suffer from asthma during pregnancy and could emerge as a major public health problem since asthma during pregnancy is associated with low birthweight babies. Lower birthweight itself is an increased risk factor for a number of adult diseases such as diabetes and coronary artery disease and thus the children of asthmatic women ....Asthma affects 12% of the Australian population and is expected to increase to 20% over the next 10 years. This rise will result in an increase in the number of women who suffer from asthma during pregnancy and could emerge as a major public health problem since asthma during pregnancy is associated with low birthweight babies. Lower birthweight itself is an increased risk factor for a number of adult diseases such as diabetes and coronary artery disease and thus the children of asthmatic women are at risk for numerous pathologies throughout life. Nevertheless, the specific mechanisms that cause low birthweight in asthmatic pregnancies are unknown. We currently have a lead in this important area. Our data so far indicates that asthma produces alterations in placental blood flow and glucocorticoid metabolism that are particularly pronounced when the fetus is female. Inhaled glucocorticoid therapy is protective of the effects of asthma on the fetus suggesting the involvement of inflammatory pathways. The long term objectives of our work are to elucidate the effects of asthma on fetal health and to design better ways to manage asthma during pregnancy to improve the outcome for the baby. The short term objective of this grant is to define whether inflammatory factors associated with asthma during pregnancy change placental function to adversely affect fetal development and whether these effects are related to the sex of the fetus. Completion of these studies will provide both scientific and clincial outcomes. Scientifically, a biological basis for understanding alterations in placental physiology observed in women with asthma will be produced. Clinically our work will open avenues to optimize therapy for this group of women to improve their pregnancy and the outcome for their babies.Read moreRead less
A Genomic Basis For Cerebral Palsy - Studies On A Large Australian Cohort
Funder
National Health and Medical Research Council
Funding Amount
$518,305.00
Summary
Cerebral Palsy (CP) is the commonest neurological disability in children, affecting 1 in every 500 children. This research will investigate genetic causes of CP by testing families with and without CP for a range of genetic alterations that change fetal protection to inflammation with resultant brain damage and CP. Research in to the causes of CP will allow prevention strategies to be developed, to ultimately reduce social and financial costs of CP for the patient, their family and the community ....Cerebral Palsy (CP) is the commonest neurological disability in children, affecting 1 in every 500 children. This research will investigate genetic causes of CP by testing families with and without CP for a range of genetic alterations that change fetal protection to inflammation with resultant brain damage and CP. Research in to the causes of CP will allow prevention strategies to be developed, to ultimately reduce social and financial costs of CP for the patient, their family and the community.Read moreRead less
The Impact Of Severe Asthma During Pregnancy On Placental Function And Fetal Hypothalamic-pituitary-adrenal Function
Funder
National Health and Medical Research Council
Funding Amount
$209,242.00
Summary
This study will examine whether the glucocorticoids administered for the control of severe asthma during pregnancy affects placental and fetal function. It is known that severe asthma during pregnancy is associated with low birth weight babies but the events that cause reduced growth of the baby are unknown. However in both animal and human pregnancies, increased exposure of the baby to glucocorticoids from the mother causes growth restriction of the baby. Therefore we propose that the increased ....This study will examine whether the glucocorticoids administered for the control of severe asthma during pregnancy affects placental and fetal function. It is known that severe asthma during pregnancy is associated with low birth weight babies but the events that cause reduced growth of the baby are unknown. However in both animal and human pregnancies, increased exposure of the baby to glucocorticoids from the mother causes growth restriction of the baby. Therefore we propose that the increased intake of glucocorticoids for the treatment of asthma during pregnancy changes how the placenta functions and allows the fetus to be exposed to maternal glucocorticoids causing changes in fetal development. We will examine placental blood flow and measure some placental enzymes that may be involved in the control of blood flow in placentas collected from women with mild, moderate and severe asthma and compare them to non-asthmatic women. We will look at placental blood flow in utero using Doppler ultrasound and also in vitro after the placenta is delivered. We want to see if the fetus is affected by increased intake of glucocorticoids by the mother by measuring a hormone estriol, which originates from the fetus. We will measure estriol throughout pregnancy as it can easily be detected in the mothers' urine. These studies will tell us if glucocorticoid intake for the treatment of asthma can exert effects on the placenta and baby during pregnancy. These studies will make a significant contribution both scientifically and clinically. At a scientific level we will be able to examine how increased maternal glucocorticoid intake during pregnancy affects placental mechanisms and whether these changes affect the fetus and clinically the outcome of this study will allow us to optimize asthma therapy during pregnancy so that we can improve the outcome for the baby.Read moreRead less