Antiplatelets For Prevention Of Pre-eclampsia: An Individual Patient Data Review
Funder
National Health and Medical Research Council
Funding Amount
$274,000.00
Summary
High blood pressure is a common complication of pregnancy affecting ~20,000 Australian women each year. Although most women and their babies do well, pre-eclampsia, defined as high blood pressure together with protein in the urine is a more serious problem. Severe pre-eclampsia is associated with 10-15% of maternal deaths. Fetal and newborn baby deaths are also increased. Mother and baby morbidity is high principally due to the associated complications in pregnancy, increased obstetric intervent ....High blood pressure is a common complication of pregnancy affecting ~20,000 Australian women each year. Although most women and their babies do well, pre-eclampsia, defined as high blood pressure together with protein in the urine is a more serious problem. Severe pre-eclampsia is associated with 10-15% of maternal deaths. Fetal and newborn baby deaths are also increased. Mother and baby morbidity is high principally due to the associated complications in pregnancy, increased obstetric interventions, fetal growth restriction and preterm birth. As yet we have no safe and effective way of preventing this life threatening condition. Aggregation of platelets (involved in blood clotting) is known to be part of the disease and could lead to the disturbances in the circulation of the mother and the placenta. Antiplatelet agents, low dose aspirin in particular, might prevent or delay the development of pre-eclampsia. Some trials and a Cochrane systematic review of all trials (involving over 30,000 women) suggest that pre-eclampsia, preterm birth and perinatal death could be reduced. However, it is still not clear which women will benefit, when in pregnancy the treatment should start and what dose of aspirin is both effective and safe. This proposed individual patient data review in which data on all women who have been entered in trials is gathered from the original investigators, including missing information on potential harms. This proposal represents a good investment of resources to obtain the information needed by women and health professional to make decisions about the use of aspirin. International investigators from all the primary trials have already formed a collaboration to oversee the project: the Perinatal Antiplatelet Review of International Studies (PARIS) Collaboration Furthermore, working through an international collaboration will ensure the highest quality in data availability, as well endorsement and implementation of the results in practice.Read moreRead less
Adaptations Of Methods For Estimation Of Familial Correlation In Age At Onset Of Disease
Funder
National Health and Medical Research Council
Funding Amount
$146,250.00
Summary
Chronic diseases such as coronary heart disease, breast cancer, prostate cancer and non-insulin dependent diabetes are responsible for a significant burden of ill-health in society. Studies of familial aggregation are important in determining the relative magnitude of genetic and lifestyle-environment factors associated with chronic diseases, and in identifying individuals and families at high risk, even in the absence of conventional risk factors. The findings have implications for health promo ....Chronic diseases such as coronary heart disease, breast cancer, prostate cancer and non-insulin dependent diabetes are responsible for a significant burden of ill-health in society. Studies of familial aggregation are important in determining the relative magnitude of genetic and lifestyle-environment factors associated with chronic diseases, and in identifying individuals and families at high risk, even in the absence of conventional risk factors. The findings have implications for health promotion in the general population and disease prevention in those identified to be at high risk. An outstanding characteristics of these studies is that many participants had an event at some unknown time before the entry. This project aims at adapting current methods to properly account for events before entry and to provide estimates of familial aggregation between parents, between children and between parents and children in the same model. Furthermore, it provides freely available software for proper familial analyses which have not had any feasible numerical methods (or software). In addition, it provides estimates of familial aggregation of coronary heart disease in Busselton families which has longer follow-up than most other studies. This project is very cost effective as the Busselton Health Study consists of a series of cross-sectional surveys since 1968 and currently has hospital morbidity and death follow-up from medical record linkage until the end of 1997.Read moreRead less
The starting point for this project is the recent finding that women who experience miscarriages or terminations of pregnancy before theuir first birth have an increased risk of having a preterm (premature) infant. These findings have prompted a re-evaluation of the relationship between the number of pregnancies a women has had and the likely outcome in later pregnancies. It will take into account the stage at which prior pregnancies ended, what the outcomes of the pregnancies were (birth, healt ....The starting point for this project is the recent finding that women who experience miscarriages or terminations of pregnancy before theuir first birth have an increased risk of having a preterm (premature) infant. These findings have prompted a re-evaluation of the relationship between the number of pregnancies a women has had and the likely outcome in later pregnancies. It will take into account the stage at which prior pregnancies ended, what the outcomes of the pregnancies were (birth, health baby, death, baby with a birth defect, termination, miscarriage etc), as well as factors such as maternal age, in relation to the risks in subsequent pregnancies. The expected outcomes and significance of the study are: * new evidence about factors causing adverse outcomes of pregnancy; * better information on the risk of recuurence of common birth defects; * more precise information on risks of adverse pregnancy outcomes for users and planners of maternity services.Read moreRead less