Research within John Hunter Children's Hospital NICU aims to improve the care and outcome of newborn babies today and in the future. Neonatal research has improved the understanding of babies with health problems and greatly improved their survival and long term outcomes. We continue to do research studies to make sure that babies continue to benefit from the best treatments. This is achieved through local studies and joining other neonatal centres around the world in their research. All research undertaken within the hospital has approval from the HNELHD Ethics Committee.
If your baby is looked after in the Neonatal Unit, you may be asked if she or he can take part in one or more of these studies. If you would like to know more about any of the research studies, please ask a nurse or doctor in the nursery. Currently, the following major studies are being conducted in the neonatal intensive care unit:
Cardiac function and development in very preterm infants during the neonatal intensive care period
The development of the heart as a fetus follows a pre-described pathway until its ‘ready’ to cope with the changes after birth at your due date. However, when born premature, the heart has to adapt to its new environment at a much earlier date. There are indications that this might influence the final function and development of the heart in later life. This study uses modern ultrasound technology to measure the heart in preterm infants at several time points during the NICU stay and aims to classify those changes.
CANS 3 study
Unfortunately babies born prematurely are much more likely to experience problems as a direct result of being born early. Previous work has demonstrated that baby boys do not do as well as baby girls. Adapting to life outside the womb successfully, requires great changes in the way a baby’s heart and lungs work and the processes underlying these changes are not yet fully understood. We aim to further investigate these changes using cardiac ultrasound and skin blood flow measurements.
Australian Placental Transfusion (APTS)
The Australian Placental Transfusion study will compare two ways of caring for babies at birth. The first is standard practice - clamping the umbilical cord at birth immediately so that care of the baby and delivery of the placenta (the third stage of labour) can start straight away. The second is to let the baby get extra blood by holding the baby below the level of the placenta and waiting for a minute or more before clamping the cord. This is called placental transfusion. Placental transfusion may help preterm babies by preventing anaemia and improving low blood flow. This may reduce bleeding in the brain, lung and gut problems, infections and need for blood transfusions.
Approximately 40% of very premature babies (those born at less than 29 weeks gestation) born in Australia and New Zealand will develop a lung disease known as bronchopulmonary dysplasia or BPD. As the lungs of premature babies are underdeveloped, the essential breathing support and oxygen they receive contributes to inflammation of the lungs. It is now thought that inflammation is one of the factors leading to BPD, a condition which can contribute to long-term brain and lung problems. The aim of this trial is to determine if DHA (Fish oil) supplementation reduces BPD in very preterm babies.
Human lactoferrin is a protein in breast milk which helps protect against infection. Bovine lactoferrin is a dairy protein in cow’s milk and a normal part of our diet. Bovine lactoferrin is very similar to human lactoferrin, and this study explores if adding lactoferrin to your babies’ milk can increase survival free from infection and other complications in very low birth weight babies.
Premature babies are at risk of infections including a specific infection of the gut called necrotising enterocolitis. Recent evidence has suggested that they may do better if they have “good bacteria” added to their milk as probiotics. The Proprems trial looked to see if using such a probiotic will protect premature e babies from infection and its consequences.The Proprems Neuro Trial is looking at the infants who participated in the Proprems Study who are now more than 2 years old. The aim is to find out if good bacteria (probiotics) given to premature babies improves their brain development.
Doctors know that seizures occur more often in babies than in older children. Seizures in babies may result in damage to their brain that may lead to epilepsy or affect their learning, thinking and memory. There is not a lot of research as to the best way to treat seizures in babies and to protect their brain function. However increased ability to monitor very small seizures that do not cause actual visible fits has led to increased treatment use. Treatments themselves may interfere with brain development and function. The aim of this research project is to compare the treatment of seizures that are physically seen by doctors and nurses (standard clinical care) to when seizures are detected using an aEEG, (a monitor attached to the head that reads brainwave patterns) to see which method is better at protecting brain function in the longer term.
Birth asphyxia occurs when there is low oxygen and/or low blood supply to the brain and may result in brain damage, disability or even death. Current treatment is to lower your baby’s body temperature (cooling) for 3 days to minimize brain damage. Even with cooling, nearly one in two infants either will not survive or will survive with major disability. This study is to find out if Erythropoietin treatment in addition to cooling improves survival and reduces the chances of disability for babies with birth asphyxia.
Some babies when born may need to help recover from the birth process. In the past we have always used 100% oxygen for babies, however, research has shown that it is better for babies born >37weeks gestation to use air first and increase oxygen as required This study is looking to see if we should be doing the same thing or change our oxygen concentration during resuscitation in premature babies at delivery.