Small babies, big costs

Thursday 7 June 2012

Media Release

Small babies, big costs

The Health Research Council of New Zealand (HRC) has announced $65.2M of government research funding investment into issues that impact most heavily on the health of New Zealanders.

It has been known for some time that there may be life-long consequences for the 8,000 New Zealanders each year who are born small - due to restricted growth in utero or premature birth. Very low birthweight babies account for nearly 2 per cent of all births but 75 per cent of the workload of newborn intensive care units. These babies are at increased risk of death and illness around birth, impaired growth and intellectual achievement, and poorer health throughout their lives. With HRC support, the Liggins Institute at The University of Auckland has greatly advanced the understanding of these consequences, and of the impact of the fetal environment on health in the vital first weeks of pregnancy. Thanks to this important work, we now know that genes that affect the risk of disease in later life can be switched on by nutritional and other triggers before a woman even knows that she is pregnant.

The HRC is supporting Associate Professor Francis Bloomfield and his team at the Liggins to continue a Programme of work to find a treatment for babies whose growth is restricted in utero, allowing them to grow before they are born. As there is currently no treatment available before birth, these babies are currently encouraged towards accelerated or "catch-up" growth after birth - but this has been associated with increased risk of later disease. It is not known if catch-up growth is the cause. The research team are also seeking to answer this question, looking at whether nutritional supplements in that critical period lead to a change in body composition and altered disease risk. The Programme will also provide a better understanding of whether the high blood glucose levels common in preterm babies has an effect on how their pancreas develops, compromising their ability to produce insulin and causing diabetes in the future.

Professor Alistair Gunn has been awarded an HRC Programme to lead his University of Auckland team in a series of studies that will help to prevent brain injury in preterm infants; the cause of around half of cerebral palsy cases. Thanks to earlier research supported by the HRC, we know that brain injury in these babies evolves over many hours, spreading to undamaged regions of the brain and finally leading to long-term impairment of brain development. Fortunately, this earlier research also focused on interrupting this process. The team has played a key role in developing brain cooling, now the first established

therapy for brain injury in babies that have been deprived of oxygen due to difficulties during their birth. The babies are fitted with a special cap that allows their heads to be actively cooled with circulating water. However, cooling is only partially protective, is effective only in a limited window of time, and may not be suitable for preterm infants. This new programme will determine the impact of several standard treatments in preventing injury to the brains of preterm babies, evaluate promising new interventions to protect the brain after injury due to low oxygen, including a peptide that can block the spread of brain injury, and then test ways of restoring long-term brain growth. Finally, the team will use new EEG measures of brain injury they developed in a clinical study to test whether it is possible to rapidly identify premature babies who may benefit from the new treatments.

Professor Brian Darlow of the University of Otago, Christchurch, has received funding from the HRC for a research project, which is being co-funded by Cure Kids, whose work contributes to funding vital medical research into life-threatening childhood illnesses in New Zealand.

Professor Darlow heads a research team that has been following the health, developmental and functional outcomes of babies born very small in 1986. They have been studied at 7-8 years and most recently in their early twenties. The current project will focus on 250 individuals from the original study, now aged 26-27 years, and measure a large number of variables in two days of intensive tests. The results will be compared with those of people who were born at full-term in the same year. No data exist for New Zealand, but overseas studies suggest such young adults have increased risks of physical and health problems, educational underachievement and poorer social functioning than their peers. The findings will inform health, education and social policies concerning very preterm survivors as well as future newborn care.

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