Newly Funded Study Aims To Improve Outcomes For More Than One In 10 New Zealand Births – Scoop.co.nz

Tuesday, 30 June 2020, 8:05 am Press Release: Health Research Council Of New Zealand

New Zealand researchers are about to undertake the largest-ever trial of corticosteroids in women having planned caesareans, to assess the treatments benefit and potential harm in newborns.

Associate Professor Katie Groom from The University of Aucklands Liggins Institute has just been awarded $1.43 million by the Health Research Council of New Zealand (HRC) to lead a nationwide placebo-controlled, randomised trial into the effects of maternal corticosteroid use prior to planned caesarean at between 35 to 39 weeks of pregnancy.

She says the trial will address a serious evidence gap and will reliably inform future practice across New Zealand and globally.

In New Zealand, birth by planned caesarean section continues to rise and now accounts for more than one in 10 births (7,500 babies a year). To counter the increased risk of breathing problems that can occur with planned caesareans, mums are often given corticosteroids at near to full-term stages of pregnancy; however, there is surprisingly limited evidence about the benefits or harm of this fairly common practice.

While corticosteroids administered in earlier stages of pregnancy have well-established benefits for babies born prematurely, little is known about their use at near or full-term, says Associate Professor Groom.

There is low-quality evidence on respiratory benefits, minimal evidence on long-term effects, and no evidence of their effect on blood-sugar levels.

The steroids might help babies with breathing, but they might also disrupt glucose control, which could be detrimental in the long-term, so our trial will look at the balance of benefit versus potential harm.

She says high-quality evidence is required to allow women with planned caesareans to make informed decisions about their treatments.

The C*STEROID Trial will take place in at least 14 hospitals across New Zealand and include 2548 babies and their mothers.

This will be a national effort to answer an important question. Findings aim to be definitive and will inform clinical practice in New Zealand and across the world, she says.

Another benefit of the trial will be the opportunity to follow-up a cohort of the children when they reach the age of six or seven and can be assessed for long-term impacts, such as childhood executive function, body size, and respiratory, cardiovascular and metabolic wellbeing.

The HRCs chief executive, Professor Sunny Collings, says clinical trials like this are imperative to ensuring patient care is informed by strong, reliable evidence not just the best available evidence which is often low quality.

Interventions in pregnancy and infancy can have long-lasting effects. This trial will find out what happens in the short-term, but maintaining contact with the cohort to allow assessment of the longer-term effects will be a major contribution in its own right, she says.

Associate Professor Grooms study is one of 47 new studies awarded a total of $71.58 million in the Health Research Councils latest funding results released today.

Of that total, $19.88 million was awarded to four research programmes that will take up to five years to complete; $47.73 million was awarded to 39 research projects, including $4.87 million for four Rangahau Hauora Mori projects; and another $3.97 million was awarded to four Pacific research projects.

See below for the full list of 2020 Programme, Project, and Pacific Project recipients. To read lay summaries about any of these studies (after the embargo lifts), go to hrc.govt.nz/resources/research-repository and filter by proposal type: Programmes and year 2020; Projects and year 2020; and Pacific Projects and year 2020.

Professor Richard Beasley, Medical Research Institute of New Zealand RCT budesonide-formoterol vs salbutamol reliever therapy in childhood asthma 36 months, $1,439,100

Professor Laura Bennet, The University of Auckland Circadian patterns of fetal heart rate predict impaired fetal oxygenation 36 months, $1,199,998

Professor Ian Bissett, The University of Auckland Randomised trial of a novel chyme reinfusion device for temporary ileostomies 36 months, $1,433,127

Associate Professor Mark Bolland, The University of Auckland Zoledronic acid and fracture prevention in early postmenopausal women 48 months, $1,192,556.85,

Dr Amohia Boulton, Whakauae Research Services Te Ao Rauropi: Mapping the biosphere of Rongo Mori 36 months, $1,199,837

Professor Winston Byblow, The University of Auckland Enhancing Spontaneous Recovery after Stroke Study (ESPRESSo) 48 months, $1,421,459

Professor Gregory Cook, University of Otago Unlocking antimicrobial tolerance in bacterial pathogens to overcome AMR 36 months, $1,197,343

Professor John Dalrymple-Alford, University of Canterbury Brain biomarkers for future cognitive health in Parkinson's disease 48 months, $1,189,160

Professor Catherine Day, University of Otago Time for destruction - switching immune responses off 36 months, $1,197,433

Dr Janak de Zoysa, Waitemata District Health Board ACHIEVE - New Zealand 60 months, $1,061,052

Dr Justin Dean, The University of Auckland Treatment of GABAergic interneuron dysfunction in preterm brain injury 36 months, $1,186,646

Professor Paul Glue, University of Otago Ketamine therapy for neurotic disorders: Is there a single mechanism? 36 months, $1,438,829

Professor David Grattan, University of Otago A neural circuit required for maternal adaptation to pregnancy 36 months, $1,199,971

Associate Professor Katie Groom, The University of Auckland Safely improving outcomes for babies after birth by planned caesarean section 48 months, $1,433,915

Associate Professor Nigel Harris, Auckland University of Technology Implementing high intensity interval training in school 36 months, $1,362,262

Professor Greg Jones, University of Otago The Metformin Aneurysm Trial 48 months, $1,325,323

Dr Kelly Jones, Auckland University of Technology BIONIC2: TBI incidence, causes, costs over time and service access in New Zealand 36 months, $1,192,610

Associate Professor Peter Jones, University of Otago Role of ryanodine receptors in Alzheimers disease 36 months, $1,189,936

Professor Beverley Lawton, Research Trust of Victoria University of Wellington He Tapu Te Whare Tangata: Empowering rural solutions 36 months, $1,293,194

Dr Khoon Lim, University of Otago, Christchurch Smart delivery of growth factors for treating osteonecrosis of the femoral head 24 months, $730,435

Dr Colin McArthur, Medical Research Institute of New Zealand Erythropoietin to improve outcomes for critically ill trauma patients 48 months, $1,199,019

Dr Melissa McLeod, University of Otago, Wellington Prioritising Mori health and equity: a critical approach to modelling 36 months, $1,199,300

Dr Matthew McNeil, University of Otago Combating antimicrobial resistance with high-throughput bacterial genetics 36 months, $1,199,272

Dr Nicole Moreland, The University of Auckland Understanding the role of IgG3 in acute rheumatic fever 36 months, $1,187,148

Dr Marama Muru-Lanning, The University of Auckland Ng Kaumtua Ttou Taonga: Supporting kaumtua health in a changing world 36 months, $1,181,194

Professor Gavin Painter, Research Trust of Victoria University of Wellington Designing a scalable vaccine to induce liver resident T cells against malaria 36 months, $1,195,993

Professor Julian Paton, The University of Auckland Novel potential anti-arrhythmic target 36 months, $1,171,620

Professor Anthony Phillips, The University of Auckland Reducing organ failure in critical illness 36 months, $1,189,800

Dr Raewyn Poulsen, The University of Auckland Turning off the cellular energy supply to treat osteoarthritis 36 months, $1,180,501

Dr Frederik Pruijn, The University of Auckland Enabling clinical development of a novel hypoxia-targeted anti-cancer agent 36 months, $1,199,945

Dr Rohit Ramchandra, The University of Auckland Respiratory modulated pacing to improve outcomes in heart failure 36 months, $1,191,072

Dr Jackie Robinson, The University of Auckland Dying as a health and social justice issue: exploring the impact of deprivation 36 months, $1,199,999

Associate Professor llva Rupenthal, The University of Auckland Tackling the vicious circle of dry eye disease 36 months, $1,195,446

Professor Lynette Sadleir, University of Otago, Wellington Genetic discoveries for unsolved developmental and epileptic encephalopathies 36 months, $1,199,869

Associate Professor Ivan Sammut, University of Otago A novel therapeutic to protect hearts in acute ischaemic procedures 36 months, $1,143,638

Dr Caroline Shaw, University of Otago, Wellington Seeking the transport sweet spot: health, equity and zero carbon 36 months, $1,199,695

Professor Paul Smith, University of Otago Galvanic vestibular stimulation as a treatment for neurological disorders 36 months, $1,188,357

Dr Genevieve Walls, Middlemore Clinical Trials Staphylococcus aureus network adaptive platform trial (SNAP) 60 months, $1,190,216

Dr Paul Young, Medical Research Institute of New Zealand A mega randomised registry trial comparing two approaches to oxygen therapy 60 months, $1,438,369

2020 Pacific Project grants

Dr Sunia Foliaki, Massey University Barriers and facilitators to self-management of asthma in Pacific children 36 months, $971,541

Dr Jesse Kokaua, University of Otago, Wellington Lighted paths and connecting pathways: Education, health and Pacific families 36 months, $1,199,999

Associate Professor Vili Nosa, The University of Auckland A study of Samoan, Tongan, Cook Island Mori, and Niuean infant care practices 36 months, $1,155,335

Dr Seini Taufa, Moana Research Responding to Pacific maternal mental health 36 months, $599,082

2020 Programme grants

Professor Michael Baker, University of Otago, Wellington SYMBIOTIC: Integrated prevention of infectious diseases and long-term conditions 60 months, $4,951,982

Professor Paul Donaldson, The University of Auckland Regulation of lens water transport: A strategy to treat presbyopia and cataract 60 months, $4,936,997

Professor Valery Feigin, Auckland University of Technology Measuring and reducing stroke burden in New Zealand 60 months, $4,996,868

Associate Professor Nevil Pierse, University of Otago, Wellington Research to maximise the health and wellbeing gains from housing 60 months, $4,996,214

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