Recently Funded Research Projects
Understanding the mechanisms mediating Sudden and Unexpected Death in Childhood
This study aims to better understand the underlying mechanism mediating sudden and unexpected death in childhood. In order to achieve this goal researchers from around the world are uniting to form effective collaborative networks.
One of the greatest human tragedies is the sudden unexpected death of a child—when that death remains unexplained, it is even more devastating for the parents, the family, and society at large. Fortunately the sudden unexplained death of a child (SUDC), which is defined as the sudden and unexpected death of a child over the age of 12 months which remains unexplained after a thorough case investigation is conducted, is rare – occurring mainly in toddlers with an incidence of 1.2/100,000 in the United States.
Yet, it is this very rarity that makes research into the causes and mechanisms of SUDC almost intractable. Indeed, it is virtually impossible for any one investigator to accrue a sufficient number of cases to determine commonalities among them—the critical clues that lead to testable hypotheses and evidence-based scientific inquiry necessary to determine the ultimate means of prediction and prevention. Thus, it is essential that investigators come together to pool their ideas, drive, and resources and study SUDC in a concentrated world-wide effort.
The Cooper Trewin SUDC Research Fund, in partnership with SIDS and Kids, announces its support of the development of an international initiative between Australia (Dr. Jhodie Duncan, Florey Institute of Neuroscience and Mental Health) and the United States (Professor Hannah Kinney, Children’s Hospital Boston/Harvard) to perform SUDC research through the organising leadership of the SUDC program at Children’s Hospital Boston. This initiative involves support in the transition and infrastructure-building period, as well as support for shared research studies into potential brain mechanisms underlying SUDC. The project also includes investigation of a new research program that explore the link between SUDC and potential serotonergic brainstem pathology as seen in Sudden Infant Death Syndrome, that is is death in SUDC cases mediated by the same factors as SIDS but occurs at a later time point in life?
Thus this project represents a critical opportunity to rethink and reshape the direction of SUDC research and to build into it for the first time the infrastructure for international collaborative endeavours with Australian and overseas researchers.
The overriding goal is to identify why children, who seem normal and health, may die suddenly and unexpectedly and is this related to abnormalities in the brain. The next step would be to implement intervention strategies to prevent an adverse outcome.
Implementation of the Perinatal Society of Australia and New Zealand Guidelines for Perinatal Mortality: Improving clinical practice in maternity hospitals to reduce stillbirth and neonatal death and provide appropriate bereavement care for parents.
The death of a child is among the most devastating life events an adult may experience in their life. In Australia and New Zealand (ANZ), 10 babies die every day through stillbirth and neonatal death.
Despite the frequency of this loss, thorough investigation and review of possible causes is often lacking, resulting in loss of important information to help explain why the baby died.
In ANZ, up to 30% of stillbirths are unexplained. However, the lack of comprehensive investigation in many instances may mean that a cause was missed.
Adequate investigation is essential in helping parents to understand “what went wrong” which may help in recovery from the loss and also in planning future pregnancies. A better understanding of these deaths enables practice changes aimed at reducing the number deaths.
In order to improve clinical practice around the time of perinatal death, the Perinatal Society of Australia and New Zealand developed national clinical practice guidelines in collaboration with professional colleges and SIDS and Kids and SANDS. From the experience of the multidisciplinary team involved in the guideline development over many years working parents who suffer the tragic loss of a baby, it was clear that improvements in the care provided was urgently needed. Therefore, in addition to recommendations about investigation of these deaths, the guideline also aimed to improve bereavement care for parents.
However, a recent survey of midwives and doctors across Australian and New Zealand hospitals clearly showed that many were not following the guideline. The Australian and New Zealand Stillbirth Alliance in collaboration with PSANZ and member organisations have developed a program to assist health care professionals in using the guideline when caring for families whose baby dies. An important part of this program is the educational program -IMPROVE (IMproving Perinatal Review and Outcomes Via Education) – an interactive educational program. The program will be undertaken across maternity hospitals in 2010 and will include an evaluation to measure how successful the program has been.
The main aim of the implementation program is to improve the information available on the causes and contributing factors for stillbirths and neonatal deaths with the goal of reducing these deaths. Further, this project aims to improve bereavement care for parents following a stillbirth or neonatal death in Australian and New Zealand maternity hospital settings.
The summary report on the evaluation of the IMPROVE program can be downloaded here:
2009 Ambulatory Fetal Monitoring
This groundbreaking research has been partly funded by SIDS and Kids and incorporates the accelerometer, a tiny electronic device that was originally developed for car airbags and is now used in Nintendo Wii, the Apple iPhone and Nike+iPod shoes.
Biomedical engineers adapted this technology to develop the fetal monitor used in the research project. The fetal monitor is being tested at the Royal Women’s Hospital, The Royal Brisbane & Women’s Hospital (RBWH) and the Mater Mothers’ Hospital. It uses the accelerometer technology to measure babies movements over a prolonged period of time.
The team of researchers led by Professor Paul Colditz, Director of the Perinatal Research Centre, Royal Brisbane and Women’s Hospital, has two major aims for this research. One, that it provides a framework to understand what a ‘normal’ pattern of movement is for a baby in the final term – a topic that is vastly under-researched. And two, that it potentially leads to a low cost, non-invasive device that could be attached to the stomach of mothers who are concerned about lack of movement.
Pregnant women feel about one third of the baby’s movements. The best way of measuring all the baby’s movements is during an ultrasound, however that is expensive and means that the pregnant woman needs to attend hospital and lie still for about half an hour to have this testing done. The Ambulatory Fetal Activity Monitorwill enable these measurements to be taken whilst the pregnant women is mobile and going about normal day-to-day activities and over a longer period of time. It is hoped that by using this device, health practitioners will obtain more information that will assist in the prevention of stillbirth.
As the next phase of the study will involve extensive clinical trials, it will be several years before the project is completed and the Ambulatory Fetal Activity Monitor has potential to be available in the market place. This project is jointly funded by the National Health and Medical Research Council (NHMRC) and SIDS and Kids.
2006-2008 Transplacental transmission of viruses and pathogenesis of stillbirth, preterm births and congenital abnormalities
A collaborative project between Virology Division SEALS POW Hospital, NSW (Prof Bill Rawlinson, Dr Lyndall Brennan), RPA Women’s and Babies (A/Prof Heather Jeffery), RNS Hospital (Prof Jonathan Morris), CH Westmead (A/Prof Cheryl Jones) & RHW (Dr Kei Lui).
The project aimed to find new techniques for testingi for nfection among pregnant women and to determine what types of viruses cause stillbirth, preterm problems and abnormalities. A third of stillbirths are still unexplained after post-mortem examination. Viruses are the most likely candidate. CMV is the most common virus found in stillbirths to date, according to our research which was funded by SIDS and Kids”. Professor Rawlinson, 2006.
You can download a copy of the Research List in PDF format below: