Injury and Altered Development
The birth of a healthy, full-term infant is the result of the successful orchestration of a multitude of individual developmental events and physiological processes. In many pregnancies a variety of environmental factors impact on the mother, embryo, fetus or newborn baby, resulting in abnormal development. Although these individual factors might have minor effects at the time, the longer-term consequences can be devastating.
Injury and abnormal development can occur in all babies but premature infants are particularly at risk. Over 8 percent of Australian babies are born premature (<37 weeks of gestation). Despite substantial effort, we do not understand why premature birth occurs, how to predict which pregnancies will be affected or how to stop preterm labour once it has begun. As a result of the events precipitating premature birth, and the medical management of women in preterm labour, premature babies are exposed to a variety of factors that result in abnormal development.
Infection or inflammation within the uterus during pregnancy is the principle contributor to the majority of premature births and increases the risk of brain damage and chronic lung disease in babies. Scientists in the Ritchie Centre are investigating the developmental processes that are altered by exposure to infection or inflammation before birth and their long term consequences (on the brain and behaviour, the lungs, heart and blood vessels and immune system). They are also investigating new treatments to try and prevent the adverse effects.
Women at risk of premature birth are routinely given injections of steroid drugs to try and accelerate development of their babies, to better prepare them for early birth. These treatments are life-saving but they do not always work and there are potential adverse side effects, to which growth restricted babies are particularly vulnerable. We are identifying how growth restricted babies respond to these steroid treatments before birth. We are also investigating alternative ways to prepare babies for preterm birth.
More than 7 percent of all Australian babies require some assistance to start breathing after they are born. Unfortunately, the support that is required can cause inadvertent damage to the delicate newborn lungs. High pressures and volumes delivered to infants’ lungs, and high oxygen levels, can cause lung injury and inflammation. With time, this injury can develop into life-threatening chronic respiratory disease; survivors commonly suffer respiratory problems for the rest of their lives, particularly if they also smoke cigarettes. The best way to provide breathing support to newborns, so as to avoid inflammation and lung injury, is not known. Ritchie Centre researchers are working to identify the optimal way in which to support breathing in newborn babies, and are trialling new treatments to prevent lung damage and subsequent disease.
Damage to the developing brain can have devastating consequences, resulting in long-term severe disability or even death. Developmental brain injury results in a spectrum of postnatal disabilities, of which one of the most severe is cerebral palsy, which affects ~35,000 Australians. Schizophrenia and autism may also originate from abnormal development or injury of the fetal or newborn brain. We are investigating the origins of developmental brain injury in a broad range of experiments targeting the various factors known to increase the risk of brain injury in babies (for example a lack of oxygen during birth and infection during pregnancy). We are also working on the development of new treatments to prevent this devastating consequence of abnormal development.