$6.4m of HRC grants to Liggins researchers
3 September 2019
Liggins Institute researchers have received almost $6.4m in funding from the Health Research Council New Zealand so far this year to carry out studies that will benefit thousands of babies, mothers and teens.
Institute director Professor Frank Bloomfield says the funding allows valuable research to be carried out.
“To have certainty of funding for three years or longer enables our researchers to focus their considerable talents on carrying out excellent, timely research that will continue to inform health policy and practice.”
Distinguished Professor Jane Harding received $4.97m over five years (Programme Grant), Professor Mark Vickers received $1.14m over three years (Project Grant), and Alvina Pauuvale and Heimata Herman received Pacific Health PhD scholarships.
Follow-ups to major child health studies to reveal long-term effects of early interventions; and discovering what matters to families
Randomised trials are the gold standard for assessing which new treatments, including those in early life, are best at improving health outcomes. To maximise the benefits of such trials, and understand long-term benefits and risks, detailed follow-up of participants is required over many years. But this is difficult, expensive, and often not feasible.
Led by Professor Harding, the research programme 'Assessing the impact of maternal and perinatal interventions on life-long health' will undertake crucial long-term follow-up of participants in six key randomised trials involving mothers and babies: hPOD and pre-hPOD (children who were at risk of newborn low blood sugars), ProVIDe (a nutritional trial for babies born preterm), the adult children of mothers in the original, landmark Mont Liggins and Ross Howie trial of antenatal corticosteroids, adult children of mothers who were in the ACToRDS trial, which compared a single to repeat courses of antenatal corticosteroids, and mothers and their children from the GEMS study of gestational diabetes.
Between 400 and 1,000 participants per year will be assessed over the next five years.
...sometimes short-term results showing a treatment is safe and effective may not be enough to change practice, because concerns about possible later adverse effects linger
“There are two main rationales for follow-up: you want to make sure you keep using effective treatments, and stop using ineffective ones. But also if there are concerns about ‘trade-offs’ – benefits in one area, adverse effects in another – only follow-up will tell us about that and transform practice. We know, for example, from the steroid research that sometimes short term results showing a treatment is safe and effective may not be enough to change practice, because concerns about possible later adverse effects linger.”
If there is a trade-off to be made – for example, a treatment that may save a newborn’s life but increase their risk of diabetes in 50 years – the research team also want to make sure that parent and whānau views of what health outcomes matter most can be taken into account.
“Traditionally, the medical research model has been to look at particular health outcomes – for example developmental disorders, health conditions, academic performance. But these may not be what the family think is most important. We want to understand the outcomes that matter to different communities and whānau.”
Blood biomarker for preterm birth?
Pregnancy complications, including preterm birth (eight percent of births in New Zealand), have major health impacts on the mother and baby, as well as significant healthcare costs. A number of those babies who survive preterm birth will have a permanent disability.
About 60 percent of preterm births occur spontaneously, often in women with no prior history or warning. Currently, there is no way of reliably predicting whether an individual woman will go into labour prematurely.
But a pilot study led by Professor Mark Vickers identified a unique molecular fingerprint in blood taken from women at 20 weeks of pregnancy who all went on to have their babies early, at 28-32 weeks. The fingerprint was not present in blood taken from women at the same stage in pregnancy who went on to deliver at term.
This could enable the targeting of existing and future therapies to delay or even prevent preterm birth
The potential biomarker was derived from micro-RNA (miRNA) analysis. MiRNAs are small non-coding RNA molecules that play key roles in the regulation of gene expression, and are also known to be involved in the development of and protection from a range of diseases.
The new, HRC-funded project will expand the preliminary findings across three sites, including Australia and Ireland. The ultimate goal is to develop and validate effective non-invasive biomarkers for preterm birth using a platform that can then be translated across other pregnancy complications, such as gestational diabetes.
“This is exciting, as it could potentially lead to much better outcomes for the babies and their mothers in the short and long terms,” says Professor Vickers. “It could enable the targeting of existing and future therapies to delay or even prevent preterm birth.”
Teens as agents of intergenerational change
Rates of noncommunicable diseases such as obesity and type 2 diabetes are steadily rising in New Zealand, particularly in Pacific and Māori populations. We’re also seeing increasing rates of related risk factors in children and adolescents, which will in turn increase the risk of their future children being susceptible to these diseases.
Supporting adolescents to develop positive dietary habits not only supports their health and wellbeing, it also helps give their children a better shot at a healthy start to life.
Alvina Pauuvale and Heimata Herman are using their Pacific Health PhD scholarships to research the best ways to support teenagers to understand the importance of good nutrition, and empower them to challenge societal factors that prevent so many families from accessing a healthy start for their children.
Alvina will investigate the potential of a school-based intervention, while Heimata is focusing on the Cook Islands, which is burdened with very high rates of NCD risk among adolescents. Her study will examine and document different styles of health-related policy currently in use within Cook Island secondary schools, testing their potential for supporting active adolescent engagement.
Nicola Shepheard | Media Adviser
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