FACULTY OF MEDICINE, DENTISTRY AND HEALTH ... - Paediatrics

Centre for Neonatal Research and Education

ANNUAL REPORT 2013

FACULTY OF MEDICINE, DENTISTRY AND HEALTH SCIENCES

Contents

02 About the Centre

04 Directors’ report

06 Staff and students

09 Awards, prizes and other honours

09 Media

09 Industry connections

10 Research highlights

12 Education highlights

14 Collaborators

15 Visitors to the Centre

16 Grants and research support

17 Clinical trials

19 Conference presentations

22 Publications

Centre for Neonatal Research and EducationAnnual Report 2013

The University of Western Australia | 01

Direction of the Centre is shared by Professor Jane Pillow and Winthrop Professor Karen Simmer, and is administered by the School of Paediatrics and Child Health in the Faculty of Medicine, Dentistry and Health Sciences.

The Centre is a joint initiative between The University of Western Australia and the Womens and Newborn Health Service. The CNRE main office is located at King Edward Memorial Hospital, where 95 per cent of all high-risk deliveries in the state of Western Australia take place.

Our research is concentrated in five nodes:ÌÌ Respiratory physiology

and ventilation;ÌÌ Neonatal cardiology;ÌÌ Nutrition, lactation and

gastrointestinal disease;ÌÌ Infection, inflammation

and immunology;ÌÌ Neurodevelopment and long

term outcomes.

We place a strong emphasis on education, offering workshops and symposia for a broad audience on such topics as neonatal nutrition, neonatal ventilation, and grant writing. Our staff run a state-wide neonatal resuscitation and stabilisation program, as well as postgraduate coursework programs in neonatal nursing (Curtin University) and Neonatology (The University of Western Australia).

The Centre co-ordinates the academic activities of medical, nursing and allied health staff working in the Neonatal Clinical Care Unit based at King Edward and Princess Margaret Hospitals. The diverse professional mix creates a vibrant atmosphere in which neonatal research and education thrives.

We also have a world-class pre-clinical research group based on campus at The University of Western Australia, through the University’s Faculty of Science.

About the CentreThe Centre for Neonatal Research and Education was officially opened on 1 April, 2011 as a Research Centre of The University of Western Australia.

02 | cnre.uwa.edu.au


These studies will include:

1. Respiratory:ÌÌ artificial ventilation equipment, and

protocols to reduce lung damage (Pillow, Tingay, Gill, Albertine)

ÌÌ effect of amniotic stem cells to reduce lung inflammation (Moss, Polglase, Pillow)

ÌÌ prevention and treatment of bronchopulmonary dysplasia (Pillow, Gill)

ÌÌ physiology of neonatal transition (Polglase, Hopper, Gill in collaboration with the Ritchie Centre, Monash Institute of Medical Research)

2. Nutrition and gastroenterology:

ÌÌ optimising processes and products in human milk banking (Hartmann, Simmer, Koorts, Davies)

ÌÌ evaluating and improving breastfeeding of very preterm babies (Geddes, Simmer)

ÌÌ high dose DHA and bronchopulmonary dysplasia, cardiovascular disease and neurodevelopment (Simmer, Burgner, French as part of NHMRC trials led by U Adelaide)

CRE funding ($2.5million) is for research infrastructure (including funding for coordinators of randomised controlled trials and the preclinical research laboratory, statistical and database support) and support for early career researchers (including stipends for Honours students, PhD students and seed funding for new projects).

The CRE is a national collaborative project led by UWA CNRE Co-Directors with partners at Telethon Kids Institute, Murdoch Childrens Research Institute and the Ritchie Centre, Monash Institute of Medical Research. Associate Investigators are from Sydney University, University of Queensland, University of Adelaide, Murdoch University and the University of Utah. The award by NHMRC is in recognition of our collective research achievements, our potential to contribute to new knowledge, and to translate our findings to improve health outcomes.

We now have the challenge to deliver the programs in collaborative efficient teams using the CRE and CNRE as a cohesive platform from which to achieve our aims.

Directors’ report The UWA CNRE was established in 2011 with the aim of securing NHMRC funding as a Centre of Research Excellence. In 2013, we were delighted to achieve this at our first attempt when awarded a CRE for improving the immediate and long-term outcomes of preterm infants. Our CRE was one of six CREs awarded nationally in the highly competitive clinical stream.

PROFESSOR JANE PILLOW

WINTHROP PROFESSOR KAREN SIMMER


4. Neurological development:

ÌÌ the effect of postnatal steroid therapy on the developing heart and brain (Pillow, Gill, Albertine)

ÌÌ evaluation of neonatal erythropoietin treatment on the need for blood transfusion, protection from gut disease and recovery from brain injury (Polglase, Pillow, Gill)

ÌÌ neurocognitive outcome and cerebral lateralisation in children born <28weeks gestation (French, Anderson, Campbell)

ÌÌ autism in preterm children- state-wide data linkage studies to explore incidence and associations aimed at future screening programs (French, Campbell, Whitehouse, Meldrum, Strunk, Simmer)

3. Infection/inflammation:ÌÌ treatment with antimicrobial

peptides to prevent postnatal infections (Strunk. Burgner, Currie, Simmer)

ÌÌ epidemiology of nosocomial infection (Gill)

ÌÌ analysing the cost associated with late-onset sepsis (Strunk, Burgner, Currie)

ÌÌ new diagnostic approaches for neonatal sepsis (Strunk, Ducuypere)

ÌÌ RCT pentoxifylline to prevent infection, NEC and inflammation (Patole, Strunk, Currie, Simmer)

ÌÌ effect of chorioamnionitis on short- and long-term outcomes of very preterm infants (Strunk, Burgner, Currie, Hammond, Simmer)

5. CardiovascularÌÌ the influence of perinatal

infection on the development of atherosclerosis (Burgner, Simmer, Strunk, Gill, Pillow)

ÌÌ effects of deferred umbilical cord clamping on cardiac output (Gill)

In 2013, the CNRE has settled in the School of Paediatrics and Child Health working closely with the School of Anatomy, Physiology and Human Biology. The award of the associated CRE has consolidated our reputation nationally and facilitated solid collaborations with our interstate colleagues. Training the next generation of research leaders in our discipline is central to the CNRE and CRE. Education at both state and national levels is important to CNRE with planning and approval for the inaugural Graduate Diploma and Masters in Neonatology completed in 2013 and the first students commencing in 2014.


Postdoctoral ScientistsÌÌ Clinical Senior Lecturer Catherine

Campbell PhDÌÌ Adjunct Associate Professor

Andrew Currie PhDÌÌ Clinical Senior Lecturer Ben

Hartmann PhD – Manager, Perron Rotary Express Milk Bank

ÌÌ Clinical Senior Lecturer Gemma McLeod PhD

ÌÌ Dr Suzanne Meldrum PhDÌÌ Research Assistant Professor

Peter Noble PhDÌÌ Research Assistant Professor

Yong Song MD, PhD

PhD Students

Research and Education Medical Staff Trainees ÌÌ Dr Sam Athikarisamy

– Neonatal FellowÌÌ Dr Roland Berger

– Neonatal FellowÌÌ Dr Suresh Birajdar

– Neonatal FellowÌÌ Dr Mangesh Deshmukh

– Neonatal FellowÌÌ Dr Sanjay Gehlot

– Neonatal FellowÌÌ Dr Mohammed Hakeem

– Neonatal FellowÌÌ Dr Gayatri Jape – Neonatal FellowÌÌ Dr Saritha Paul – Neonatal FellowÌÌ Dr Jenny Svedenkrans

– Clinical Research FellowÌÌ Dr Jason Tan – Neonatal FellowÌÌ Dr Rebecca Thomas

– Neonatal FellowÌÌ Dr Kirsten Thompson

– Neonatal FellowÌÌ Dr Rory Trawber – Neonatal FellowÌÌ Dr Natalia Vollrath

– Neonatal Fellow

Research and Education Nursing StaffÌÌ Clinical Lecturer Laurene Aydon

– Neonatal Research NurseÌÌ Ms Pippa Vines – Nursing Director,

NICU KEMH & PMHÌÌ Clinical Lecturer Barbara Carter

– Neonatal Medical EducatorÌÌ Ms Hilary Cross – Neonatal

Outreach Educator WA & Curtin University Teaching Fellow

ÌÌ Clinical Lecturer Yen Kok – Neonatal Research Nurse

ÌÌ Ms Judith Kristensen – Neonatal Pharmacist

ÌÌ Clinical Lecturer Linda McKean – Neonatal Nursing Education

DirectorsÌÌ Professor Jane Pillow BMedSci

(Dist), MBBS, FRACP, PhD (Dist)ÌÌ W/Professor Karen Simmer

MBBS, MRCP, FRCPH, FAICD, PhD, FRACP

Business Development ManagerÌÌ Ms Diane Arnott, MSc

Senior Research and Education Medical StaffÌÌ Clinical Associate Professor Noel

French FRACPÌÌ Clinical Associate Professor Andy

Gill FRACPÌÌ Clinical Associate Professor

Rolland Kohan MBBS, FRACP, MBA

ÌÌ Dr Emma Harris, FRACPÌÌ Dr Corrado Minutillo MBBS,

FRACPÌÌ Clinical Professor Sanjay Patole

MBBS, MD, DCH, FRACP, DrPH, MSc

ÌÌ Clinical Associate Professor Shripada Rao FRACP

ÌÌ Clinical Senior Lecturer David Baldwin PhD FRACP

ÌÌ Dr Jean DuPlessis FRACP, MHPEÌÌ Dr Kathy Martin FRACPÌÌ Dr Abhijeet Rakshasbhuvankar,

FRACPÌÌ Clinical Senior Lecturer Steve

Resnick FRACP – Medical Director, Newborn Emergency Transport Service

ÌÌ Clinical Senior Lecturer Dr Mary Sharp, FRACP, Dip RACOG, M Med Sci

ÌÌ Clinical Senior Lecturer Tobias Strunk MD, PhD, FRACP

ÌÌ Dr Deepika Waugh, FRACP

Staff and students

Ms Emma DeJongInfants born prematurely are very prone to serious infections in the first few weeks of life. In particular, they’re at risk of infections with bacteria called Escherichia coli and Staphylococcus epidermidis. However, we still don’t know why these preterm infants can’t defend themselves against these bacteria, or even how healthy, full-term infants manage to control infection. Recent findings from studies of the immune system have suggested that our inborn (innate) immune defences are critical for preventing bacterial infections, but there is little information on the function of these defences in infants. In my


Thus, the integrity of the diaphragm muscle at birth may critically influence the development of respiratory failure after birth.

Inflammation is linked to more than 70 per cent of very preterm births. My PhD aims to determine the effect of antenatal inflammation and the timing of the inflammatory insult on the metabolic, functional and structural phenotype of the fetal and newborn diaphragm. In addition, potential treatments to ameliorate the severity of diaphragm dysfunction that contributes to respiratory failure will be investigated.

which began in 2005. IFOS is a randomised control trial whereby half of the infants were given high dose fish oil, while the other half received a placebo from birth to six months. We hypothesised that fish-oil supplementation during infancy would have a positive effect on cognitive development at six years of age. Our three main areas of inquiry were: language and communication, executive functioning, and behaviour. Our results suggest that in healthy term infants, high dose fish oil supplementation provides no significant benefit at six years of age for any of the neuro-cognitive outcomes measured. Over the coming months, we will be exploring how this might be influenced by individual genetic variability, as it is possible that some people may benefit more than others.

PhD study I will use sophisticated molecular tools to measure the responses of all 22,000 human genes to bacterial challenge at one time. By comparing the pattern of gene responses in newborns at high risk of infection (premature) and low risk of infection (full term), we believe that we will identify the specific set of genes required to control E. coli and S. epi infections. Identifying the most important defence genes will give us a powerful tool for potentially predicting which infants (preterm or otherwise) are at the greatest risk of infections. Knowing this would pave the way for new treatments that can reduce infections, or even prevent them in the first place.

Ms Alexandra HeatonFish oil supplements are currently marketed to pregnant women and infants, and are commonly added to premium infant formula. They contain omega-3 long-chain polyunsaturated fatty acids, including docosahexaenoic acid (DHA). DHA is suggested to be the ‘magic’ ingredient which may make babies smarter. However, at this stage, there is insufficient evidence to clearly indicate whether infant DHA supplementation is necessary – particularly with respect to healthy term infant populations.

My project involves following-up the 6-year old children who were enrolled in the Infant Fish Oil Study

Ms Kana KarisnanDespite major advances in neonatal care over the last two decades, preterm birth is the leading cause of perinatal morbidity and mortality in developed countries. The incidence of respiratory distress syndrome (RDS) is higher among human infants who are born prematurely and the incidence increases with decreasing gestation. A functional diaphragm is critically important to the successful establishment of unsupported spontaneous breathing. We hypothesized that the mechanism for diaphragm failure after birth is related to increased mechanical load on the diaphragm in preterm babies.

Ms Sharon PerrellaFeeding intolerance is common in preterm infants, characterised by signs of delayed gastric emptying such as abdominal distension and large gastric aspirates that may herald the onset of necrotising enterocolitis. The detection of delayed gastric emptying is limited to the identification of gross clinical signs. In the absence of a validated method of assessing gastric emptying in the preterm population, normal patterns of emptying, and the influences of milk composition and curding are not well understood.

In my PhD study I have validated an ultrasound method for measuring gastric volume that is accurate to ±1mL. The biochemical composition of breastmilk has a small influence on gastric emptying, with higher concentrations of casein, whey


Ms Stephanie TrendBreast milk provides both nutritional and immunological benefits to babies. The immune protection provided by mothers’ milk is especially important in the first months of life when a newborn’s immune system is developing. We know that babies that are born prematurely are at a higher risk of getting infections, but the specific causes of this higher risk are not well understood. There

risk. I will, in collaboration with ENT surgeon Dr Shyan Vijayasekaran, describe the structure and function of the children’s voice boxes. This will tell us whether their voice difficulties are caused by damage to their voice boxes or the way they use them, or both. Finally, I will trial a behavioural voice therapy protocol, to see what effect non-invasive speech therapy has on the preterm children’s voices. It may not be possible to alter resuscitation and ventilation practices shortly after birth, as the preservation of life must take priority over any potential long-term damage to the voice. However, if we are able to establish that voice difficulties are experienced by many preterm children, describe their nature and extent and provide evidence regarding the appropriateness of voice therapy, we will be able to develop a clinical pathway for voice assessment and care for at-risk children.

and lactose marginally facilitating emptying. When compared to unfortified mother’s own milk (MOM), pasteurized donor human milk (PDHM) and FM-85 fortified milk empty more slowly. However final gastric residual volumes are similar for MOM and PDHM, and on average 1.5mL higher for FM-85 fortified feeds. Gastric curding of breastmilk does not influence emptying in preterm infants.

Ultrasound assessment of gastric emptying provides a noninvasive and accurate method of monitoring emptying that may prove useful in developing normal gastric emptying parameters and evaluating feeding tolerance in the preterm population.

Ms Victoria ReynoldsOur laboratory has previously found that many extremely preterm infants have hoarse and husky voices when they grow up, related to the number of times an endotracheal tube was passed through the windpipe when the children were born. Preterm infants have immature lungs and may require resuscitation or ventilation with tubes, which can cause long-lasting damage to the voice box. Many children with voice problems struggle to make themselves heard; these problems may persist into adulthood.

In my PhD, I will establish the rate of voice difficulties amongst very preterm children, who are most at

is some evidence to suggest that the milk produced by mothers of very premature infants (<32 weeks gestation) may be different to milk produced by mothers that give birth at full term (37+ weeks gestation). However, so far there is very little research in this area.

My research investigates whether the natural antibiotic molecules, known as antimicrobial peptides and proteins, and other immune factors are in the same concentration in breast milk from mothers that give birth prematurely compared to at full term, and whether consumption of the molecules in milk that can inhibit the growth of bacteria is lower in preterm infants that develop infections. In order to answer these questions, we have collected breast milk from more than 150 mothers of preterm and full term infants in the first month after giving birth through the PREDICT and COMET studies. The findings of this research could improve breast milk feeding guidelines for preterm infants, or lead to new treatments with breast milk-derived antimicrobial molecules, resulting in lower infection rates in preterm infants.


Clinical Lecturer Barbara Carter2013 Western Australia Nursing and Midwifery Excellence Awards – Education

Dr Stefan MinocchieriRichard D. Rowe Award at the Society for Pediatric Research 2013 Annual Meeting, Washington, DC, USA.

Dr Kirsten ThompsonEarly Research Career Award, Paediatric Society of Australia and New Zealand 2013 Annual Meeting.

MediaIn 2013, CNRE research featured in the following news outlets:ÌÌ The West Australian – a feature on

the Centre of Research Excellence and research studies conducted through the CNRE at King Edward Memorial Hospital

ÌÌ ABC News – a feature on breakthroughs in human milk banking by CNRE researchers

Awards, prizes and other honours

Industry connectionsThe CNRE continues to foster strong links with our industry partners, and we are very appreciative of support received from:ÌÌ Chiesi FarmaceuticaÌÌ Draeger MedicalÌÌ Fresenium KabiÌÌ Medela AG


Researchers measured the size of the PDA in preterm infants and treated those with a large PDA with the drug indomethacin. As in previous studies, however, there was no definite decrease in death or abnormal cranial ultrasound rates in those babies receiving treatment compared to those not treated.

This study was able to show that it is possible to identify babies with a large PDA and target them for treatment, and that the treatment showed no adverse effects on the gastrointestinal system or kidneys. The researchers recommend that further research be done, particularly looking at the neurodevelopmental outcomes of treatment on babies born with PDA.

The condition is known as ‘patent ductus arteriosus’ (PDA) and while it would seem obvious that these babies should be treated in order to close the PDA, there is no difference in death or abnormal cranial ultrasound rates among those receiving treatment versus those not treated. As a result, doctors are frequently unwilling to expose babies with a PDA to the side effects of drugs when they are unable to show benefit.

CNRE researcher Andy Gill, with colleagues from Royal North Shore Hospital and the University of Sydney, designed a study to test whether only treating babies with a large PDA would result in decreases in death and abnormal cranial ultrasound rates. These babies would be expected to benefit more from treatment.

Fixing the smallest heartsAll newborns have a blood vessel that is meant to close shortly after birth, known as the ductus arteriosus. However in preterm infants, there is an increased likelihood of this vessel not closing, allowing oxygen-rich and oxygen-poor blood to mix and resulting in shortness of breath, failure to thrive, and potentially congestive heart failure.

Research highlights Every year CNRE researchers publish the results of their work in major medical journals. Here are three examples of research that we published in 2013 that will result in changes to how newborn infants are treated.


perfect emulsion. The research has led to us changing to SMOFlipid for later preterm and term infants, but continuing research in the very preterm infant where current studies are looking at supplementing the intravenous emulsion with tuna oil fed via an oro-gastric tube.

Donor breast milk for babies – keeping it safeIt is widely accepted that breast milk is the best nutritional option for babies, but frequently mothers of preterm infants do not produce enough milk. In these cases, donor human milk is the next best option and CNRE researchers are world leaders in the development of guidelines for human milk banks.

Donor milk must be pasteurised just like any other liquid food product, to ensure that any disease-causing bacteria present are killed. The worldwide standard used by human milk banks involves heat pasteurisation, which unfortunately also damages several immune proteins including one that helps babies digest fat. This may be why some research suggests that babies fed donor milk grow more slowly than those fed their mother’s own (unpasteurised) milk.

CNRE researcher and Perron Rotary Express Milk Bank Manager Ben Hartmann was involved in a study to determine if ultraviolet radiation could be an effective method of pasteurisation without damaging the heat-sensitive immune proteins. UV radiation has proven useful in surface decontamination but is limited in cases where the rays need to penetrate, such as opaque liquids. This study was designed to show whether irradiating milk in small batches would be effective at killing

bacteria while retaining the actions of the immune proteins and not destroying the fatty acids in the milk.

Results have shown that indeed UV radiation meets all three targets – kills bacteria to an acceptable standard for milk banks, maintains the immune proteins, and does not negatively impact the fatty acids. While extremely promising, the study will now need to be expanded to investigate the effect of UV radiation on other components of donor human milk. In the future, we hope to be able to provide even higher quality donor milk for preterm infants as a result of this study and its extensions.

The best fats for preterm infants The topic of omega-3 vs omega-6 fatty acids has been a hot one in recent years in adult nutrition, but it is just as important in preterm infants. Preterm babies receive a fatty acid emulsion with their intravenous feeds – until recently this was one based on soy oil. Over the last few years, babies at King Edward Memorial Hospital and Princess Margaret Hospital have received a new lipid emulsion when fed intravenously. This emulsion contains a mixture of olive oil and soy oil (Clinoleic) and our research showed that feeding this emulsion resulted in blood levels of fats more similar to a breastfed preterm infant than when feeding the soy emulsion. However, it would be even better if these patients could maintain blood levels of fats equal to those in-utero.

CNRE researchers continue to investigate this issue and studied a new commercially available lipid emulsion called SMOFLipid which contains soy, coconut, olive and fish oil. The SMOFlipid maintained fat levels in the blood of babies near to those of the fetus but only in babies born after 34 weeks gestation. In the very preterm infant, especially those born at less than 30 weeks gestation, we have still to find a


Perinatal Society of Australia and New ZealandThe annual PSANZ congress, themed ‘Networking – The New Frontier’ will be held in Perth in April 2014 and CNRE staff have been instrumental in the organisation of this conference. Invited speakers include Atul Singhal from University College, London; Kjersti Aagaard from Baylor College of Medicine in Texas, USA, Ofer Levy from Harvard University Medical School in Massachusetts, USA, and Kurt Albertine from University of Utah School of Medicine, USA.

Workshops and symposiaThe CNRE will coordinate two workshops in 2014 during the week of the Perinatal Society of Australia and New Zealand conference:ÌÌ Scientific WritingÌÌ Advanced Mechanical Ventilation

in Neonates

Both will be supported by the NHMRC Preterm Infant Centre of Research Excellence, and will involve colleagues from the eastern States and overseas who are in Perth for the PSANZ conference – Kurt Albertine and David Tingay.

Education highlightsPostgraduate courses2013 saw CNRE staff very actively involved in the establishment of two new postgraduate coursework courses for 2014 commencement:ÌÌ Graduate Diploma in NeonatologyÌÌ Master of Neonatology

These courses are designed for practicing doctors, and are one year and two years in duration part-time. The courses feature units in nutrition, immunology, ventilation, evidence-based medicine, transport medicine, surgery, and cardiology, as well as skills-based practicum units.

CNRE staff are involved as unit coordinators as well as guest lecturers in the courses. In the first year (2014) both courses will be classroom-based, but plans are in place to convert them both to an online format due to demand from eastern States and overseas doctors.



Local CollaboratorsÌÌ A/Professor Tony Bakker, School

of Anatomy, Physiology and Human Biology, UWA

ÌÌ Professor Dorota Doherty, School of Women’s and Infant’s Health

ÌÌ Adj Professor Graham Hall, Telethon Kids Institute

ÌÌ Dr Geoffrey Hammond, Telethon Kids Institute

ÌÌ Assoc Professor Kathryn Hird, Faculty of Medicine, University of Notre Dame

ÌÌ Dr Anthony Keil, PathWest Laboratory Medicine WA

ÌÌ Dr Hannah Moore, Telethon Kids Institute

ÌÌ Ms Elizabeth Nathan, Women and Infants Research Foundation and King Edward Memorial Hospital

ÌÌ Dr Gavin Pinniger, School of Anatomy, Physiology and Human Biology, UWA

ÌÌ W/Professor Susan Prescott, School of Paediatrics and Child Health

ÌÌ Professor Peter Richmond, School of Paediatrics and Child Health

ÌÌ Professor Andrew Whitehouse, Telethon Kids Institute

ÌÌ Dr Andrew Wilson, Dept of Respiratory Medicine, Princess Margaret Hospital and School of Paediatrics and Child Health, UWA

National CollaboratorsÌÌ Professor David Burgner, Murdoch

Children’s Research Institute, University of Melbourne

ÌÌ Dr Patricia Conway, University of New South Wales

ÌÌ Dr Girish Deshpande, University of Sydney

ÌÌ Dr Meera Esvaran, University of New South Wales

ÌÌ A/Professor Nick Evans, University of Sydney

ÌÌ Professor Bob Gibson, University of Adelaide

ÌÌ Dr Rod Hunt, University of Melbourne

ÌÌ A/Professor Martin Kluckow, University of Sydney

ÌÌ Professor Maria Makrides, University of Adelaide

ÌÌ A/Professor Andy McPhee, University of Adelaide

ÌÌ Dr Tim Moss, Monash Institute for Medical Research, Melbourne

ÌÌ Dr Graeme Polglase, Monash Institute for Medical Research, Melbourne

ÌÌ Professor William Tarnow-Mordi, University of Sydney

ÌÌ Dr David Tingay, Murdoch Children’s Research Institute, Melbourne

International CollaboratorsÌÌ Professor Kurt Albertine,

University of Utah School of Medicine, USA

ÌÌ Dr Donald Davidson, University of Edinburgh

ÌÌ A/Professor Raffaele Dellaca, Politecnico do Milano

ÌÌ Professor Robert Hancock, University of British Columbia

ÌÌ Professor Zoltan Hantos, Szeged University, Hungary

ÌÌ Professor Alan Jobe, University of Cincinnati, USA

ÌÌ A/Professor David Kaczka, University of Iowa

ÌÌ Professor Berthold Koletzko, University of Munich

ÌÌ Asst Professor Tobias Kollmann, University of British Columbia

ÌÌ A/Professor Ofer Levy, Harvard University, Boston Children’s Hospital

ÌÌ Dr Stefan Minocchieri, University of Basel, Switzerland

ÌÌ Professor Neena Modi, Imperial College, London

ÌÌ Professor Sven Schulzke, University of Basel, Switzerland

ÌÌ Professor Bela Suki, University of Boston, USA

ÌÌ Dr Mark Underwood, University of California Davis, USA

Collaborators


Professor Ferdinand Haschke, Director, Nestle Nutrition Institute visited the Neonatal Intensive Care Unit for a research collaboration meeting.

Dr Rod Hunt, University of Melbourne, collaborator and CIA on the Neonatal Electrographic Seizures Trial investigating the effect of amplitude integrated EEG treatment of electrical and clinical seizures in term infants visited CNRE for a collaboration meeting.

We also had visits from our international collaborators Associate Professor Raffaele Dellaca from the Politecnico di Milano, and Professor Bela Suki and Professor Elizabeth Bartolak-Suki from Boston University.

Ms Mirielle Lindeman, a student at the Karolinska Institute in Sweden, visited for three months in early 2013 to conduct research with Professor Jane Pillow.

Dr Bjorn Pilstrom, Medical Director of Orphan Biovitrum, visited Professor Jane Pillow in April 2013 and spoke at the Neonatal Clinical Care Unit weekly meeting. His talk was entitled ‘Kineret (Anakirna and IL-1 Antagonist’.

On the 16 October we welcomed Professor Zulfiqar Bhutta from the Aga Khan University in Karachi, Pakistan. He gave a talk entitled ‘Innovations to Prevent Newborn Infections: What Can We Do Everywhere?’ detailing his experience in neonatal intensive care units around the world. His visit was also supported by King Edward Memorial Hospital Postgraduate Medical Education.

Professor David Burgner from Murdoch Childrens Research Institute and Monash Medical Centre, is a paediatric infectious diseases consultant. He gave the annual Alfred Grauaug Oration at the Neonatal Symposium at King Edward Memorial Hospital in February 2013. His visit was supported by Postgraduate Medical Education.

Associate Professor Ross Haslam, Chair of the Australia New Zealand Neonatal Network met with neonatal consultants and toured our Neonatal Intensive Care Unit.

Peter Aggersbery, CEO Medela Switzerland, Irene Zoppi, Medela USA visited the CNRE for research and development discussions.

Visitors to the Centre


CLIN A/PROFESSOR SHRIPADA RAO, PROFESSOR ZULFIQAR BHUTTA, MRS SALLY LEONG, W/PROFESSOR KAREN SIMMER,

CLIN PROFESSOR SANJAY PATOLE, AND CLIN SR LECTURER TOBIAS STRUNK

Grants and research supportAgency Title CIs Years Amount

NHMRC Centre of Research Excellence: Improving immediate and long-term outcomes of preterm infants

Pillow, Simmer, Patole, Strunk, Moss, Burgner, Whitehouse, Prescott, Tingay, Gill

2013-17 $2,499,203

NHMRC Project Grant: Bronchopulmonary Dysplasia: Identifying Cardiorespiratory Consequences and Targets for Prevention and Intervention

Pillow, Hall, Hantos, Gill, Wilson, Doherty

2013-17 $1,328,857

NHMRC Project Grant: Influence of in utero environment on diaphragm structure and function

Pillow, Pinniger, Bakker 2011-13 $478,365

NHMRC Project Grant: Consequences of waveform composition for epithelial integrity and homogeneous ventilation during HFOV

Pillow, Bassom, Tingay 2011-13 $395,696

NHMRC Project Grant: A study of the impact of treating electrographic seizures in term or near-term infants with neonatal encephalopathy

Hunt, Colditz, Inder, Badawi, Simmer, Liley, Osborn, Cheong, Wright

2011-15 $1,301,309

NHMRC Project Grant: Effect of high dose infant fish oil supplementation and FADS 1 & 2 genetic polymorphisms on cognitive development and school giftedness

Simmer, Foster, Smith 2011-13 $314,865

NHMRC Project Grant: Australian Placental Transfusion Study

Tarnow-Mordi, Evans, Newnham, Osborn, Isaacs, Simmer

2009-13 $2,696,700

NHMRC Project Grant: Investigation of factors that influence Aboriginal maternal and infant health outcomes: improvements to be achieved with the introduction of Aboriginal Health Workers into tertiary care

Doherty, Newnham, Larson, Hornbuckle, Simmer, Henderson

2012-14 $567,101

NHMRC Project Grant: Docosahexaenoic acid for the reduction of bronchopulmonary dysplasia in preterm infants born at less than 29 weeks gestational age: a RCT

Collins, Gibson, McPhee, Thio, Sullivan, Simmer, Rajadurai

2012-14 $1,870,914

National Institutes of Health

Endogenous Surfactant Therapy for the Developing Lung

Suki, Bartolak-Suki, Pillow

2013 USD$488,184

Women and Infants Research Foundation

Starter Grant: Characterisation of milk after preterm birth (COMET study)

Strunk, Trend 2013 $15,000

Telethon – Perth Children’s Hospital Research Fund

Postnatal steroids and antenatal chorioamnionitis: Between the scylla and charybdis of inflammation and apoptosis after preterm birth

Pillow 2013 $200,000

Telethon – Perth Children’s Hospital Research Fund

Antimicrobial proteins and peptides to prevent late-onset sepsis in preterm infants

Strunk 2013 $186,000


Types of Nutrition on GI ResponseTrial purpose: Study the preterm infants’ GI response to different volumes and compositions of mother’s own milk, pasteurised donor human milk, and formula milk and during the transition from IV feeding to full oral feeds

Recruiting: Stable infants 28-33 weeks gestational age

Treatment/investigation: Different volumes and compositions of mother’s own milk, pasteurised donor human milk, and formula milk

Funded by: Medela

Australian Placental Transfusion StudyTrial purpose: To determine if placental transfusion in very preterm babies will improve health outcomes compared to early cord clamping

Recruiting: Babies less than 30 weeks gestational age

Treatment/investigation: Placental transfusion or cord clamping

Funded by: National Health and Medical Research Council

Australian Placental Transfusion Study Echo SubstudyTrial purpose: To determine the effect of placental transfusion vs early clamping on systemic blood flow

Recruiting: Babies less than 30 weeks gestational age

Treatment/investigation: Echocardiogram


Clinical trials

NEST (Neonatal Seizures)Trial purpose: To determine the effects of treating neonatal clinical and electrographic seizures

Recruiting: Babies 35 weeks gestational age and older; less than 48 hours old

Treatment/investigation: Treatment of either clinical seizures alone, or clinical plus electrographic seizures


Novel Teat StudyTrial purpose: To test the effect of a novel feeding device

Recruiting: Infants born at 25 to 34 weeks gestational age

Treatment/investigation: Use of a control teat or the test teat

Funded by: Medela

PREDICTTrial purpose: To investigate mechanisms behind exquisite vulnerability of very preterm infants to coagulase-negative Staphylococcus infections

Recruiting: Infants born at 23 weeks and above

Treatment/investigation: Development of the innate immune system in very preterm infants during the period of highest life-time risk of sepsis


DINO7Trial purpose: Randomised controlled trial investigating high vs low dose DHA in preterm infants

Recruiting: Previous participants in DINO, now aged seven

Treatment/investigation: Neurodevelopmental assessments



Preterm Infant Functional and Clinical Outcomes Study (PIFCO)Trial purpose: Measuring the contributions of the lung, respiratory muscles and the blood vessels to severity of chronic lung disease in very preterm infants.

Recruiting: 550 infants born <33 weeks gestational age

Treatment/investigation: various respiratory, cardiac, nutritional and immune measurements


GenMoveTrial purpose: to describe the general movements in babies born less than 26 weeks gestation

Recruiting: infants born <26 weeks gestational age; studied at 38-44 weeks corrected gestational age, and 12 weeks post term age

Treatment/investigation: video analysis of movement

N3ROTrial purpose: To evaluate the impact of docosahexaenoic acid supplementation on the incidence of BPD in infants born less than 29 weeks gestational age compared with placebo

Recruiting: infants born <29 weeks gestational age

Treatment/investigation: docosahexaenoic acid (omega-3 fatty acid) supplement


NIRS (Near Infrared Spectroscopy)Trial purpose: To study oxidative stress and changes in plasma pro-inflammatory cytokines, gut oxygenation and gut permeability after packed red blood cell transfusion in preterm neonates

Recruiting: infants born at <33 weeks gestational age, >2 weeks post-natal age

Treatment/investigation: Gut oxygenation and permeability, plasma cytokine measurements, and oxidative stress assessments before and after transfusion


Pillow J., Dahl M., Noble P., Nitsos I., Albertine K., Berry C., Gill A., Karisnan K., McDonald C., Melville J., Polglase G., Roehr C., Song Y., Moss T. A collaborative Australian preterm lamb ICU to evaluate medium to long term outcomes after preterm birth. Perinatal Society of Australia and New Zealand Annual Congress, April 2013, Adelaide, Australia.

Saritha P., Resnick, S., Gardiner K., Ramsay J. Transport of neonates with TGA for cardiac surgery: A 26 year Western Australian experience. Perinatal Society of Australia and New Zealand Annual Congress, April 2013, Adelaide, Australia.

Simmer, K. Human milk banking. International Paediatric Congress, August 2013, Melbourne.

Simmer, K. Enteral feeding and probiotics for preterm infants. Neommune International Collaboration, October 2013, Ghanzhou, China.

Simmer, K. Clinical issues in preterm nutrition. ESPGHAN Neommune workshop, March 2013, London.

Simmer, K. Novel feeding system to promote breastfeeding for preterm infants. International Breastfeeding and Lactation Symposium, April 2013, Copenhagen.

Simmer, K. LCPUFA supplementation of term and preterm infants. University of California, Davis, March 2013, California, USA.

Simmer, K. Omega-3 fatty acids in neonatal nutrition: What do the systematic reviews say? International Society for the Study of Fatty Acids and Lipids, International Workshop on Lipids in Perinatal Care, April 2013, Adelaide, Australia.

Hammond G., Strunk T., DeKlerk N., Jacoby P., Moore H., Stanley F., Burgner D. Gestational age, birth weight and risk of infection in early childhood. Paediatric Academic Societies Annual Meeting, May 2013, Washington DC, USA.

Karisnan K., Pinniger G., Bakker A., Berry C., Noble P., Song Y., Pillow J. Gestation at onset of chorioamnionitis determines adverse effect of inflammation on diaphragm function. Perinatal Society of Australia and New Zealand Annual Congress, April 2013, Adelaide, Australia.

Kok C., Geddes DT., Nancarrow K., Hepworth AR., Simmer K. Ultrasound imaging of infant tongue movement with a novel teat compared to breastfeeding. Perinatal Society of Australia and New Zealand Annual Congress, April 2013, Adelaide, Australia.

Ofek Shlomai N., McLeod G., Simmer K. An audit of feeding intolerance and metabolic bone disease. Perinatal Society of Australia and New Zealand Annual Congress, April 2013, Adelaide, Australia.

Pillow J., Berry C., Hagan R., Athalye G., Shah P., Simmer K., Chiffi ngs D., Minocchieri S. Nebulised surfactant for treatment of respiratory distress in the first hours of life: The CureNeb study. Perinatal Society of Australia and New Zealand Annual Congress, April 2013, Adelaide, Australia.

Pillow J., Berry C., Wood A., Kee J., Lavin T., Noble P. Airway pressure release ventilation: Initial experience in preterm lambs. Perinatal Society of Australia and New Zealand Annual Congress, April 2013, Adelaide, Australia.

Bell M., Campbell C., Reid C., McMichael J., French N., Anderson M. The role of attention, speed of information processing and working memory in the intellectual function of very preterm (VP) children. Perinatal Society of Australia and New Zealand Annual Congress, April 2013, Adelaide, Australia.

Campbell C., Hagan RA., French N., Hagan R. Factors influencing mothers’ psychological adjustment to very preterm birth. Perinatal Society of Australia and New Zealand Annual Congress, April 2013, Adelaide, Australia.

Deshpande G., Rakshasbhuvankar A., Simmer K., Ravikumara M., Mori T., Croft K., Shave M., Currie A. Efficacy and safety of a novel fish oil based emulsion (SMOF®) compared with olive oil based lipid emulsion (CLINOLEIC®) in term and near-term (>34 weeks) surgical neonates: A randomised controlled trial. Perinatal Society of Australia and New Zealand Annual Congress, April 2013, Adelaide, Australia.

Deshpande G., Rao S., Patole S. Second updated meta-analysis of probiotics for preterm neonates: How much more evidence is needed? Perinatal Society of Australia and New Zealand Annual Congress, April 2013, Adelaide, Australia.

Grainger S., Hird K., Oehmen R., Bulsara M.,, McMichael J., French N., Patole S., Simmer, K. Outcomes of preterm Jehovah’s Witness neonates: A retrospective cohort study. Perinatal Society of Australia and New Zealand Annual Congress, April 2013, Adelaide, Australia.

Conference presentations


Tarnow-Mordi W., Darlow B., Stenson B., Brocklehurst P., Morley C., Davis P., Juszczak E., King A., Doyle L., Simmer K., Simes J. Hospital outcomes in the BOOST II trials of neonatal oxygen saturation targeting. Perinatal Society of Australia and New Zealand Annual Congress, April 2013, Adelaide, Australia.

Thompson K., Davis P., Jacobs S. Immunisation of preterm infants in the neonatal unit. Perinatal Society of Australia and New Zealand Annual Congress, April 2013, Adelaide, Australia.

Thompson K., Gill A. Antibiotic use and nosocomial infection in the neonatal unit. Princess Margaret Hospital Research Symposium, 2013, Perth, Australia.

Stephens A., Campbell C., Reid C., McMichael J., French N., Anderson M. Two things at once: Attention vulnerabilities in very preterm children. Perinatal Society of Australia and New Zealand Annual Congress, April 2013, Adelaide, Australia.

Strunk T., Prosser A., Hibbert J., Simmer K., Richmond P., Burgner D., Currie A. Phagocytosis of neonatal pathogens by cord and peripheral blood neutrophils and monocytes of human preterm and term infants. Paediatric Academic Societies Annual Meeting, May 2013, Washington DC, USA.

Strunk T., Granland C., Hibbert J., Prosser A., Simmer K., Burgner D., Richmond P., Currie A. Competence of the NOD1 and NOD2 pattern recognition receptor system in the very preterm infant monocyte. Paediatric Academic Societies Annual Meeting, May 2013, Washington DC, USA.

Simmer K., Kok C., Nancarrow K., Hepworth AR. Improving Transition Time from Tube to Sucking feeds in Breastfeeding Preterm Infants – Novel Teat Study. Perinatal Society of Australia and New Zealand Annual Congress, April 2013, Adelaide, Australia.

Song Y., Lavin T., Pinniger G., Pillow J., Bakker A. The biological effects of maternal betamethasone on development of fetal diaphragm in rat pups. Perinatal Society of Australia and New Zealand Annual Congress, April 2013, Adelaide, Australia.

Srinivasjois R., Rao S., Patole S. Prebiotic supplementation in preterm neonates: Updated systematic review and meta-analysis of randomised controlled trials. Perinatal Society of Australia and New Zealand Annual Congress, April 2013, Adelaide, Australia.



Four-week nutritional audit of preterm infants born <33 weeks gestation.McLeod G, Sherriff J, Nathan E, Hartmann PE, Simmer K. J Paediatr Child Health. 2013 Apr; 49(4):E332-9. doi: 10.1111/jpc.12013.

Oxygen saturation and outcomes in preterm infants.BOOST II United Kingdom Collaborative Group; BOOST II Australia Collaborative Group; BOOST II New Zealand Collaborative Group, Stenson BJ, Tarnow-Mordi WO, Darlow BA, Simes J, Juszczak E, Askie L, Battin M, Bowler U, Broadbent R, Cairns P, Davis PG, Deshpande S, Donoghoe M, Doyle L, Fleck BW, Ghadge A, Hague W, Halliday HL, Hewson M, King A, Kirby A, Marlow N, Meyer M, Morley C, Simmer K, Tin W, Wardle SP, Brocklehurst P. N Engl J Med. 2013 May 30;368(22):2094-104.

Intravenous levetiracetam for treatment of neonatal seizures.Rakshasbhuvankar A, Rao S, Kohan R, Simmer K, Nagarajan L. J Clin Neurosci. 2013 Aug; 20(8):1165-7.

Poractant alfa versus beractant for respiratory distress syndrome in preterm infants: a retrospective cohort study.Paul S, Rao S, Kohan R, McMichael J, French N, Zhang G, Simmer K. J Paediatr Child Health. 2013 Oct;49(10):839-44.

Autism spectrum disorder in children born preterm-role of exposure to perinatal inflammation.Meldrum SJ, Strunk T, Currie A, Prescott SL, Simmer K, Whitehouse AJ. Front Neurosci. 2013 Jul 22;7:123.

Altered canonical Wingless-Int (Wnt) signaling in the ovine fetal lung after exposure to intra-amniotic lipopolysaccharide (LPS) and antenatal betamethasone.Kuypers E, Willems MG, Collins JJ, Wolfs TG, Nitsos I, Pillow JJ, Polglase GR, Kemp MW, Newnham JP, Delhaas T, Jobe AH, Kallapur SG, Kramer BW. Pediatr Res. 2013 Nov 14. doi: 10.1038/pr.2013.226.

Clinical prediction models for bronchopulmonary dysplasia: a systematic review and external validation study.Onland W, Debray TP, Laughon MM, Miedema M, Cools F, Askie LM, Asselin JM, Calvert SA, Courtney SE, Dani C, Durand DJ, Marlow N, Peacock JL, Pillow JJ, Soll RF, Thome UH, Truffert P, Schreiber MD, Van Reempts P, Vendettuoli V, Vento G, van Kaam AH, Moons KG, Offringa M. BMC Pediatr. 2013 Dec 17; 13:207.

Effects of intra-amniotic lipopolysaccharide and maternal betamethasone on brain inflammation in fetal sheep.Kuypers E, Jellema RK, Ophelders DR, Dudink J, Nikiforou M, Wolfs TG, Nitsos I, Pillow JJ, Polglase GR, Kemp MW, Saito M, Newnham JP, Jobe AH, Kallapur SG, Kramer BW. PLoS One. 2013 Dec 17; 8(12):e81644.

Feasibility of using ultrasound to measure preterm body composition and to assess macronutrient influences on tissue accretion rates.McLeod G, Geddes D, Nathan E, Sherriff J, Simmer K, Hartmann P. Early Hum Dev. 2013 Aug; 89(8):577-82.

Standardised parenteral nutrition.Simmer K, Rakshasbhuvankar A, Deshpande G. Nutrients. 2013 Mar 28; 5(4):1058-70.

Developmental changes in diaphragm muscle function in the preterm and postnatal lamb.Lavin T, Song Y, Bakker AJ, McLean CJ, Macdonald WA, Noble PB, Berry CA, Pillow JJ, Pinniger GJ. Pediatr Pulmonol. 2013 Jul; 48(7):640-8.

Ureaplasma parvum serovar 3 multiple banded antigen size variation after chronic intra-amniotic infection/colonization.Robinson JW, Dando SJ, Nitsos I, Newnham J, Polglase GR, Kallapur SG, Pillow JJ, Kramer BW, Jobe AH, Payton D, Knox CL. PLoS One. 2013 Apr 26; 8(4):e62746.

In utero LPS exposure impairs preterm diaphragm contractility.Song Y, Karisnan K, Noble PB, Berry CA, Lavin T, Moss TJ, Bakker AJ, Pinniger GJ, Pillow JJ. Am J Respir Cell Mol Biol. 2013 Nov; 49(5):866-74.

Developmental regulation of molecular signalling in fetal and neonatal diaphragm protein metabolism.Song Y, Pillow JJ. Exp Biol Med (Maywood). 2013 Aug 1; 238(8):913-22.

Lipopolysaccharide-induced weakness in the preterm diaphragm is associated with mitochondrial electron transport chain dysfunction and oxidative stress.Song Y, Pinniger GJ, Bakker AJ, Moss TJ, Noble PB, Berry CA, Pillow JJ. PLoS One. 2013 Sep 6; 8(9):e73457.

Publications


Association of inhibitors of gastric acid secretion and higher incidence of necrotizing enterocolitis in preterm very low-birth-weight infants.More K, Athalye-Jape G, Rao S, Patole S. Am J Perinatol. 2013 Nov; 30(10):849-56.

Bubble CPAP versus ventilator CPAP in preterm neonates with early onset respiratory distress – a randomized controlled trial.Tagare A, Kadam S, Vaidya U, Pandit A, Patole S. J Trop Pediatr. 2013 Apr; 59(2):113-9.

Progress in the field of necrotising enterocolitis – year 2012.Athalye-Jape G, More K, Patole S. J Matern Fetal Neonatal Med. 2013 May; 26(7):625-32.

Children surviving intrauterine and neonatal insults have a significant risk of long-term adverse neurodevelopmental outcomes.Patole S, Rao SC. Evid Based Med. 2013 Feb; 18(1):37-8.

Suppurative submandibular mass in a preterm infant.Tho L, Rao S, Shipman P, Vijayasekaran S, Strunk T. Pediatr Infect Dis J. 2013 May; 32(5):578-9.

Dysphonia in preterm children: Assessing incidence and response to treatment.Reynolds V, Meldrum S, Simmer K, Vijayasekaran S, French NP. Contemp Clin Trials. 2013 Dec 28; 37(2):170-175.

Prebiotic supplementation in preterm neonates: updated systematic review and meta-analysis of randomised controlled trials.Srinivasjois R, Rao S, Patole S. Clin Nutr. 2013 Dec; 32(6):958-65.

Prolonged exposure to antibiotics and its associations in extremely preterm neonates – the Western Australian experience.Shah P, Nathan E, Doherty D, Patole S. J Matern Fetal Neonatal Med. 2013 Nov; 26(17):1710-4.

Role of probiotics in short bowel syndrome in infants and children – a systematic review.Reddy VS, Patole SK, Rao S. Nutrients. 2013 Mar 5; 5(3):679-99.

Validation of ultrasound methods to monitor gastric volume changes in preterm infants.Perrella SL, Hepworth AR, Simmer KN, Geddes DT. J Pediatr Gastroenterol Nutr. 2013 Dec; 57(6):741-9.

Phagocytosis of neonatal pathogens by peripheral blood neutrophils and monocytes from newborn preterm and term infants.Prosser A, Hibbert J, Strunk T, Kok CH, Simmer K, Richmond P, Burgner D, Currie A. Pediatr Res. 2013 Nov; 74(5):503-10.

Randomized Trial of Fish Oil (SMOFlipid) and Olive Oil Lipid (Clinoleic) in Very Preterm Neonates.Deshpande G, Simmer K, Deshmukh M, Mori TA, Croft KD, Kristensen J. J Pediatr Gastroenterol Nutr. 2013 Sep 16.

Does docosahexaenoic acid supplementation in term infants enhance neurocognitive functioning in infancy?Heaton AE, Meldrum SJ, Foster JK, Prescott SL, Simmer K. Front Hum Neurosci. 2013 Nov 20;7:774.


Preterm birth: Strategies for establishing adequate milk production and successful lactation.Geddes D, Hartmann P, Jones E. Semin Fetal Neonatal Med. 2013 Apr 25.

Cells in human milk: state of the science.Hassiotou F, Geddes DT, Hartmann PE. J Hum Lact. 2013 May; 29(2):171-82.

Longitudinal changes in suck-swallow-breathe, oxygen saturation, and heart rate patterns in term breastfeeding infants.Sakalidis VS, Kent JC, Garbin CP, Hepworth AR, Hartmann PE, Geddes DT. J Hum Lact. 2013 May; 29(2):236-45.

Developmental origins of health and disease: the role of human milk in preventing disease in the 21(st) century.Geddes DT, Prescott SL. J Hum Lact. 2013 May;29(2):123-7.

Evaluating hypoxia during air travel in healthy infants.Khanna M, Shackleton C, Verheggen M, Sharp M, Wilson AC, Hall GL. Thorax 2013.

Evaluation of the frequency and obstetric risk factors associated with term neonatal admissions to special care units.Alkiaat A, Hutchinson M, Jacques A, Sharp MJ, Dickinson JE. The Australian & New Zealand journal of obstetrics & gynaecology 2013, 53(3): 277-282.

Delaying cord clamping until ventilation onset improves cardiovascular function at birth in preterm lambs.Bhatt S, Alison BJ, Wallace EM, Crossley KJ, Gill AW, Kluckow M, te Pas AB, Morley CJ, Polglase GR, Hooper SB. J Physiol. 2013 Apr 15; 591(Pt 8):2113-26.

A randomised placebo-controlled trial of early treatment of the patent ductus arteriosus.Kluckow M, Jeffery M, Gill A, Evans N. Arch Dis Child Fetal Neonatal Ed. 2013 Dec 6.

Is extubation associated with changes in ductal and pulmonary blood flow in extremely preterm neonates?Wagh D, Gill A. J Paediatr Child Health. 2013 Dec; 49(12):1052-6.

Off-label use of ondansetron in pregnancy in Western Australia.Colvin L, Gill AW, Slack-Smith L, Stanley FJ, Bower C. Biomed Res Int. 2013; 2013:909860.

Attitudes and barriers to the introduction of umbilical cord blood gas and lactate analysis at birth.White CR, Kohan R, Doherty DA, Newnham JP, Pennell CE. Aust N Z J Obstet Gynaecol. 2013 Jun; 53(3):271-6.

Breastmilk cell and fat contents respond similarly to removal of breastmilk by the infant.Hassiotou F, Hepworth AR, Williams TM, Twigger AJ, Perrella S, Lai CT, Filgueira L, Geddes DT, Hartmann PE. PLoS One. 2013 Nov 6; 8(11):e78232.

Validation of ultrasound methods to monitor gastric volume changes in preterm infants.Perrella SL, Hepworth AR, Simmer KN, Geddes DT. J Pediatr Gastroenterol Nutr. 2013 Dec; 57(6):741-9.

Genetic and epigenetic susceptibility to early life infection.Strunk T, Jamieson SE, Burgner D. Curr Opin Infect Dis. 2013 Jun; 26(3):241-7.

The Effect of UV-C Pasteurization on Bacteriostatic Properties and Immunological Proteins of Donor Human Milk.Christen L, Lai CT, Hartmann B, Hartmann PE, Geddes DT. PLoS One. 2013 Dec 23; 8(12):e85867.

Longitudinal analysis of protein glycosylation and β-casein phosphorylation in term and preterm human milk during the first 2 months of lactation.Molinari CE, Casadio YS, Hartmann BT, Arthur PG, Hartmann PE. Br J Nutr. 2013 Jul 14; 110(1):105-15.

Donor human milk banking and the emergence of milk sharing.Landers S, Hartmann BT. Pediatr Clin North Am. 2013 Feb; 60(1):247-60.

Ultraviolet-C Irradiation: A Novel Pasteurization Method for Donor Human Milk.Christen L, Lai CT, Hartmann B, Hartmann PE, Geddes DT. PLoS One. 2013 Jun 26; 8(6):e68120.

A practical method for preparation of pneumococcal and nontypeable Haemophilus influenzae inocula that preserves viability and immunostimulatory activity.Kirkham LA, Corscadden KJ, Wiertsema SP, Currie AJ, Richmond PC. BMC Res Notes. 2013 Dec 9; 6:522.

Agonistic anti-CD40 antibody therapy is effective against postoperative cancer recurrence and metastasis in a murine tumor model.Khong A, Brown MD, Vivian JB, Robinson BW, Currie AJ. J Immunother. 2013 Sep;36(7):365-72.



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FACULTY OF MEDICINE, DENTISTRY AND HEALTH ... - Paediatrics