Maternal and Infant Conditions

Stillbirth and fetal growth restriction in New Zealand

In New Zealand, around 3000 pregnancies are affected by fetal growth restriction each year. Pregnancies with fetal growth restriction have a high risk of ending in stillbirth (the loss of the unborn baby after 20 weeks of pregnancy or during birth). 

Babies who survive fetal growth restriction have an increased risk of neurodevelopmental delay – which is a delay in developing skills necessary to achieve developmental ‘milestones’, such as walking or talking. These babies also have an increased risk of developing cardiovascular diseases and metabolic diseases later in life. But researchers are working on solutions.

By the numbers — Cure Kids researchers helping reduce infant mortality

Supported by Cure Kids, Dr Christine McIntosh and her University of Auckland research team, developed the ‘Safe Sleep Calculator’. The calculator allows healthcare staff to give individually tailored advice to protect against deaths in babies, and to target help to the 19% of babies at the highest risk from SUDI (sudden unexpected death in infants).

The advice and support given to parents and whanau includes breastfeeding advice, sleeping advice for the baby, and support on how to reduce exposure to smoking, drugs, and alcohol. And the impact? On average, one infant death will be prevented for every 310 families given this personalised and intensive support — an amazing intervention.

WHAT ARE WE DOING TO HELP?

Investigating the impact of antenatal steroids on infant wellbeing and lactation

Administering antenatal steroids (ANS) to pregnant women at risk of preterm delivery reduces the likelihood of severe breathing issues or death in newborns, but the impact on lactation is unclear.

And Dr. Mariana Muelbert’s previous research had indicated lower hormone concentrations in the milk of mothers treated with ANS, although it was uncertain if this was due to the treatment or the preterm birth itself.

So the ALMA study, within the C*STEROID trial, will investigate ANS's effects on lactation, breastmilk hormones, and newborn cortisol regulation to determine if enhanced lactation support is needed for these women.

Reducing brain injury in babies

Dr Guido Wassink, University of Auckland

When the blood flow that carries oxygen and nutrients to a baby is severely restricted during birth, there is a significant risk of death — or survival, but with a major disability. Known as perinatal “hypoxic-ischemic encephalopathy”, or HIE, this is one of the most serious and life-threatening types of infant brain damage that can occur during childbirth. 

Currently, the only treatment for babies born with this condition involves cooling of the baby’s brain or body (called therapeutic hypothermia) — but this doesn’t fully protect every baby (most babies, just not enough). So a team of Auckland researchers are testing a growth hormone to see if it can further improve the recovery of a newborn’s brain after this treatment.

‘Sleep on side’ advice during pregnancy – a successful campaign to reduce still birth

Professor Lesley McGowan, University of Auckland

We have supported a programme of research which has provided the evidence for the ‘Sleep on Side – Stillbirth Prevention Campaign’ since 2007, enabling New Zealand researchers to lead the way with these internationally significant findings. 

Recent results from a survey of pregnant women in the 3rd trimester showed that 86% of women had received sleep-on-side advice. Also, women sleeping on their back was reduced from 3.9% in the previous nationwide study to 1.8% (i.e. two thirds of women who were supine sleeping changed to sleep on their side based on the advice). The survey of healthcare professionals found that 77% were aware of the risk associated with a sleeping-on-their-back position and late stillbirth. A great result.