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Using sildenafil to improve the growth of a baby in a mother’s womb

Dr Katie Groom
University of Auckland

What is the problem and who does it affect?

Intrauterine growth restriction (IUGR) is a term used to characterise poor growth of a baby in a mother’s womb. It affects approximately 10% of all pregnancies, some of which require very early delivery (less than 32 weeks’ gestation).

We know that very preterm birth, in addition to growth restriction, can subject babies to numerous short and long-term adverse health outcomes, including cerebral palsy and hypertension. Tragically, it can also be a contributing cause to stillbirth. IUGR is characterised by placental insufficiency, more specifically, a lack of oxygen and nutrients reach the baby through the placenta.

The only available treatment is for an obstetrician to plan an early birth. As these adverse health outcomes associated with very early birth are numerous, it is imperative that treatments are found to improve growth and wellbeing in the womb enabling better health for these babies.

How is the research being carried out?

Dr Katie Groom is the lead investigator on the multicentre STRIDER NZAus Trial, funded by the Health Research Council. This randomised placebo controlled trial is testing whether sildenafil is an effective treatment to improve the wellbeing of very growth restricted babies still in the womb. Sildenafil has the potential to dilate blood vessels within the mother’s pelvis and so improve blood supply and oxygen delivery to the baby.

Cure Kids funding will support a Clinical Trial Manager to oversee the completion of recruitment as well as supporting the planning of an essential longer-term follow up of recruited mothers and their children. The primary outcome of this study is fetal growth velocity. The trial is part of larger international collaboration which will be able to assess the effect of sildenafil on health and wellbeing of off-spring through to early childhood.

Cure Kids funding is critical to realise the potential effect of sildenafil as a treatment for fetal growth restriction.