Researchers receive grant to improve outcomes for preterm infants who struggle to take first breaths

Monash University researchers have received a prestigious National Institutes of Health (NIH) project grant to find ways to improve outcomes for very preterm infants who struggle to take their first breaths.

Chief Investigator Professor Stuart Hooper, from the Monash Institute of Medical Research (MIMR), and his team have been awarded a four-year R01 grant from the US-based NIH, worth $1.65 million.

The unique, multidisciplinary research team, led by Professor Hooper, includes Dr Graeme Polglase and Associate Professor Timothy Moss from MIMR, Associate Professor Andreas Fouras from the Department of Mechanical Engineering and Dr Marcus Kitchen from the School of Physics. The team also includes Professor Peter Davis, Dr Marta ThioLluch and Dr Jennifer Dawson from the Royal Women's Hospital in Melbourne, who are neonatologists - experts in neonatal resuscitation.

"Many preterm infants struggle with the transition to newborn life and require assisted ventilation due to their underdeveloped lungs," Professor Hooper said.

"However, this can injure their lungs leading to the development of bronchopulmonary dysplasia (BPD), which can be lethal and have major long-term health implications."

Research shows that of the survivors of BPD, 50 per cent are re-hospitalised in their first year of life for serious respiratory disease.

"Clearly, there is a pressing need to reduce the substantial burden of illness associated with prematurity," Professor Hooper said.

"To achieve this we need to better understand how to manage the transition to air-breathing at birth in these very preterm infants. This NIH grant will help us to achieve this."

The research team will provide data detailing the most effective way of applying the first breaths after birth in preterm infants. They will also provide the first scientific data detailing why umbilical cord clamping should be delayed until after ventilation onset at birth, and the factors that determine whether delayed cord clamping is beneficial or not.

Dr Polglase said the research team would also establish the link between early breathing support and brain injury, using Magnetic Resonance Imaging (MRI).

"Demonstrating how the delivery of the first breaths of life at birth can lead to brain injury, and developing strategies to prevent this, can reduce the significant burden of brain injury and long-term consequences such as cerebral palsy, which are a major problem in preterm infants," Dr Polglase said.

The researchers are currently the only group in the world employing synchrotron x-ray imaging and physiological techniques to image air as it enters the lungs at birth, and combining this with subsequent MRI to determine the effects upon the preterm brain.

"By using these techniques we can identify the most efficient procedures for facilitating the process of air entering the lungs, and make detailed measurements of the physiological changes that take place at birth," Professor Hooper said.

"This technology will help us to understand the physiology underpinning the transition to newborn life and answer some of the most pressing questions in neonatal medicine."