Preterm Health

What is preterm birth?

The World Health Organization (WHO) defines preterm
babies as those born alive before 37 weeks of pregnancy are
completed. But there are sub-categories of preterm birth,
based on gestational age:

• extremely preterm (less than 28 weeks)
• very preterm (28 weeks to less than 32 weeks)
• moderate to late preterm (32 weeks to less than 37 weeks).

At Cure Kids, although there is a natural overlap with areas of
health research, our preterm researchers are often focused
on extremely preterm babies, i.e. those between 23 and 27
weeks gestation (i.e. less than 28 weeks)

Why does preterm birth happen?

Preterm birth occurs for a variety of reasons. While most
preterm births ‘just happen’ (spontaneously) some are due to
early induction of labour or a caesarean birth (which could be
for medical or non-medical reasons).
Common causes of preterm birth include multiple
pregnancies, infections and chronic conditions such as
diabetes and high blood pressure; however, often no cause is
identified. There can also be various genetic or social factors
that lead to preterm birth. A better understanding of these
causes and mechanisms will help health researchers to offer
new solutions to help prevent preterm birth.

What are we doing to help?

Here are just some of the research projects we are funding
to help improve preterm health in New Zealand.

IN PROGRESS

Seeking a new treatment to prevent lung disease in extremely preterm babies

There are around 500 babies born extremely premature in New
Zealand every year and over 50% of these babies will develop
bronchopulmonary dysplasia (BPD) — a lung disease that
increases the risk of many other medical serious conditions.
But researchers led by Dr Chis McKinlay from Auckland
University are working on a new treatment to help premature
babies — and their families — breathe a little easier. Along
with neonatal specialists from around New Zealand and
Australia, Dr McKinlay has been investigating a new way of
giving anti-inflammatory steroids (corticosteroids) to babies
to help prevent the development of BPD.

Impact of preterm baby nutritional support on neurodevelopment

Babies born at moderate to late preterm (32 weeks to less than
37 weeks) account for more than 80% of all preterm births and
are at increased risk of adverse neurodevelopmental outcomes.
They’re also at risk of adverse long-term health outcomes such
as cardiovascular disease, obesity, and diabetes.
Nutrition in preterm babies is critical for supporting healthy
growth, including brain growth. But there is little evidence
to guide ‘optimal nutritional’ and practices varies widely.
Professor Frank Bloomfield’s trial is investigating the effects
of different feeding strategies in the early days after birth
until four months corrected age. The trial will enable the
research team to develop evidence-based nutritional support
recommendations.

PREVIOUS RESEARCH

Measuring the effect on babies (at age 2) treated with dextrose gel at birth.

Hypoglycaemia (low blood sugar) is the only readily
preventable cause of brain damage in newborn babies.
While up to 15% of newborn babies have low blood sugar,
this number is higher when the mother has diabetes
(50%) or the baby is born preterm (60%).
Professor Jane Harding is a neonatologist specialising in
the care of newborn babies. Her team (recent winners of the
Prime Minister’s Science Prize) have conducted a world-first trial which showed that dextrose gel massaged into the
inside of a baby’s cheek can be used to treat hypoglycemia
and therefore reduce the need for admission to intensive
care for treatment.

Improving the nutritional care of preterm babies 

Researchers know that extremely preterm births
or extremely low birthweights can be considered a nutritional
emergency. So adequate protein intake in the weeks after
birth is critical for optimum growth and development, but
there is little evidence on the amount required.
Led by Dr Barbara Cormack and Professor Frank Bloomfield
the ProVIDe Study aims to assess whether a higher protein
intake in the week after birth will improve neurodevelopment
and the amount required.