The Victorian Brain Infants Studies (VIBeS) began a very important research project in January 2005, which aimed to establish if receiving developmental care at home was more beneficial than the current standard care, the study is known as the VIBeS Plus program.

There are around 3,000 very low birth weight (less than 1500 grams) or very preterm infants (less than 30 weeks gestational age) born each year in Australia. Survival rates for these very preterm infants have improved dramatically in the last few decades to be greater than 85%, however a significant proportion of children experience movement, behavioural or social problems which have life-long consequences. Early intervention programs, such as the VIBeS Plus program may reduce these risks. To date, the success of these programs has not been fully established.

The original VIBeS Plus study was a randomised control trial of a preventative care intervention. There were 120 families who participated and were randomised to either the “intervention group” or “control group”. The intervention designed by the Victorian Infant Brain Studies (VIBeS) team, consisted of 9 visits over the first year of life, conducted by 2 teams comprising a psychologist and a physiotherapist who were specially trained to deliver the intervention program. The intervention aimed to educate the primary caregivers about infant self-regulation and techniques for improving postural stability, coordination, and strength and to support the parents’ mental health and parent infant relationship throughout the first year. Each session lasted ~1.5 to 2.0 hours and was conducted in the family home, with a few exceptions in which the infants were seen in the hospital. Both groups were offered an MRI scan of their infant's brain at term corrected age.

Many of the neurobehavioral impairments described in preterm children persist into adolescence and adulthood. Further, caregivers of very preterm survivors experience high rates of mental health problems. Studies examining the effectiveness of early developmental intervention programs designed to reduce the burden of developmental problems report short-term benefits for infants and their caregivers.

VIBeS Plus previously demonstrated that at 2 years the early preventive care program improved preterm infants’ behavioural outcomes and reduced primary caregivers’ anxiety and depression. The follow-up study conducted at age 4 years showed that home-based preventive care over the first year had selective long-term benefits. There were meaningful differences in the thinking and learning, language and motor scores between treatment groups. Also, children in the intervention group showed less attention problems, such as ADHD, and behavior difficulties as well as increased competence compared with the controls.

Given the important role of parenting on child development, it is possible that the full benefits of this preventive care program will not be observed until later in development. Thus it is vital to determine whether early preventative care programs have long-term benefits beyond early development and preschool years. VIBeS Plus are currently following up this group of preterm children at school-age. Follow-up at school age is ideal for assessing the usefulness of this program, as this is when brain development and social maturation are relatively stable, and when the social demands of the environment (primary school) are also relatively consistent.

Published in Industry News
Sunday, 01 June 2014 11:40

Stem Cells Could Help Preterm Infants

Premature babies have underdeveloped lungs and often have difficulty breathing by themselves. Respiratory distress syndrome and chronic lung disease are the most common breathing difficulties related to preterm birth.

Difficulty breathing due to underdeveloped lungs is often a common consequence of preterm birth that needs immediate attention. Respiratory distress syndrome, also called hyaline membrane disease (HMD), is the most common lung disorder in preterm infants. Preterm infants do not produce enough of a slippery, protective substance called surfactant, which helps the lungs inflate with air and keeps them from collapsing, when the infant tries to breathe in air, after birth, by themself. Preterm infants with respiratory distress syndrome are treated with exogenous surfactant and has been shown to decrease neonatal mortality in very low birth weight and preterm infants. Where possible steroids are given to mother’s before a preterm delivery to help prevent problems associated with underdeveloped organs and lung immaturity.

Early difficulties with breathing and the need for ventilation can result in chronic lung disease (CLD), also called bronchopulmonary dysplasia (BPD), which is common in babies born preterm. CLD is a disorder that results from inflammation, injury, and scarring of the airways and the alveoli.

New research which has focused on lung problems associated with preterm birth has reported some fascinating findings. Dr. Bernard Thébaud, who is a pediatrician at the Children’s Hospital of Eastern Ontario and The Ottawa Hospital, published a paper in the medical journal Circulation reporting findings that showed that damaged lungs of preterm infants can be safely repaired using stem cells and regenerative medicine. This is the first study to demonstrate the use of vascular progenitor cells (stem cells that make blood vessels) for this purpose.

Research findings so far are based on research conducted on lab animals but the next phase of the study will begin working on opportunities for clinical trials.

These research findings have huge implications for the treatment of lung disease in preterm infants as well as the potential regeneration of other organs and other lung diseases in adult populations. This research is very important, not just for the short-term benefits but also the potential long-term benefits. For example, a lack of oxygen to other parts of the preemie infant’s body can result in other difficulties. For example, lack of oxygen can affect brain and eye development. Respiratory problems are the most common cause of death in preterm infants, although these problems have lessened over time, and they also have a large effect on other health outcomes. That is, they are related to high rates of cognitive (thinking and reasoning), motor skills, educational, and behavioural difficulties.

Research such as this could be a great step in lessening the burden and stress for families of preterm infants who often have to deal with many and varied many challenges.

Published in Industry News
Wednesday, 20 August 2014 08:51

Prevention of Preemie Parent Distress

The birth of a preterm infant can cause significant psychological distress for parents and families. In particular it has been consistently reported that the birth and hospitalisation of an unwell baby is associated with high levels of distress and depressive symptoms in the mother of the infant. Most research in this area has focused on the mother of preterm infants but some research groups are now trying to evaluate the emotional affect preterm birth also has on fathers.

Research suggests that 10% of mothers of infants with very low birth weight (VLBW; infants born less than 1,500 g) report severe symptoms of psychological distress in the neonatal period which is five-fold the rate of term mothers, and almost one-third of mothers of VLBW infants have clinically meaningful levels of depression and anxiety.

A research team in the United States have recently evaluated a treatment intervention developed for reducing symptoms of posttraumatic stress, depression, and anxiety in parents of preterm babies.

There were 105 mothers of preterm infants who particpated in the study. The gestational age of preemies ranged from 25 to 34 weeks' gestational age and all were born more than 600grams. The 105 participants were randomly selected to be part of 2 groups; 1)intervention group - these mothers received 6 sessions of intervention which combined trauma-focused treatments, including psychoeducation, cognitive restructuring, progessive muscles relaxation, and development of their trauma narrative. It also included material which targeted infant redefinition - changing the mother's negative perceptions of her baby and the parenting experience; 2)control group - these mothers were described as an active comparison group who received an education session.

The research findings were positive for the intervention group - mothers greater reduction in trauma symptoms and depression, both groups reported less anxiety, and mothers who experienced higher NICU stress before the intervention benefited more from the intervention than mothers who reported low NICU stress.

The researchers concluded that, "This short, highly manualized intervention for mothers of preterm infants reduced symptoms of trauma and depression. The intervention is feasible, can be delivered with fidelity, and has high ratings of maternal satisfaction. Given that improvements in mothers’ distress may lead to improved infant outcomes, this intervention has the potential for a high public health impact.

Research such as this could be a great step in lessening the burden and stress for families of preterm infants who often have to deal with many and varied challenges.

Published in Industry News

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Preemie, Premmie, or Prem?

Most babies spend between 38 and 42 weeks in their mother’s uterus. So, technically a preterm birth, preemie, premmie, or prem, is an infant who is born less than 37 completed gestational weeks. 


Read More: Defining Preterm birth


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