Improving longer-term outcomes for premature babies with lung disease

Murdoch Children’s Research Institute researcher Associate Professor Brett Manley has been recognised for an international trial that aims to improve the long-term outcomes for extremely premature babies with a common chronic lung disease.

Associate Professor Manley, who is also a Consultant Neonatologist at The Royal Children’s Hospital and an Associate Professor in Obstetrics and Gynaecology at The University of Melbourne, received the $534,370 E.W. "Al" Thrasher Award which aims to improve children's health through medical research.

His trial will test if a corticosteroid (anti-inflammatory drug) treatment given directly into the lungs soon after birth can prevent bronchopulmonary dysplasia (BPD), an inflammatory chronic lung disease common in extremely premature babies, and whether this will result in longer-term health benefits.

Preterm birth rates are increasing around the world and currently represent around 10 per cent of all births. Extremely preterm infants are those born before 28 weeks’ gestation (at least three months early) and are at the highest risk of death and complications. About half of extremely preterm infants admitted to intensive care either die or develop BPD. Currently, there are few therapies that safely reduce BPD and none that prevent it.

“Corticosteroids are used to treat BPD, but they may increase the risk of neurodisability such as developmental delay, cerebral palsy, blindness or deafness, when used in the first week of life,” Associate Professor Manley said. Therefore, a safe, early treatment is urgently required.”

To reduce the risk of neurodisability occurring due to corticosteroid treatment, Associate Professor Manley is studying the use of corticosteroid budesonide, given directly into the windpipe, mixed with surfactant (a natural substance that lines the airspaces) as an alternative to the current treatment.

“This is a simple, inexpensive therapy that has the potential to increase survival of extremely preterm infants and prevent BPD in this high-risk population,” he said.

The study will recruit 1060 extremely preterm infants and assess surviving children (expected to number around 850) at two years of age to see if there are longer-term benefits or harms to this new therapy.

Associate Professor Manley said this trial could improve longer-term outcomes for tens of thousands of extremely preterm infants each year.

“If this simple, readily available and inexpensive intervention is effective and safe in the longer term, it will be quickly translated into worldwide clinical practice by our internationally recognised team,” he said.

Funding

This award is provided by the Thrasher Research Fund, and the trial is supported by an NHMRC grant GNT1158555.