Victorian Infant Brain Studies (VIBeS)
Long-term neurodevelopmental and health outcomes in very preterm babies and their families.
Our group aims to improve the long-term quality of life for children born preterm. We conduct some of the world’s largest longitudinal observational and neuroimaging cohort studies with preterm children, which enables them to better understand the factors contributing to developmental problems observed in a high proportion of these children. Based on information from our observational cohort studies, the team develops early intervention programs that aim to prevent or minimise developmental problems in preterm children.
We aim to understand the processes that cause brain injury and the factors that disrupt normal brain development in preterm children. Researchers are also trying to determine how early brain injury impacts subsequent brain development in preterm children, identify brain abnormalities and environmental factors associated with developmental problems in preterm children, and develop and trial interventions to improve the outcome for preterm children.
VIBeS is a large multi-disciplinary group with experts in the fields of neonatology and general paediatrics, neuroscience, neuropsychology, clinical and developmental psychology, physiotherapy, nursing, occupational therapy, and speech pathology. The group comprises five specialist teams including neuroimaging, motor development, neurology, neuropsychology, and mental health and parenting.
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Our projects
AQUA Study Stage 2: Early School Years (AQUA at 6)
The children in the AQUA study turned six during 2018 and 2019, and we followed their development as they began their journey through school. This stage of the study is called the AQUA Early School Years Follow-up, or AQUA at 6 for short.
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Asking Questions About Alcohol in Pregnancy (AQUA) Study
AQUA is one of the world’s largest long-term studies looking at the effects on child development of drinking low or moderate levels of alcohol in pregnancy. Women are told not to drink during pregnancy to protect their babies. But can the occasional glass of wine hurt? And what if a woman has already had a drink before knowing she is pregnant? MCRI is seeking to answer these questions through the AQUA study.
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VIBeS 20-year follow-up
The VIBeS cohort is the world’s largest prospective longitudinal neuroimaging and neurodevelopmental study of very preterm and term children. This cohort has undergone brain magnetic resonance imaging (MRI) shortly after birth and at seven and 13 years old, and neurodevelopmental assessments throughout childhood and adolescence (two, five, seven, and 13 years).
The current study involves a 20-year follow-up of the VIBeS cohort and seeks to better understand cognitive, physical, and mental health outcomes in early adulthood. The study aims to examine the trajectories of brain and cognitive development from infancy to adulthood, and if these trajectories and outcomes are influenced by individual differences such as genes and early health and social factors. Finally, the study aims to assess the association between brain structure and function with cognitive development in 20-year-old individuals born very preterm and at term.
Read more...Victorian Infant Collaborative Study (VICS)
VICS is Victoria’s longest-running study on outcomes following extremely preterm birth. For over four decades, VICS has been working towards improving the lives of the most premature (born before 28 weeks gestation) and tiniest babies (those with a birth weight less than 1000g) by better understanding the extent of long-term health and developmental problems that these infants may face.
To date, there have been six VICS cohorts dating back to the late 1970s, that have been followed from birth, throughout their childhood and some into adulthood to determine how extreme prematurity/extremely low birth weight and the intensive care they receive as an infant affects them long-term. The VICS team includes paediatricians, psychologists, nurses and research staff and is a collaboration between the Royal Women’s Hospital, Mercy Hospital for Women, Monash Medical Centre, the Royal Children’s Hospital, and Joan Kirner Women’s and Children’s Hospital.
In July 2022, recruitment for the new VICS cohort began. All babies born extremely preterm (before 28 weeks gestation) or extremely low birth weight (less than 1000g) in Victoria between the 1 July 2022 and 30 June 2023 will be invited to take part. We will also be recruiting normal birth weight, and term-born infants as a comparison group.
This study will look at long-term outcomes for the child (cognition, behaviour and physical development) and parents including mental health and quality of life. This study will also provide important information on how recent changes in care (recommending active neonatal care for infants born as early as 22 weeks gestation) and the COVID-19 pandemic have influenced outcomes for premature babies and their parents.
This information will help the children and their parents, by directing resources for parents who may need additional emotional support following the birth of a premature infant in the future.
VIBeS Plus Trial - Long-term outcomes of a preventive care intervention for preterm infants and their families
The VIBeS Plus intervention was a preventative care program for very preterm infants and their families. The program involved home visits over the first year of life by a team of psychologists and physiotherapists. The team provided education about infant development, supported the parent-infant relationship and parents’ mental health, and assisted families with issues such as settling and adjustment issues. The VIBeS Plus study conducted follow-up assessments at two, four, seven to eight, and most recently 13 years of age, to assess the long-term effects of this preventative care program.
The study found that children born very preterm who received the preventative care program had fewer behavioural difficulties than those who did not at two, four, and 13 years. Parents who participated in the program also reported slightly fewer depressive symptoms than parents who did not up to seven to eight years after the intervention. Overall, these results suggest that the positive effects from such early preventative programs may last into early adolescence for children born very preterm and their families.
LaPrem cohort - Brain development and short-term outcomes of children born late preterm
The LaPrem study is an observational cohort study focusing on brain development and developmental outcomes of children born between 32 and 36 completed weeks of pregnancy (known as moderate and late preterm). Moderate and late preterm births form more than 80 per cent of all preterm births, and yet little is known about how being born during this gestation affects brain development.
LaPrem has recruited 200 children born moderate or late preterm and 200 term-born controls. This group of children had brain MRI at term equivalent age and underwent developmental assessment in the newborn period and at 2 years. The LaPrem cohort is now coming back for a comprehensive assessment of health, cognitive, and brain development at 9 years.
VIBeS 2 cohort - Neurobehavioural development in very preterm infants and psychological distress in their parents
The VIBeS 2 study is continuing from the original VIBeS cohort by investigating early neurodevelopment in the neonatal intensive care and special care units of infants born earlier than 30 weeks’ gestational age and their parent’s psychological wellbeing between birth and 5 years of age. VIBeS 2 is a unique study because we also assessed parental mental health (both mother and father) throughout the first 2 years of the child’s life to better understand how parenting experiences differ when a child is born early compared to term and if this has an effect on later development of the child.
We recruited 150 preterm infants and 150 term-born controls and their parents, measured brain growth and injury in the newborn period, as well as assessed parent mental health and child developmental outcomes at term, one, two, and five years of age.
e-prem Trial- Improving child and parent outcomes after preterm birth using clinician-assisted web-based early intervention
e-prem is a clinician-assisted web-based intervention that provides information and strategies for parents to promote their child’s development and support parental mental health. The intervention is delivered over the first year of life and is based on our successful home-visiting early intervention program (VIBeS Plus). For this study, we conducted a randomised control trial to know if the intervention improved child development (in areas including thinking and talking), parent mental health, and the way parents and their children interacted with one another (their relationship) compared with standard care. Results are currently being analysed and a summary will be available soon.
TEDI-Prem: Telehealth for Early Developmental Intervention in babies born very preterm
In a multi-centre randomised controlled trial of 466 very preterm (VPT) infants, the TEDI-Prem trial compares an early intervention program delivered face-to-face in the neonatal unit and via telehealth across the child’s first 12 months of life with the usual care VPT infants receive and its effects on child neurodevelopment and parent wellbeing. The intervention focuses on early motor, cognitive, and language development, environmental enrichment, and supporting parent-infant interaction and integrates the psychosocial education components of ‘e-prem’ with the principles of ‘SPEEDI - supporting play exploration and early development intervention’.
Funding
- National Health and Medical Research Council (NHMRC)
Collaborations
- Professors Maria Makrides and Robert Gibson, The University of Adelaide
- Professors Terrie Inder, Jeffrey Neil, and Simon Warfield, Harvard University
Featured publications
- Determinants and outcomes for regional brain growth over the first 13 years of life in term and very preterm born children.
Nature Communications, 11, 696.
Thompson DK, Matthews LG, Alexander B, Lee KJ, Kelly CE, Adamson CL, Hunt RW, Cheong JLY, Spencer-Smith M, Neil JJ, Seal ML, Inder TE, Doyle LW, Anderson PJ (2020). - Changes in long-term prognosis with increasing postnatal survival and the occurrence of postnatal morbidities in extremely preterm infants offered intensive care: a prospective observational study.
The Lancet Child & Adolescent Health, 2(12), 872-879
Cheong JLY, Lee KJ, Boland RA, Spittle AJ, Opie GF, Burnett AC, Hickey LM, Roberts G, Anderson PJ, Doyle LW, for the Victorian Infant Collaborative Study Group. (2018) - Changing neurodevelopment at 8 years of children born extremely preterm since the 1990s.
Pediatrics, 139(6), e20164086
Cheong JLY, Anderson PJ, Burnett AC, Roberts G, Davis N, Hickey L, Carse E, Doyle LW, for the Victorian Infant Collaborative Study Group. (2017). - Evolution of depression and anxiety symptoms in mothers and fathers of very preterm infants during the newborn period – a longitudinal study.
JAMA Pediatrics, 170(9), 863-870
Pace C, Spittle AJ, Molesworth CML, Lee KJ, Northam EA, Cheong JLY, Davis PG, Doyle LW, Treyvaud K, Anderson PJ (2016). - Psychiatric disorders in individuals born very preterm / very low birth weight: An individual participant data (IPD) meta-analysis.
EClinicalMedicine, 42, 101216
Anderson PJ, Marques de Miranda D, Albuquerque MR, Indredavik MS, Evensen KAI, Van Lieshout R, Saigal S, Taykor HG, Raikkonen K, Marlow N, Johnson S, Woodward LJ, Austin N, Nosarti C, Jaekel J, Wolke D, Cheong JLY, Burnett A, Treyvaud K, Lee KJ, Doyle LW. (2021)