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Adult outcomes after antenatal steroids


About This PhD Project

Project Description

The Liggins Institute at the University of Auckland has PhD projects assessing adult outcomes after antenatal steroids.

Steroids given to women at risk of preterm birth markedly reduce the risk of serious illness in their newborn babies. However, it is possible that they increase the risk of diabetes and heart disease in adults who were exposed to steroids before birth. Repeat doses are recommended if birth is delayed, but effects on adult health are not known. The Auckland Steroid trial was the first randomised trial of antenatal steroids, and the survivors of that trial were assessed at 30 years. They are now in their 50’s. We have also completed the ACTORDS randomised trial comparing single with repeat doses of steroids, and have assessed those children’s growth and development at 6-8 years.

This project will involve assessing whether nationally collected data held in the government Integrated Data Structure (IDI) can be used to determine later adult outcomes of babies whose mothers took part in the Auckland Steroid Trial and the ACTORDS trial.

Objectives:

i) Compare IDI data with that collected by individual assessment at 6-8 years and 30 years.

ii) Assess education, employment, health and social outcomes later in adulthood.

Who we are: The Liggins Institute is a world-leading centre for research on fetal and child health, nutrition, development, genome biology and translational and implementation science. Our mission is to improve life-long health through excellent research into the long-term consequences of early life events.

We work across a range of fields to view human health problems from different angles. This unique approach enables us to turn research discoveries into real strategies that will help people to prevent or manage major health problems in the 21st century.

As a research-only institute, we attract some of the best research students and clinical fellows in the world. You’ll be supported by internationally-recognised staff and you’ll benefit from state-of-the-art laboratory facilities and a dedicated clinical research unit.

We are looking for candidates with a First Class Masters or Honours degree or equivalent in a health-related discipline and a clinical background. Examples include (but are not limited to) neonatology, nursing, midwifery, paediatrics, obstetrics, medicine, cardiology, public health, epidemiology, developmental or educational psychology, education.

Please send a CV and academic transcript to:

Distinguished Professor Jane Harding
Email:



References

Crowther CA, Haslam RR, Hillier JE, Doyle LW, Robinson JS, for the Australasian Collaborative Trial of Repeat Doses of Steroids (ACTORDS) Study Group. Neonatal respiratory distress syndrome after repeat exposure to antenatal corticosteroids: a randomised controlled trial. Lancet 367: 1913-1919, 2006.

Crowther CA, Doyle LW, Haslam RR, Hiller JE, Harding JE, Robinson JS, for the ACTORDS Study Group. Outcomes at 2 years of age after repeat doses of antenatal corticosteroids. New England Journal of Medicine 357: 1179-89, 2007.

McKinlay CJD, Cutfield WS, Battin MR, Dalziel SR, Crowther CA, Harding JE on behalf of the ACTORDS Study Group. Cardiovascular risk factors in children after repeat doses of antenatal glucocorticoids: an RCT. Pediatrics 135: e405-415, 2015. DOI: 10.1542/peds.2014-2408

Crowther CA, Anderson PJ, McKinlay CJD, Harding JE, Ashwood PJ, Haslam, RR, Robinson JS, Doyle LW for the ACTORDS Follow-up Group. Mid-childhood outcomes of repeat antenatal corticosteroids: a randomized controlled trial. Pediatrics 138, e20160947, 2016.

Crowther CA, McKinlay CJD, Middleton P, Brown J, Harding JE. Repeat doses of prenatal corticosteroids for women at risk of preterm birth for improving neonatal health outcomes. Cochrane Database of Systematic Reviews Issue 7, Art. No.: CD003935. DOI: 10.1002/14651858.CD003935.pub4, 2015.

Dalziel SR, Walker NK, Parag V, Mantell C, Rea HH, Rodgers A, Harding JE. Cardiovascular risk following exposure to antenatal betamethasone: Thirty year follow-up of a randomised controlled trial. Lancet 365: 1856-1862, 2005.

Dalziel SR, Lim VK, Lambert A, McCarthy D, Parag V, Rodgers A, Harding JE. Antenatal exposure to betamethasone: psychological functioning and health related quality of life 31 years after inclusion in a randomised controlled trial. British Medical Journal 331: 665-671, 2005. (Accompanied by editorial commentary)

Dalziel SR, Rea HH, Walker NK, Parag V, Mantell C, Rodgers A, Harding JE. Long term effects of antenatal betamethasone on lung function: 30 year follow up of a randomised controlled trial. Thorax, 61:678-683, 2006.

Dalziel SR, Fenwick S, Cundy T, Parag V, Beck TJ, Rodgers A, Harding JE. Peak bone mass following exposure to antenatal betamethasone and prematurity: Follow-up of a randomised controlled trial. Journal of Bone and Mineral Research 21: 1175-1186, 2006.

To learn more about the Liggins Institute visit https://www.auckland.ac.nz/en/liggins.html

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