A5006423005- Neonatal Respiratory Health Research
- Infant Nutrition and Health
- Infant Development and Preterm Care
- Congenital Heart Disease Studies
- Maternal and Perinatal Health Interventions
- Delphi Technique in Research
- Preterm Birth and Chorioamnionitis
- Cardiovascular Conditions and Treatments
- Pregnancy and preeclampsia studies
- Cardiovascular Issues in Pregnancy
- Neonatal and Maternal Infections
- Assisted Reproductive Technology and Twin Pregnancy
- Central Venous Catheters and Hemodialysis
- Reproductive Biology and Fertility
- Maternal and fetal healthcare
- Neonatal skin health care
- Infant Health and Development
- Ovarian function and disorders
- Child and Adolescent Psychosocial and Emotional Development
- Pelvic floor disorders treatments
- Pediatric Hepatobiliary Diseases and Treatments
- Wireless Power Transfer Systems
- Statistical Methods in Clinical Trials
- Birth, Development, and Health
- Health Systems, Economic Evaluations, Quality of Life
University of Oxford
2011-2023
Nuffield Health
2019
Hospice UK
2001
The clinically appropriate range for oxygen saturation in preterm infants is unknown. Previous studies have shown that had reduced rates of retinopathy prematurity when lower targets were used.
BackgroundIn women with late preterm pre-eclampsia, the optimal time to initiate delivery is unclear because limitation of maternal disease progression needs be balanced against infant complications. The aim this trial was determine whether planned earlier initiation reduces adverse outcomes without substantial worsening neonatal or outcomes, compared expectant management (usual care) in pre-eclampsia.MethodsIn parallel-group, non-masked, multicentre, randomised controlled done 46 maternity...
<h2>Summary</h2><h3>Background</h3> Infections acquired in hospital are an important cause of morbidity and mortality very preterm infants. Several small trials have suggested that supplementing the enteral diet infants with lactoferrin, antimicrobial protein processed from cow's milk, prevents infections associated complications. The aim this large randomised controlled trial was to collect data enhance validity applicability evidence previous inform practice. <h3>Methods</h3> In...
The cyclooxygenase inhibitor ibuprofen may be used to treat patent ductus arteriosus (PDA) in preterm infants. Whether selective early treatment of large PDAs with would improve short-term outcomes is not known.
Objective To compare the effect of two methods perineal management used during spontaneous vaginal delivery on prevalence pain reported at 10 days after birth. Design Randomised controlled trial. Setting Two English maternity care units. Sample 5471 women who gave birth between December 1994 and 1996. Methods At end second stage labour were allocated to either ‘hands on’ method, in which midwife's hands put pressure baby's head support (‘guard’) perineum; lateral flexion is then facilitate...
Observational data have shown that slow advancement of enteral feeding volumes in preterm infants is associated with a reduced risk necrotizing enterocolitis but an increased late-onset sepsis. However, from randomized trials are limited.We randomly assigned very or very-low-birth-weight to daily milk increments 30 ml per kilogram body weight (faster increment) 18 (slower until reaching full volumes. The primary outcome was survival without moderate severe neurodevelopmental disability at 24...
Background Necrotising enterocolitis (NEC) and late-onset sepsis remain important causes of death morbidity in preterm babies. Probiotic administration might strengthen intestinal barrier function provide protection; this is supported by published meta-analyses, but there a lack large well-designed trials. Objective To test the use probiotic Bifidobacterium breve strain BBG-001 to prevent NEC, babies while monitoring colonisation participants. Design Double-blind, randomised,...
Objectives. To investigate behavioral and emotional problems positive adjustment of 15-to 16-year-olds who were born at extremely low gestational age (ELGA), from the perspective parents, teachers, teenagers. Methods. Prospective follow-up was conducted birth cohorts, with classroom control subjects. All infants before 29 weeks in 1983–1984 (mean age: 27 weeks) to mothers resided 3 regions United Kingdom studied. A total 82% (179 218) survivors traced 15 16. The 150 mainstream school...
In the UK, 1–2% of infants are born very preterm (<32 weeks gestation) or have low birth weight (<1500 g). Very initially unable to be fed nutritional volumes milk and therefore require intravenous nutrition. Milk feeding strategies influence several long short term health outcomes including growth, survival, infection (associated with nutrition) necrotising enterocolitis (NEC); both NEC being key predictive factors disability. Currently there is no consistent strategy for across UK. The...
Infertility affects one in seven couples; many of these need vitro fertilisation (IVF). IVF involves external hormones to stimulate a woman's ovaries produce eggs which are harvested surgically. Embryos, created the laboratory by mixing with sperm, grown culture for few days before being replaced within uterus (fresh embryo transfer). Spare embryos usually frozen view transfer at later point time – especially if initial fresh does not result pregnancy. Despite improvements technology,...
Infections acquired in hospital are an important cause of morbidity and mortality very preterm infants. Several small trials have suggested that supplementing the enteral diet infants with lactoferrin, antimicrobial protein processed from cow's milk, prevents infections associated complications. To determine whether or not supplementation bovine lactoferrin (The Tatua Cooperative Dairy Company Ltd, Morrinsville, New Zealand) reduces risk late-onset infection (acquired > 72 hours after birth)...
Introduction Necrotising enterocolitis (NEC) is a potentially devastating neonatal disease. A temporal association between red cell transfusion and NEC well described. Observational data suggest that withholding enteral feeds around transfusions may reduce the risk of but this has not been tested in randomised trials; current UK practice varies. Prevention research priority no appropriately powered trials have addressed question. The use simplified opt-out consent model embedding trial...
Intrahepatic cholestasis of pregnancy (ICP) is the most common liver disorder specific to and presents with maternal pruritus, raised concentrations serum bile acids abnormal function tests. ICP associated increased rates spontaneous iatrogenic preterm labour, fetal hypoxia, meconium-stained amniotic fluid intrauterine death. Some clinicians treat ursodeoxycholic acid (UDCA) improve pruritus biochemical abnormalities. However, there are currently no data support use UDCA outcome as none...
Pre-eclampsia is a pregnancy disorder, characterised by hypertension and multisystem complications in the mother. The adverse outcomes of pre-eclampsia include severe hypertension, stroke, renal hepatic injury, haemorrhage, fetal growth restriction even death. optimal time to instigate delivery prevent morbidity when occurs between 34 37 weeks' gestation, without increasing problems related infant immaturity or complications, remains unclear. PHOENIX trial non-masked, randomised controlled...
Background Observational data suggest that slowly advancing enteral feeds in preterm infants may reduce necrotising enterocolitis but increase late-onset sepsis. The Speed of Increasing milk Feeds Trial (SIFT) compared two rates feed advancement. Objective To determine if faster (30 ml/kg/day) or slower (18 daily increments improve survival without moderate severe disability and other morbidities very low-birthweight infants. Design This was a multicentre, two-arm, parallel-group, randomised...
Introduction Catheter-related sepsis is one of the most dangerous complications neonatal intensive care and associated with significant morbidity mortality. Use catheter-care ‘bundles’ has reduced incidence catheter-related sepsis, although individual components have not been well studied. Better evidence needed to guide selection appropriate antiseptic solution for skin disinfection in preterm neonates. This study will inform feasibility design first randomised controlled trial examine...
Background Freezing all embryos, followed by thawing and transferring them into the uterine cavity at a later stage (freeze-all), instead of fresh-embryo transfer may lead to improved pregnancy rates fewer complications during in vitro fertilisation pregnancies resulting from it. Objective We aimed evaluate if policy freeze-all results higher healthy baby rate than current fresh embryos. Design This was pragmatic, multicentre, two-arm, parallel-group, non-blinded, randomised controlled...
Abstract Background The neonatal period carries the highest risk of bacterial meningitis (~ 1 in 5000 births), bearing high mortality 10%) and morbidity (20–50%) rates. Lumbar puncture (LP) remains essential to diagnosis meningitis. Though LP is a common procedure neonates, success rates are lower (50–60%) than other patient populations. None currently-practised techniques supported by evidence from adequately-powered, randomised controlled trials (RCTs). NeoCLEAR aims compare two...
Background Sepsis is a leading cause of direct and indirect maternal death in both the UK globally. All forms operative delivery are associated with an increased risk sepsis, National Institute for Health Care Excellence’s guidance recommends use prophylactic antibiotics at all caesarean deliveries, based on substantial randomised controlled trial evidence clinical effectiveness. A Cochrane review, updated 2017 (Liabsuetrakul T, Choobun Peeyananjarassri K, Islam QM. Antibiotic prophylaxis...
Background Intrahepatic cholestasis of pregnancy, characterised by maternal pruritus and raised serum bile acid concentrations, is associated with increased rates stillbirth, preterm birth neonatal unit admission. Ursodeoxycholic widely used as a treatment, but without an adequate evidence base. Objective We aimed to evaluate whether or not ursodeoxycholic reduces adverse perinatal outcomes in affected women. Design Multicentre, masked, randomised, placebo-controlled, two-arm, parallel-group...
Tongue-tie can be diagnosed in 3-11% of babies, with some studies reporting almost universal breastfeeding difficulties, and others very few feeding difficulties that relate to the tongue-tie itself, instead noting incorrect positioning attachment are primary reasons behind observed not itself. The only existing trials frenotomy small underpowered and/or include short-term or subjective outcomes.To investigate whether is clinically cost-effective promote continuation at 3 months infants...
<h3>Aims</h3> The management of PDA continues to be a clinical conundrum in extremely low gestational age newborns (ELGANS). Presence at 72 hours after birth ELGANS is associated with an increased risk death and complications prematurity. Functional echocardiography (fEcho) increasingly used assess the haemodynamic impact can first 3 days identify babies large pre-symptomatic PDA. objective this study was evaluate whether early targeted treatment (diagnosed by fEcho) extreme preterm...
To evaluate the cost-effectiveness of two rates enteral feed advancement (18 vs 30 mL/kg/day) in very preterm and low birth weight infants.