Perinatal Transition

Research > The Ritchie Centre > Perinatal Transition

Perinatal Transition

Research Group Head: Dr Graeme Polglase

This group undertakes research focusing on how events prior to, during, and after birth can adversely alter respiratory, cardiovascular and neurological outcomes, with specific focus on the transition from a fetus to a newborn. The unique strength of the group is the close collaboration between scientists and clinicians, incorporating respiratory and cardiovascular physiologists, neurologists, obstetricians and neonatologists, which focus the research on major clinical issues with rapid translation into improving the health and wellbeing of infants. We aim to understand how events around the time of birth can lead to lung, heart and brain inflammation, and injury leading to life-long consequences such as bronchopulmonary dysplasia pulmonary and systemic hypertension and cerebral palsy. With a focus on infants born preterm, with an increased risk of morbidity and mortality, we are investigating the impacts of events in three key periods around the time of birth, which increases susceptibility to organ injury:

  1. The preterm fetus is commonly exposed to a number of insults while in the womb, including inflammation/infection, antenatal corticosteroids and growth restriction. All of these may have adverse or beneficial effect on the developing lung, heart and brain.
  2. The period around the time of birth is a time of significant instability within the cardiopulmonary-cerebral circulation, and as such, is a critical period for the development of acute inflammation and injury. Our research focuses on improving the haemodynamic transition by investigating the influence of delayed cord clamping, physiological cord clamping and he influence of obstetric management on the circulatory transition at birth.
  3. Preterm infants often require respiratory support in the form of mechanical ventilation at birth. While life saving, our research has shown that it increases the risk of respiratory, cardiovascular and cerebral inflammation and injury. Our research focuses on improving respiratory support for preterm infants, which reduces lung and brain inflammation and injury, while improving the circulatory transition at birth. We utilise state of the art imaging techniques, including MRI, for early detection of injury, and test new therapies including Stem Cells and Erythropoietin, to protect the preterm brain.

 

Research Projects:

  • Effect of intrauterine inflammation on preterm lung, heart and brain injury
  • Effect of intrauterine growth restriction on preterm lung, heart and brain injury
  • Physiological based cord clamping for improving the cardiopulmonary-cerebral circulation at birth.
  • Erythropoietin for protection of preterm lung and brain injury
  • Human amnion epithelial cells for protection of preterm lung and brain injury
  • Early detection of ventilation induced brain injury
  • Influence of resuscitation strategy on preterm lung, heart and brain injury
  • Long-term cardiovascular consequences of preterm birth.

 

Research Group:

Dr Graeme Polglase (Research Group Head

Selected Publications:

Polglase G.R., Miller S. L., Barton S. K., Kluckow M.,Gill A.W.,Hooper S.B. and Tolcos M. Respiratory support for premature neonates in the delivery room: potential effects on cardiovascular function and brain injury. Invited Review. Pediatr Res. 2014 Jun;75(6):682-8.

Skiold B., Hooper S.B., Wu Q., Hooper S.B., Davis P.G., McIntyre R., Tolcos M., Pearson J., Vreys R., Egan G.F., Barton S.K., Cheong J.L.Y. Polglase G.R. Early detection of ventilation-induced brain injury using magnetic resonance spectroscopy and diffusion tensor imaging: an in vivo study in preterm lambs. PLoS One. 2014 Apr 23;9(4):e95804.

Tare M., Bensley J., Moss T.J.M., Lingwood BE., Kim MY., Barton S.K., Kluckow M., Gill A.W., De Matteo R., Harding R., Black MJ., Parkington H.C. and Polglase G.R., Cardiac function of preterm lambs is compromised by intrauterine inflammation. In Press Clinical Science (London), 2014.

Polglase G.R., Barton S.K., Melville J.M., Zahra V., Wallace M.J., Siew M.L., Tolcos M. and Moss T.J.M. Prophylactic erythropoietin exacerbates ventilation-induced lung inflammation and injury in preterm lambs. J Physiol. 2014 May 1;592(Pt 9):1993-2002.

Polglase G.R., Miller S.L., Barton S.K., Baburamani A.A., Wong F.Y., Aridas J., Gill A.W., Moss T.J.M., Kluckow M. and Hooper S.B. Initiation of resuscitation with high tidal volumes causes cerebral hemodynamic disturbance, brain inflammation and injury in preterm lambs. PLoS One. 2012;7(6):e39535.