ARCH
in
2016
Making
a meaningful
difference for
women
and babies
Australian Research
Centre
for Health of
Women and Babies
Highlights for 2016
............................................
. .RANDOMISED
. . . . . . . . TRIALS
.
Recruitment Phase
 MAGENTA (Magnesium sulphate at 30 to 34 weeks’ gestational age: neuroprotection trial),
funded by a National Health and Medical Research Council (NHMRC) project grant, is assessing
whether antenatal magnesium sulphate immediately prior to a preterm birth at 30 to 34 weeks’
gestation increases the chances of survival free of cerebral palsy. Total of 1145 women and 1348
babies (80%) recruited by 24 collaborating hospitals.
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STRIDER NZAus (A Randomised Controlled Trial of Sildenafil Therapy In Dismal Prognosis EarlyOnset Intrauterine Growth Restriction), funded by a New Zealand Health Research Council (HRC)
grant, is led by Dr Katie Groom at the Auckland City Hospital, with Dr Peter Muller the site clinical
leader at the Women’s’ and Children’s Hospital as a collaborating centre.
Total of 109 woman and babies enrolled from 13 collaborating hospitals.
My Baby’s Movements (cluster-randomised trial of maternal awareness of fetal movements to
prevent stillbirth), funded by an NHMRC project grant, and led by Professor Vicki Flenady from
the Mater Research Institute, Brisbane, with Caroline Crowther and Philippa Middleton as
investigators. All hospitals recruited and first cluster of hospitals have commenced.
hPOD The hPOD (hypoglycaemia prevention in newborns with oral dextrose) trial, funded by a
New Zealand HRC grant, is assessing whether prophylactic dextrose gel can reduce the number
of admissions to neonatal intensive care in at risk infants. Led by Professor Jane Harding, and
coordinated from the Liggins Institute, Auckland. The Women’s and Children’s Hospital
is now a collaborating centre with Dr Anu Kochar the site clinical lead.
Follow-Up Phase
 ASTEROID (Study to evaluate dexamethasone versus betamethasone prior to preterm birth to
increase survival free of neurosensory disability) – NHMRC project grant – 2 year follow-up of
1508 children completed and data analysis now underway.

IDEAL (Investigation of dietary advice and lifestyle for women with borderline gestational diabetes)
– NHMRC project grant – data analysis underway.

PROGRESS (Progesterone after previous preterm birth for the prevention of neonatal respiratory
distress syndrome) – NHMRC project grant – 2 year follow-up data analysis of 799 children
completed and data analysis underway.

BAC (Birth After Caesarean: Planned vaginal birth or elective repeat caesarean for women at term
with a previous caesarean) – 6-8 year follow-up of women and children at 6 to 8 years of age is
completed and analysis underway.
TRANSLATIONAL HEALTH PROJECTS

WISH Project (Working to Improve Survival and Health for babies born very preterm), funded by
the Cerebral Palsy Alliance, aimed to monitor the uptake of the antenatal magnesium sulphate
guidelines for fetal neuroprotection. Recruitment at four sites (Auckland City Hospital, Mater
Mothers’ Hospital, Royal North Shore Hospital and Women’s and Children’s Hospital) was
completed.

WISH Follow-Up Study – funded by the Cerebral Palsy Alliance (2014-2019), is continuing to
monitor uptake of the antenatal magnesium sulphate cerebral palsy guidelines for fetal
neuroprotection. Follow-up of infants recruited into the WISH study ongoing at 2 years’
corrected age. Longer-term follow-up of the WISH children at 3 to 5 years’ corrected age is
underway. The WISH cohort of children will be linked with the Cerebral Palsy Registries
in Australia and New Zealand.
Staff and
students
Research Leaders
and Fellows
Caroline Crowther,
Philippa Middleton.
Research Fellows and
Scholars
Emily Shepherd,
Shanshan Han,
Zohra Lassi.
Senior Trial Manager
Pat Ashwood.
Research Coordination
Mary Paleologos,
Melissa Ewens,
Michaela Gooding,
Elise Thompson.
Data Management
Vincent Ball,
Sasha Zhang,
Thach Tran.
Postgraduate
Students
Emily Shepherd.
Collaborators
Vicki Flenady,
Maria Makrides,
Andy McPhee,
Ross Haslam,
Chad Andersen,
Anu Kochar,
Jane Harding,
Jeffrey Robinson,
Lex Doyle,
Andrew Dwyer,
Bob Gibson,
Julie Brown,
Debbie Samuel,
Sarah McIntyre,
Nadia Badawi,
Katie Groom.
RESEARCH SYNTHESIS

Australian and New Zealand Satellite of Cochrane Pregnancy and Childbirth aims to support Australian and New
Zealand review authors to prepare and maintain their high quality Cochrane reviews, as well as to introduce and support
new review authors to the processes and methods of the Cochrane Collaboration.
o
o
o
o
o
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Provided support to 307 review authors based in Australia (283) and New Zealand (24).
Contributed to over one-third of the review output of Cochrane Pregnancy and Childbirth (37% (32/86) of all
protocols and 33% (182/546) of all reviews).
Supported the publication of 11 protocols, 13 new reviews, and 16 review updates in the last year.
Reviews were cited in over 60 national clinical practice guidelines and used in local guidelines.
Held a well-attended workshop at the Perinatal Society of Australia and New Zealand’s (PSANZ) annual conference
in May 2016 in conjunction with the Cochrane Neonatal Satellite to communicate and discuss the latest
developments.
Involved in methodological innovations such as development of core outcomes for diabetes in pregnancy and
preterm birth, individual participant data meta-analyses and overviews, and new methods for assessing risk of
bias.
Involved in conducting overviews of Cochrane Pregnancy and Childbirth systematic reviews for antenatal
corticosteroids, gestational diabetes prevention/treatment, stillbirth prevention, and cerebral palsy prevention.
Grants
.....................................................
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Emily Shepherd, Philippa Middleton, Caroline Crowther. Diet and exercise interventions for preventing
gestational diabetes: a Cochrane systematic review update, £5000, NIHR (National Institute of Health Research), UK.
Emily Shepherd, Philippa Middleton, Caroline Crowther. Treatments for women with gestational diabetes mellitus:
an overview of Cochrane systematic reviews, £10,000, NIHR, UK.
Dr Anu Kochar, Dr Chad Andersen, Ms Pat Ashwood, Professor Jane Harding. hPOD (hypoglycaemia prevention
in newborns with oral dextrose), $75,000, Women’s and Children’s Hospital Foundation Project Grant, Australia.
Emily Shepherd, Philippa Middleton, Maria Makrides, Caroline Crowther. Neonatal and infant adverse effects of
antenatal magnesium sulphate for improving outcomes for mothers and babies: a systematic review, $23,542,
Cerebral Palsy Alliance Research Foundation, Australia.
Philippa Middleton, Emily Shepherd, Maria Makrides. Methodological reviews of nutrient reference values: iodine,
fluoride and sodium, $16,800, NHMRC.
Event and Conference Participation
.....................................................
PSANZ 20th Annual Conference, Townsville, 2016
 Alsweiler JM, Woodall S, Crowther CA, Harding JE. A survey on the use of oral dextrose gel to treat neonatal
hypoglycaemia in New Zealand maternity hospitals.
 Brown JA, Crawford T, Alsweiler J, Crowther CA. Can antenatal supplementation with myo-inositol prevent gestational
diabetes mellitus?
 Coetzee RL, Wall CR, Bloomfield FH, Crowther CA. Dietetic service provision and management of GDM in New Zealand.
 Lassi Z, Middleton P, Bhutta Z, Crowther CA. Strategies for improving health care seeking for maternal and newborn
illnesses in low and middle income countries: a systematic review and meta-analysis.
 McGoldrick E, Brown JA, Groom K, Crowther CA. A New Zealand and Australian survey investigating antenatal
corticosteroid practices at an organisational level.
 McGoldrick E, Crawford T, Brown JA, Groom KM, Crowther CA. Semi-structured interviews or online questionnaires to
identify barriers and enablers to administration of antenatal corticosteroids: A randomised trial.
 McGoldrick E, Crawford T, Brown JA, Groom KM, Crowther CA. Consumers’ attitudes and beliefs towards the receipt of
antenatal corticosteroids.
 Shepherd E, McBain R, Flenady V, Crowther CA, Middleton P. Planned early birth versus expectant management for
prelabour rupture of membranes at term: a Cochrane systematic review.
24th Cochrane Collaboration Colloqium, Seoul, Korea, 2016
 Emily Shepherd, Zohra Lassi and Philippa Middleton attended/presented.
.
Brown J, Grzeskowiak L, Williamson K, Downie MR, Crowther CA. Insulin for the
treatment of women with gestational diabetes (Protocol). Cochrane Database of
Systematic
Reviews
2016,
Issue
1.
Art.
No.:
CD012037.
DOI:10.1002/14651858.CD012037.
Brown J, Crawford TJ, Alsweiler J, Crowther CA. Dietary supplementation with myoinositol in women during pregnancy for treating gestational diabetes. Cochrane
Database of Systematic Reviews 2016, Issue 9. Art. No.: CD012048.
DOI:10.1002/14651858.CD012048.pub2.
Culliney KAT, Parry GK, Brown J, Crowther CA. Regimens of fetal surveillance of
suspected
large-for-gestational-age
fetuses
for
improving
health
outcomes. Cochrane Database of Systematic Reviews 2016, Issue 4. Art. No.:
CD011739. DOI: 10.1002/14651858.CD011739.pub2.
Crawford TJ, Crowther CA, Alsweiler J, Brown J. Dietary supplementation with myoinositol in women during pregnancy for treating gestational diabetes
(Protocol). Cochrane Database of Systematic Reviews 2016, Issue 2. Art. No.:
CD012048. DOI: 10.1002/14651858.CD012048.
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 2016;138(4):e20160947. DOI: 10.1542/peds.2016-0947.
Crowther CA, Harding JE. Antenatal Glucocorticoids for Late Preterm Birth? The New
England Journal of Medicine 2016;374(14):1376-1377. DOI:10.1056/NEJMe1601867.
Dodd JM, Newman A, Moran LJ, Deussen AR, Grivell RM, Yelland LN, Crowther CA,
McPhe, AJ, Wittert G, Owens JA, Turnbull D, Robinson JS for the LIMIT Randomised
Trial Group. The effect of antenatal dietary and lifestyle advice for women who are
overweight or obese on emotional well-being: the LIMIT randomized trial. Acta
Obstetricia
et
Gynecologica
Scandinavica
2016;95(3):309-318.
DOI:
10.1111/aogs.12832.
Flenady V, Wojcieszek AM, Middleton P, Ellwood D, Erwich JJ, Coory M, et al.
Stillbirths: recall to action in high-income countries. Lancet 2016;387(10019):619702. DOI: 10.1016/S0140-6736(15)01020-X.
Flenady V, Wojcieszek AM, Fjldheim I, Friberg IK, Nankabirwa V, Jani JV, Myhre S,
Middleton P, Crowther C et al. eRegistries: indicators for the WHO Essential
Interventions for reproductive, maternal, newborn and child health. Lancet
2016;16:293. DOI: 10.1186/s12884-106-1049-y.
Grivell RM, Yelland LN, Deussen A, Crowther CA, Dodd JM. Antenatal dietary and
lifestyle advice for women who are overweight or obese and the effect on fetal
growth and adiposity: the LIMIT randomised trial. BJOG 2016; 123(2):233-243.
DOI:10.1111/1471-0528.13777.
Han S, Middleton PF, Tran TS, Crowther CA. Assessing use of a printed lifestyle
intervention tool by women with borderline gestational diabetes and their
achievement of diet and exercise goals: a descriptive study. BMC Pregnancy and
Childbirth 2016;16:44. DOI 10.1186/s12884-016-0825-z.
Hegarty JE, Harding JE, Crowther CA, Brown J, Alsweiler J. Oral dextrose gel for the
prevention of hypoglycaemia in newborn infants (Protocol). Cochrane Database of
Systematic
Reviews
2016,
Issue
4.
Art.
No.:
CD012152.
DOI: 10.1002/14651858.CD012152.
Hegarty JE, Harding JE, Gamble GD, Crowther CA, Edlin R, Alsweiler JM. Prophylactic
oral dextrose gel for newborn babies at risk of neonatal hypoglycaemia: a
randomised controlled dose-finding trial (the pre-hPOD study). PLOS Medicine
2016;13(10):e1002155. doi:10.1371/journal.pmed.1002155.
Lassi ZS, Middleton PF, Bhutta ZA, Crowther C. Strategies for improving health care
seeking for maternal and newborn illnesses in low- and middle-income countries: a
systematic review and meta-analysis. Global Health Action 2016;9:1-13. DOI:
10.3402/gha.v9.31408.
Lawrence RL, Wall CR, Bloomfield FH, Crowther CA. Dietetic management of
gestational diabetes in New Zealand: A cross-sectional survey. Nutrition and
Dietetics 2016. DOI:10.1111/1747-0080.12311.
Lawrence RL, Brown J, Middleton P, Shepherd E, Brown S, Crowther CA. Interventions
for preventing gestational diabetes mellitus: an overview of Cochrane Reviews.
Cochrane Database of Systematic Reviews 2016, Issue 10. Art. No.: CD012394. DOI:
10.1002/14651858.CD012394.
Madden K, Middleton P, Cyna AM, Matthewson M, Jones L. Hypnosis for pain
management during labour and childbirth. Cochrane Database of Systematic
Reviews 2016, Issue 5. Art. No.: CD009356. DOI: 10.1002/14651858.CD009356.pub3.
Martis R, Brown J, Alsweiler J, Crawford TJ, Crowther CA. Different intensities of
glycaemic control for women with gestational diabetes mellitus. Cochrane Database
of
Systematic
Reviews
2016,
Issue
4.
Art.
No.:
CD011624.
DOI:10.1002/14651858.CD011624.pub2.
Martis R, Brown J, Alsweiler J, Downie MR, Crowther CA. Treatments for women with
gestational diabetes mellitus: an overview of Cochrane systematic reviews (Protocol).
Cochrane Database of Systematic Reviews 2016, Issue 8. Art. No.: CD012327. DOI:
10.1002/14651858.CD012327.
McGoldrick E, Brown J, Middleton P, McKinlay CJD, Haas DM, Crowther
CA. Antenatal corticosteroids for fetal lung maturation: an overview of Cochrane
reviews (Protocol). Cochrane Database of Systematic Reviews 2016, Issue 4. Art. No.:
CD012156. DOI: 10.1002/14651858.CD012156.
McGoldrick EL, Crawford T, Brown J, Groom K, Crowther C, Consumers attitudes
and beliefs towards the receipt of antenatal corticosteroids and use of clinical
practice guidelines. BMC Pregnancy and Childbirth 2016. DOI: 10.1186/s12884-0161043-4.
McGoldrick EL, Crawford T, Brown JA, Groom KM, Crowther CA. Identifying the
barriers and enablers in the implementation of the New Zealand and Australian
Antenatal Corticosteroid Clinical Practice Guidelines. BMC Health Services Research
2016;16:617. DOI: 10.1186/s12913-016-1858-8.
McGoldrick EL, Crawford TJ, Brown JA, Groom KM, Crowther CA (2016).
Investigating antenatal corticosteroid clinical guideline practice at an organisational
level. Australian and New Zealand Journal of Obstetrics and Gynaecology
November 2016 (in press).
Middleton P, Crowther CA, Simmonds L. Different intensities of glycaemic control
for pregnant women with pre-existing diabetes. Cochrane Database of Systematic
Reviews 2016, Issue 5. Art. No.: CD008540. DOI:10.1002/14651858.CD008540.pub4.
Middleton P, Shepherd E, Flenady V, McBain RD, Crowther CA. Planned early birth
versus expectant management (waiting) for prelabour rupture of membranes at
term (37 weeks or more). Cochrane Database of Systematic Reviews 2016, accepted.
Molakatalla S, Shepherd E, Grivell RM. Aspirin (single dose) for perineal pain in early
postpartum period. Cochrane Database of Systematic Reviews 2016, Issue 3. Art.
No.: CD012129. DOI: 10.1002/14651858.CD012129.
Morris JM, Roberts CL, Bowen JR, Patterson JA, Bond DM, Algert CS, Thornton JG,
Crowther CA. Immediate delivery compared with expectant management after
preterm pre-labour rupture of the membranes close to term (PPROMT trial): a
randomised controlled trial. Lancet 2016;387(10017):444-452. DOI:10.1016/S01406736(15)00724-2.
Shepherd E, Middleton P, Makrides M, McIntyre SJ, Badawi N, Crowther CA.
Antenatal and intrapartum interventions for preventing cerebral palsy: an overview
of Cochrane systematic reviews (Protocol). Cochrane Database of Systematic
Reviews 2016, Issue 2. Art. No.: CD012077. DOI: 10.1002/14651858.CD012077.
Shepherd E, Middleton P, Makrides M, McIntyre S, Badawi N, Crowther CA. Neonatal
interventions for preventing cerebral palsy: an overview of Cochrane systematic
reviews. Cochrane Database of Systematic Reviews 2016, Issue 10. Art. No.:
CD012409. DOI: 10.1002/14651858.CD012409.
Tieu J, Shepherd E, Middleton P, Crowther CA. Dietary advice interventions in
pregnancy for preventing gestational diabetes mellitus. Cochrane Database of
Systematic Reviews 2016, accepted.
Van Ryswyk EM, Middleton PF, Hague WM, Crowther CA. Women's views on
postpartum testing for type 2 diabetes after gestational diabetes: Six month followup to the DIAMIND randomised controlled trial. Primary Care Diabetes
2016;10(2):91-102. DOI:10.1016/j.pcd.2015.07.003.
Wilkinson D, Shepherd E, Wallace EM. Melatonin for women in pregnancy for
neuroprotection of the fetus. Cochrane Database of Systematic Reviews 2016,
Issue 3. Art. No.: CD010527. DOI: 10.1002/14651858.CD010527.pub2.
Wojcieszek AM, Shepherd E, Middleton P, Lassi ZS, Wilson T, Heazell AEP, Ellwood
DA, Flenady V. Care prior to and during subsequent pregnancies following stillbirth
for improving outcomes. Cochrane Database of Systematic Reviews 2016, Issue 5.
Art. No.: CD012203. DOI: 10.1002/14651858.CD012203.
Wojcieszek AM, Shepherd E, Middleton P, Gardener G, Ellwood DA, McClure EM,
Gold KJ, Khong TY, Silver RM, Erwich JJH.M., Flenady V. Interventions for
investigating and identifying the causes of stillbirth. Cochrane Database of
Systematic Reviews 2016, accepted.
ARCH
Bain E, Middleton P, Crowther CA. Progressing towards standard outcomes in
gestational diabetes Cochrane reviews and randomised trials. Australian and New
Zealand Journal of Obstetrics and Gynaecology 2016;56(1):113-116.
DOI:10.1111/ajo.12433.
Robinson Research Institute,
Discipline of Obstetrics and Gynaecology, The University of Adelaide, Women’s and Children’s Hospital, 72 King William Road, North Adelaide, SA 5006, Australia
[email protected]
Phone: +61 8 8161 7767
Fax: +61 8 8161 7652
Publications 2016