Helping to improve long-term outcomes for very premature babies.

VICS July 2014 Newsletter


The Victorian Infant Collaborative Study (VICS) is a long term study of prematurely born infants throughout their childhood and into adulthood. VICS is a collaboration between the Royal Women’s Hospital, Mercy Hospital for Women, Monash Medical Centre and the Royal Children’s Hospital. The paediatricians, psychologists, nurses and research staff are all dedicated to improving the lives of extremely premature babies.

For over three decades VICS has been working towards better understanding the extent of long-term health problems that occur in the tiniest babies (those of birth weight <1000 g) and most premature (those of <28 weeks of gestation) born in Victoria. We are very grateful for the participation of children and families in these important clinical research studies.

To better understand the outcomes for very preterm babies, we always need groups of babies who are born at term and of normal birth weight to participate in our studies. This allows us to put into context what the outcomes mean for the very preterm children. We thank these children and their families.


Bridie O'Breza

One of the VICS participants in the recent follow up of children born in 2005. Bridie, born at 25 weeks and weighing only 590 grams at birth, is now a healthy active seven year old

2005 Cohort

Firstly we would like to extend a big thank you to the participating families of our 2005 VICS group.
We have almost completed seeing these children. It has been wonderful to see how well the children are growing and developing.

There are many of you who travelled vast distances to enable your child to participate. We really appreciate your efforts and we hope you and your child found it a rewarding experience.

It was exciting for us based at the Royal Women’s Hospital to be able to use some of the facilities at the lovely new Royal Children’s Hospital. The beautiful aquarium and the meerkats are a definite drawcard!

Please let us know of any contact detail changes – we would like to keep in touch!

Imprint Study

Leona and Andrea from the IMPRINT study

The IMPRINT study, which recruited from the VICS 2005 cohort, recently finished its recruitment in May. The study’s final sample is 91 children and these children have now all gone through the working memory training program at home. The study is now completing 12-month follow-up assessments following the training, and will commence the 24-month follow-up later this year. The IMPRINT team would like to thank participating children and families for their support and involvement in the study! Future newsletters will inform you of the results of this study.

Results from the recent follow up of the 1991-1992 VICS Cohort

We would like to share with you some more results which have been published over the last year. This is only made possible with the cooperation of our wonderful young people who were born in 1991-92.


Blood Pressure

Studies that followed up adults who were born preterm in the 1980s have reported that they have higher blood pressure (BP), compared with adults born at term. High BP is known to be a risk factor for heart disease later in life. We wanted to understand if young people who were born extremely preterm or extremely low birth weight (EP/ELBW) in 1991-92 also had higher BP, compared with individuals born at term. We measured BP continuously over 24 hours using portable machines. The EP/ELBW individuals had higher BP, as expected. Males and those who had rapid weight gain between birth and age two had higher BP, and high BP measured at age eight predicted high BP at age 18 years. Given this increased risk, it is important that individuals who are born EP/ELBW have their heart health monitored carefully over time.

These results were published by Roberts G, Lee K, Cheong J, Doyle L. Higher ambulatory blood pressure at 18 years in adolescents born <28 weeks’ gestation in the 1990s compared with term controls. Journal of Hypertension. March 2014 Mar; 32(3):620-6


Jack (19) checking his blood pressure

Growth

The young people who participated in the VICS 1991-92 cohort study had their weight and height (or length) measured at birth, discharge from hospital, and at age two, five, eight and 18 years of age. With this information, we were also able to calculate their BMI from age two onwards. We found that the individuals who were born extremely preterm or extremely low birth weight (EP/ELBW) were lighter and shorter compared with individuals who were born at term, at all ages. The greatest difference in weight was at hospital discharge. Although the weight differences diminished over time, the height differences persisted at age 18 years. Body mass index (BMI) at age 18 was similar in the EP/ELBW and term groups. Although we usually think of mid-parental height as a good predictor of adult height, height at age two years was a better predictor of height at age 18 years in the EP/ELBW group.

These results were published by Roberts G, Cheong J, Opie G, Carse E, Davis N, Duff J, Lee K, Doyle L, and on behalf of the Victorian Infant Collaborative Study Group. Growth of extremely preterm survivors from birth to 18 years of age compared with term controls.

Pediatrics; 2013 February: 131 (2): 1-7. doi:10.1542/peds.2012-113

Dr Alice Burnett, Psychologist

Mental Health

At age 18 years, the young people who participated in the VICS 1991-1992 cohort study were asked questions about their mental health (e.g. mood, worrying), personality, emotions, and attention skills. Encouragingly, the young people born extremely preterm or extremely low birthweight (EP/ELBW) reported very similar mental health and personality traits to the normal birthweight young people. However, the young people born EP/ELBW did report more difficulties with attention skills, such as paying attention, not getting distracted, keeping themselves organised, and so on. These results are important because they tell us how these young people are feeling about their own emotional wellbeing and attention skills.

These results were published by Burnett A, Davey CG, Wood SJ, Wilson-Ching M, Molloy C, Cheong JL, et al. Extremely preterm birth and adolescent mental health in a geographical cohort born in the 1990s. Psychological Medicine. 2014;44(7):1533-1544.

Brain size, IQ and education performance.

We know from previous studies that as a group, children and young people born preterm have a higher chance of difficulties in intellect and educational tasks when compared with peers born at full term. How much this is accounted for by brain size is unclear. With the information from the brain MRI that was performed on the young people of the VICS 1991-92 cohort, we found that brain size was smaller and this partly explained the poorer performances in intellectual and educational tests that were performed as part of the study.

These results were published by Cheong JL, Anderson PJ, Roberts G, Burnett AC, Lee KJ, Thompson DK, Molloy C, Wilson-Ching M, Connelly A, Seal ML, Wood SJ, Doyle LW, on behalf of the Victorian Infant Collaborative Study Group. Contribution of brain size to IQ and educational underperformance in extremely preterm adolescents. PLoS One. 2013 Oct 9;8(10):e77475.

Aidan Dullard3
Aidan was born at 28 weeks gestation weighing only 816 grams. He had a long and stormy time in the neonatal Nursery, finally going home after five months.

Aidan performed brilliantly in VCE and graduated at the end of last year from Melbourne University with a Bachelor of Arts in Chinese and International Studies, and a Diploma in Japanese. He is now in Taiwan continuing Chinese study, and plans to return to Melbourne next year to pursue post graduate studies.

Roberts, Gehan

Dr Gehan Roberts Developmental Paediatrician

Quality of Life

At age 18-20 years, the young people in the VICS 1991-92 cohort provided information to us about their quality of life, health status and self-esteem. The results were very positive: individuals who were born extremely preterm or extremely low birth weight (EP/ELBW) reported similar overall quality of life, health status, and self-esteem, compared with individuals who were born at term. The only exception was a report of slightly lower physical functioning (especially dexterity) in the EP/ELBW group. Importantly, within the EP/ELBW group, those who were the most preterm and lightest at birth had similar quality of life as the more mature or heavier EP/ELBW individuals. We think these findings are important, given the increasing numbers of children who are born EP/ELBW in recent years. These results remind us of the importance of asking the individuals who agree to participate in our studies about their own perspectives about their lives.

These results are published by Roberts G, Burnett A, Lee K, Cheong J, Wood S, Anderson P, Doyle L. Quality of life at age 18 years after extremely preterm birth in the post-surfactant era. The Journal of Pediatrics, 2013 Oct;163(4):1008-13.


Elaine Kelly, Psychologist

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Dr Jeanie Cheong Neonatal Neurologist and Paediatrician

Postnatal dexamethasone and brain volumes

Postnatal dexamethasone is a treatment given to preterm babies at risk of developing “bronchopulmonary dysplasia,” a condition where oxygen and/or help with breathing is still required at 36 weeks’ corrected age. Although there are beneficial effects on the lungs of preterm infants, there are concerns that postnatal dexamethasone may have effects on other organs such as the brain. We wanted to see if postnatal dexamethasone treatment in the newborn period was associated with brain size at age 18 years. Thirty seven percent of the young people born preterm in the VICS 1991-92 cohort received dexamethasone and when compared with those who did not receive dexamethasone, the size of the brain in several regions were smaller indicating that there may be vulnerable regions of the brain associated with postnatal dexamethasone treatment. These results remind us that some treatments, although beneficial in some aspects, may have less than desirable effects on others and need to be taken into consideration when managing tiny preterm babies in intensive care.
These results were published by Cheong JL, Burnett AC, Lee KJ, Roberts G, Thompson DK, Wood SJ, Connelly A, Anderson PJ, Doyle LW, on behalf of the Victorian Infant Collaborative Study Group.

Association between postnatal dexamethasone for treatment of bronchopulmonary dysplasia and brain volumes at adolescence in infants born very preterm.

J Pediatr. 2014 Apr;164(4):737-743.e1.

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Dr Rachel Madhwan, Paediatrician


1997 Cohort

We are in the process of contacting the families of the children born in 1997 who were recruited for the VICS research. All of these children were less than one kilogram at birth or less than 28 weeks’ gestation. Along with them there is a wonderful group of families of full term babies who participate alongside the Premmies.

There are plans afoot to send out an online survey a little later in the year, so we would love you to update us with your current email address.
Many of you are currently very busy undertaking VCE/VCAL – we wish you all the best with this.
If we haven’t been in touch already, please call or email us with any contact detail updates.

Iman, lex and her father
Iman was born prematurely in 1997 at 25 weeks’ gestation, weighing 746 grams and smaller than her father’s hand. She is now in Year 10, is her school’s sports captain and top of her class academically.

Her family moved to Kenya when she was nine years old, and she has recently fulfilled a lifetime wish to return to Melbourne to thank the staff that saved her life.


Dr Julianne Duff, one of our paediatricians at work

A special thank you to the many families who are also involved in other premature baby research studies.


VIBeS Victorian Infant Brain Study, about to start reviewing the original cohort of children for a 13 year old follow up
CAP Study Caffeine for Apnea of Prematurity
We are currently reviewing this cohort at 11-12 years of age.
ACTOMgSO4 Magnesium Sulphate now finished
LaPrem Late Preterm babies, currently being assessed at two years of age
VIBeS2 A cohort of babies born less than 32 weeks who are being assessed at two years of age


It is from your experiences that we gain the knowledge to improve the lives of extremely premature babies and their families in the future.
Thank you for your participation in these important research studies.


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Thank you from the VICS Researchers

Back Row: Dr Kate Lee (Statistician), Margaret Charlton (Psychologist), Dr Deanne Thompson (Neuroimaging scientist), A/Prof Peter Anderson (Psychologist), Professor Lex Doyle (Paediatrician), Dr Gillian Opie (Paediatrician), Heather Woods (Research Coordinator, Mercy Hospital), Kate Callanan (Research Coordinator, Royal Women’s Hospital).

Front row: Dr Noni Davis (Paediatrician), Elaine Kelly (Psychologist), A/Prof Jeanie Cheong (Paediatrician), Dr Leah Hickey (Paediatrician), Dr Julianne Duff (Paediatrician), Alice Burnett (Psychologist), Maree Hayes (Research Coordinator, Monash Medical Centre), Marion McDonald (Research Coordinator, Royal Women’s Hospital).

To update us with your current contact details, including your email address
OR
To find out more about the Victorian infant Collaborative Study, visit our website:
http://www.vics-infantstudy.org.au/



The Royal Childrens Hospital

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Monash Children’s Hospital

Give Maree Hayes a call!

Phone: 03-9594 2572

Mercy Hospital families

Give Heather Woods a call!

Phone: 03-8458 4750

Royal Women’s Hospital

Call Kate Callanan or
Marion McDonald

Phone: 03-8345 3709/3710


Email: This e-mail address is being protected from spambots. You need JavaScript enabled to view it