Newly Funded Study Aims To Improve Outcomes For More Than One In 10 New Zealand Births

New Zealand researchers are about to undertake the largest-ever trial of corticosteroids in women having planned caesareans, to assess the treatment’s benefit and potential harm in newborns.

Associate Professor Katie Groom from The University of Auckland’s Liggins Institute has just been awarded $1.43 million by the Health Research Council of New Zealand (HRC) to lead a nationwide placebo-controlled, randomised trial into the effects of maternal corticosteroid use prior to planned caesarean at between 35 to 39 weeks of pregnancy.

She says the trial will address a serious evidence gap and will reliably inform future practice across New Zealand and globally.

In New Zealand, birth by planned caesarean section continues to rise and now accounts for more than one in 10 births (7,500 babies a year). To counter the increased risk of breathing problems that can occur with planned caesareans, mums are often given corticosteroids at near to full-term stages of pregnancy; however, there is surprisingly limited evidence about the benefits or harm of this fairly common practice.

While corticosteroids administered in earlier stages of pregnancy have well-established benefits for babies born prematurely, little is known about their use at near or full-term, says Associate Professor Groom.

“There is low-quality evidence on respiratory benefits, minimal evidence on long-term effects, and no evidence of their effect on blood-sugar levels.

“The steroids might help babies with breathing, but they might also disrupt glucose control, which could be detrimental in the long-term, so our trial will look at the balance of benefit versus potential harm.”

She says high-quality evidence is required to allow women with planned caesareans to make informed decisions about their treatments.

The C*STEROID Trial will take place in at least 14 hospitals across New Zealand and include 2548 babies and their mothers.

“This will be a national effort to answer an important question. Findings aim to be definitive and will inform clinical practice in New Zealand and across the world,” she says.

Another benefit of the trial will be the opportunity to follow-up a cohort of the children when they reach the age of six or seven and can be assessed for long-term impacts, such as childhood executive function, body size, and respiratory, cardiovascular and metabolic wellbeing.

The HRC’s chief executive, Professor Sunny Collings, says clinical trials like this are imperative to ensuring patient care is informed by strong, reliable evidence – not just the ‘best available’ evidence which is often low quality.

“Interventions in pregnancy and infancy can have long-lasting effects. This trial will find out what happens in the short-term, but maintaining contact with the cohort to allow assessment of the longer-term effects will be a major contribution in its own right,” she says.

Associate Professor Groom’s study is one of 47 new studies awarded a total of $71.58 million in the Health Research Council’s latest funding results released today.

Of that total, $19.88 million was awarded to four research ‘programmes’ that will take up to five years to complete; $47.73 million was awarded to 39 research projects, including $4.87 million for four Rangahau Hauora Māori projects; and another $3.97 million was awarded to four Pacific research projects.

See below for the full list of 2020 Programme, Project, and Pacific Project recipients. To read lay summaries about any of these studies (after the embargo lifts), go to hrc.govt.nz/resources/research-repository and filter by proposal type: ‘Programmes’ and year ‘2020’; ‘Projects’ and year ‘2020’; and ‘Pacific Projects’ and year ‘2020’.

2020 HRC Project and Programme grants:

Professor Richard Beasley, Medical Research Institute of New Zealand
RCT budesonide-formoterol vs salbutamol reliever therapy in childhood asthma
36 months, $1,439,100

Professor Laura Bennet, The University of Auckland
Circadian patterns of fetal heart rate predict impaired fetal oxygenation
36 months, $1,199,998

Professor Ian Bissett, The University of Auckland
Randomised trial of a novel chyme reinfusion device for temporary ileostomies
36 months, $1,433,127

Associate Professor Mark Bolland, The University of Auckland
Zoledronic acid and fracture prevention in early postmenopausal women
48 months, $1,192,556.85,

Dr Amohia Boulton, Whakauae Research Services
Te Ao Rauropi: Mapping the biosphere of Rongoā Māori
36 months, $1,199,837

Professor Winston Byblow, The University of Auckland
Enhancing Spontaneous Recovery after Stroke Study (ESPRESSo)
48 months, $1,421,459

Professor Gregory Cook, University of Otago
Unlocking antimicrobial tolerance in bacterial pathogens to overcome AMR
36 months, $1,197,343

Professor John Dalrymple-Alford, University of Canterbury
Brain biomarkers for future cognitive health in Parkinson's disease
48 months, $1,189,160

Professor Catherine Day, University of Otago
Time for destruction - switching immune responses off
36 months, $1,197,433

Dr Janak de Zoysa, Waitemata District Health Board
ACHIEVE - New Zealand
60 months, $1,061,052

Dr Justin Dean, The University of Auckland
Treatment of GABAergic interneuron dysfunction in preterm brain injury
36 months, $1,186,646

Professor Paul Glue, University of Otago
Ketamine therapy for neurotic disorders: Is there a single mechanism?
36 months, $1,438,829

Professor David Grattan, University of Otago
A neural circuit required for maternal adaptation to pregnancy
36 months, $1,199,971

Associate Professor Katie Groom, The University of Auckland
Safely improving outcomes for babies after birth by planned caesarean section
48 months, $1,433,915

Associate Professor Nigel Harris, Auckland University of Technology
Implementing high intensity interval training in school
36 months, $1,362,262

Professor Greg Jones, University of Otago
The Metformin Aneurysm Trial
48 months, $1,325,323

Dr Kelly Jones, Auckland University of Technology
BIONIC2: TBI incidence, causes, costs over time and service access in New Zealand
36 months, $1,192,610

Associate Professor Peter Jones, University of Otago
Role of ryanodine receptors in Alzheimer’s disease
36 months, $1,189,936

Professor Beverley Lawton, Research Trust of Victoria University of Wellington
He Tapu Te Whare Tangata: Empowering rural solutions
36 months, $1,293,194

Dr Khoon Lim, University of Otago, Christchurch
Smart delivery of growth factors for treating osteonecrosis of the femoral head
24 months, $730,435

Dr Colin McArthur, Medical Research Institute of New Zealand
Erythropoietin to improve outcomes for critically ill trauma patients
48 months, $1,199,019

Dr Melissa McLeod, University of Otago, Wellington
Prioritising Māori health and equity: a critical approach to modelling
36 months, $1,199,300

Dr Matthew McNeil, University of Otago
Combating antimicrobial resistance with high-throughput bacterial genetics
36 months, $1,199,272

Dr Nicole Moreland, The University of Auckland
Understanding the role of IgG3 in acute rheumatic fever
36 months, $1,187,148

Dr Marama Muru-Lanning, The University of Auckland
Ngā Kaumātua ō Tātou Taonga: Supporting kaumātua health in a changing world
36 months, $1,181,194

Professor Gavin Painter, Research Trust of Victoria University of Wellington
Designing a scalable vaccine to induce liver resident T cells against malaria
36 months, $1,195,993

Professor Julian Paton, The University of Auckland
Novel potential anti-arrhythmic target
36 months, $1,171,620

Professor Anthony Phillips, The University of Auckland
Reducing organ failure in critical illness
36 months, $1,189,800

Dr Raewyn Poulsen, The University of Auckland
Turning off the cellular energy supply to treat osteoarthritis
36 months, $1,180,501

Dr Frederik Pruijn, The University of Auckland
Enabling clinical development of a novel hypoxia-targeted anti-cancer agent
36 months, $1,199,945

Dr Rohit Ramchandra, The University of Auckland
Respiratory modulated pacing to improve outcomes in heart failure
36 months, $1,191,072

Dr Jackie Robinson, The University of Auckland
Dying as a health and social justice issue: exploring the impact of deprivation
36 months, $1,199,999

Associate Professor llva Rupenthal, The University of Auckland
Tackling the vicious circle of dry eye disease
36 months, $1,195,446

Professor Lynette Sadleir, University of Otago, Wellington
Genetic discoveries for unsolved developmental and epileptic encephalopathies
36 months, $1,199,869

Associate Professor Ivan Sammut, University of Otago
A novel therapeutic to protect hearts in acute ischaemic procedures
36 months, $1,143,638

Dr Caroline Shaw, University of Otago, Wellington
Seeking the transport sweet spot: health, equity and zero carbon
36 months, $1,199,695

Professor Paul Smith, University of Otago
Galvanic vestibular stimulation as a treatment for neurological disorders
36 months, $1,188,357

Dr Genevieve Walls, Middlemore Clinical Trials
Staphylococcus aureus network adaptive platform trial (SNAP)
60 months, $1,190,216

Dr Paul Young, Medical Research Institute of New Zealand
A mega randomised registry trial comparing two approaches to oxygen therapy
60 months, $1,438,369

2020 Pacific Project grants

Dr Sunia Foliaki, Massey University
Barriers and facilitators to self-management of asthma in Pacific children
36 months, $971,541

Dr Jesse Kokaua, University of Otago, Wellington
Lighted paths and connecting pathways: Education, health and Pacific families
36 months, $1,199,999

Associate Professor Vili Nosa, The University of Auckland
A study of Samoan, Tongan, Cook Island Māori, and Niuean infant care practices
36 months, $1,155,335

Dr Seini Taufa, Moana Research
Responding to Pacific maternal mental health
36 months, $599,082

2020 Programme grants

Professor Michael Baker, University of Otago, Wellington 
SYMBIOTIC: Integrated prevention of infectious diseases and long-term conditions 
60 months, $4,951,982

Professor Paul Donaldson, The University of Auckland 
Regulation of lens water transport: A strategy to treat presbyopia and cataract 
60 months, $4,936,997

Professor Valery Feigin, Auckland University of Technology 
Measuring and reducing stroke burden in New Zealand 
60 months, $4,996,868

Associate Professor Nevil Pierse, University of Otago, Wellington 
Research to maximise the health and wellbeing gains from housing 
60 months, $4,996,214

© Scoop Media