REBECCA WHITE, ASSISTANT MINISTER FOR HEALTH AND AGED CARE: Australia has a proud reputation for investing in evidence based research to support better health outcomes for our community. The Medical Research Future Fund (MRFF). recently announced $25 million in grants, including here at the University of Melbourne, to look at how we can support women throughout their pregnancy who might be identified at risk of stillbirth. We want mums to feel confident, to have information that's evidence based as they're traveling through their pregnancy journey, so that they can make good decisions about how they deliver healthy babies. We know in Australia, on average, every day, about six babies are lost to stillbirth, which is devastating for those families and parents. And if we can do more to support parents with information that might allow them to deliver a healthy baby, then that's what we want to do. This investment with the University of Melbourne is $2 million for them to continue the work that they have been doing to validate studies that is allowing them through a simple blood test to identify whether a woman is at risk of delivering a baby through stillbirth, or whether there can be interventions made to support them to deliver a healthy baby. It's really important for us to continue to support medical research in this country, and this $25 million that was announced through the Medical Research Future Fund, is going to support a range of projects in our country. Supporting clever work happening right across the research sector that will improve health outcomes for women and children. And this is something that we should be celebrating as a nation.
ASSOCIATE PROFESSOR ROXANNE HASTIE: Every day in Australia, far too many babies are born still. And sometimes this can happen when the placenta, which is the lifeline to a continuing pregnancy .as it provides oxygen and nutrients to the unborn baby, is not functioning properly. And then when this happens, the babies can be smaller than they otherwise would have been, and their growth slows down. It's these babies that are an increased risk. Currently, when doctors are worried about a baby’s growth, they actually use a tape measure to measure how big mom's tummy is. And for those that they're concerned of they will have an ultrasound. As you can imagine, this can miss many cases of babies that aren't growing well. Importantly, and thanks to the Medical Research Future Fund, we can now undertake our Tim Tam study, which aims to validate a simple blood test to check how well a placenta is functioning. So currently, when doctors are worried about the function of other organs such as the liver or the kidney or heart, they're able to order a simple blood test to see how well those organs are working. And our team have uncovered a marker that can be found in mum’s blood that can tell us how well the placenta is functioning.
This marker is called spin one, it's a protein that's found in mum's blood and when spin levels are low, this can tell us that the placenta is struggling. But when they're high, it means that the placenta might be working well, and these results are reassuring. If a patient has a low spin level, this can mean that they will receive additional monitoring, or that they might be able to plan appropriate and timely birth so that these babies don't experience adverse outcomes such as stillbirth, but again, if results are reassuring, this can mean that unnecessary interventions are not placed on families that don't need them. And so through Tim Tams, we're excitingly now collecting blood samples from 10,000 pregnancies across Australia, and that includes women who are living in cities as well as remote and rural areas as well. And this is so that we can find out where the spin works for everyone. Our plan is straightforward, we want to have a reliable, easy to access, simple blood test that can tell us how well the placenta is functioning, so that we can identify babies who are at a greater risk of being stillborn.
SABRINA (CASESTUDY): I was 25 weeks into my first pregnancy, and I went for a routine appointment, and it was at that appointment I was measuring small, but there were no red flags that were raised by the midwife. And it was actually as I was walking out the door of that appointment that the midwife asked me about babies' movements, and I took a moment to think about that, and I said to her, Oh, look, baby's movements were still there, but they had actually reduced over the last fortnight. I was immediately referred for an ultrasound, and it was at that ultrasound that it was found that there were abnormal dopplers, which is essentially issues with the blood flow in the placenta, and that was a reason why my daughter was measuring small and was growth restricted. I moved to weekly monitoring, weekly ultrasounds, weekly foetal heart monitoring, and was put on aspirin straight away. After two weeks of that that moved to appointments every three to four days and that's when I realised, the gravity of the situation, and that I would make to 38 weeks. And also the realisation that every time I was coming in for an appointment, was there a heartbeat, or was our daughter stillborn, and if she was even going to make it, what were the long term impacts for her, in terms of quality of life, for her and for us as a family, both physically and intellectually.
Then from those appointments, I was then given a steroid injection to help with the maturity of the lungs, and then, very quickly, I moved to daily appointments. I reached the 23 of December, which was the 30-week mark, and I again went in for an ultrasound. But this one was different. It was different because it was with my fabulous obstetrician, Professor, Sue Walker, and the ultrasound went for quite some time, and there was also not a lot of talking between us, which was unusual. And that's when I thought, Okay, our daughter's either stillborn, but we'd done quite a lot of ultrasounds by then, so I felt like I knew when I could see a heartbeat, so I could see that wasn't the case, but there was obviously something severely wrong. And that's when Sue told me that the abnormal dopplers had resulted in reverse blood flow, and we needed to get my daughter out. I was admitted for an emergency caesarean that day, I was given a second set of steroids to help with the lung development, and also given magnesium sulphate to help with protection of baby's brain, to reduce the risk of brain damage, which was actually quite awful, because it felt like your skin was burning. It was really quite a traumatic experience. Our daughter was born at 30 weeks, weighing one kilo, or 1040 grams, to be exact, and she was immediately sent down to neonatal intensive care, and that's where she stayed for the next two months. She was on CPAP, which is essentially oxygen to help her breathe for the first 48 hours, and then put on high flow oxygen for the remaining seven weeks.
It was a really difficult time, she continued to grow, but she's suffered from jaundice, suspected sepsis and a mild brain hemorrhage But I think we're one of the lucky families who were able to bring home our daughter, and we're able to do that weighing 2.3 kilos. We're incredibly lucky because while we're in NICU, we saw many families that weren't able to bring their babies home. And when I say that we're lucky, we're lucky not only for a potential miracle, but because of the incredible care, medical care that we got from the Mercy Hospital, from the perinatal unit, as well as from the NICU unit. And now we have a thriving five and a half year old that started prep this year. Thank you. Sabrina needs some nutrition, no problems. Do you have any questions for either
JOURNALIST: When will these trials start?
WHITE: The work here has already commenced on 1 July. The research team at the University of Melbourne were provided advice from the Medical Research Future Fund that they'd been successful. The work that's happening here through the Melbourne University is about validating previous research to make sure that what they understand through this blood test is applicable for women, no matter where they live or what their background right across our country. The trial now has expanded to 10,000 women who provided blood samples, and through that, we'll be able to gather more evidence to ensure that what we think we know is true, and that is through a simple blood test we can assess the health of a woman's placenta.
JOURNALIST: Expectant Australian mothers would be hearing this new advice from the White House on paracetamol. Should they be concerned? And are investigations into paracetamol’s links with autism?
WHITE: Any new mum is looking for good information so they can have a safe pregnancy for their baby. And I'd encourage any woman in Australia to have a conversation with their health professional. There's good evidence through the Therapeutic Goods Administration here in Australia that demonstrates that using paracetamol through pregnancy is safe, but it's up to every woman to make sure they have a good conversation with their health professional throughout their pregnancy, to ensure that they feel comfortable with that advice and it's suitable for their personal circumstances.
JOURNALIST: Are the government looking into these claims at all?
WHITE: Minister Butler has said that he sought some urgent advice. We obviously are very keen to ensure that any information women receive here in Australia is backed by science and evidence we have confidence in the therapeutic administration's advice they've released today that demonstrates that our evidence through the work that we've undertaken here illustrates that taking paracetamol as a pregnant woman in this country is safe, but again, women should seek medical advice from their treating health professional if they've got any concerns, to make sure that they ask those questions relevant to their own personal health circumstances.
JOURNALIST: How will this project help build public trust in safe, evidence based guidance?
WHITE: The Medical Research Future Fund has a proud history of backing institutions who are undertaking research that's looking at how we build an evidence base that's based in science clinical practice, that illustrates that the decisions we take around the medicines we use, or the interventions in practice. We have a very proud reputation in our country of relying on evidence based in science to inform the decisions we make in healthcare, and announcements like this one today that are talking about how we support women throughout their pregnancy are based on good information backed by evidence and science. Hopefully this gives courage and confidence to women that here in Australia, we have a fantastic health system, fantastic and skilled health professionals, backed by medical researchers, who are doing everything possible to make sure they can access good and high-quality health care that is safe. Thank you.