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School of Women’s and Infants’ Health Overview of Research by Jeff Keelan.

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1 School of Women’s and Infants’ Health Overview of Research by Jeff Keelan

2 SWIH research Major programmes Raine study; genetics; sheep studies Group-based research Obstetrics, neonatology, reproductive health, placentology

3 Raine study Pennell, Newnham, Doherty, Hart et al (plus many TICHR researchers) WA pregnancy cohort (DoHaD resource) 2900 women (2686 babies), 1989-91 Ante-natal / cord blood samples, growth, development, perinatal/obstetric parameters Follow-up at 1, 2, 3, 5, 8, 10, 14, 17-18, 20 years Data: health, fitness, obesity, BP, asthma, nutrition/diet, mood & mental health, cognitive function, stress… Studies: Ante-natal exposure to androgens, estrogens, vitamins, plasticizers, endocrine disrupters Impact of genes on health and development Ante-natal / postnatal risk factors for autism spectrum disorders

4 Genetic Epidemiology and Prediction Pennell, Palmer, Beilin, Newnham et al GWAS, Raine cohort, epigenetics. Genetic associations with birth weight, asthma, eczema, obesity, age of menarche, insulin resistance/glycemia Preterm birth Genome Project (PREBIC) – 4000 women (800 to date), 75% PTB rate. 1200 DNA samples genotyped, results pending. Variety of other genetic associations studies in progress Funding: Channel 7 Telethon Trust, WIRF, NHMRC, CIHR, WHO, March of Dimes Birth Defects Foundation

5 NIH collaboration Newnham, Pillow, Kemp et al (Jobe, Kallapur) Fetal sheep (large animal) model Intrauterine ureaplasma infection Fetal lung development / inflammation Fetal lung ventilation strategies Fetal brain development / inflammation Fetal skin development / inflammation Funding: NIH (20 years), NHMRC

6 Obstetric Research Newnham, Dickinson, Pennell, Doherty, Simmer, Fletcher et al Fetal futures – long term outcomes of children with antenatal & perinatal problems Effects of fetal blood transfusions on cardiac function Gastroschisis - long term health implications Umbilical gas / lactate monitoring Maternity care in remote aboriginal communities Vascular risk factors in prediction of preeclampsia Exercise effects on gestational diabetes Funding: WIRF, Channel 7 Telethon Trust, NHMRC, WA Department of Health

7 Neonatal Research Simmer, Pillow, Hartmann et al Neonatal immune development, infection and late onset sepsis. Neonatal lung function and development – ventilation strategies; diaphragm structure and development; nebulizer-based surfactant supplementation; caffeine therapy; mathematical modeling of lung epithelia during ventilation. Neonatal nutrition – breast milk quality and quantity; alternative sterilization procedures; Prem Milk Bank;  3- PUFA supplementation, FAD genetics and infant development; probiotic supplementation; fat emulsions of parenteral nutrition. Funding: NHMRC, SHRAC, Fisher & Paykel, Madela AG, WIRF, Raine Foundation, NIH, Channel 7 Telethon Trust, Viertel Charitable Foundation.

8 Reproductive Health Research Hart, Hickey, Newnham, Dickinson, Pennell, Doherty, Leung, Hammond, Salfinger et al Early childhood origins of PCOS Early life origins of impaired testicular function Epidemiology, histology, genetics and treatment of ovarian cancer Laparoscopic detection of endometrial cancer Funding: NHMRC, WIRF, Raine Medical Research Foundation, TICHR

9 Placental function and pathophysiology Keelan, Waddell, Dharmarajan, Mori Inflammation and oxidative stress in placenta and pregnancy disorders Anti-inflammatory drugs – prevention and treatment of placental inflammation Lipid derived mediators in pregnancy – lipoxins, resolvins, protectins, endocannabinoids, prostanoids, oxysterols, isoprostanes, lysophospholipids, sphingolipids etc Placental differentiation –  -catenin/Akt signalling, sphingolipids (ceramide, S1P) Placental transport – lipids, drugs, nanoparticles Funding: NHMRC, Raine Foundation, March of Dimes Foundation

10 Education research McGurgan, Carmody, Tregonning Teaching of clinical skills in intimate examinations Use of audience transponders in teaching Effects of presence of medical students in delivery suites Effects on peer review of teaching Simulation training in obstetric emergencies Research on professional development

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