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ARCH:Australian Research Centre for Health and Wellbeing for Women and Babies

Research Leaders

Professor Caroline Crowther
Dr Jodie Dodd
Associate Professor Ross Haslam
Dr Andrew McPhee
Ms Philippa Middleton
Professor Jeffrey Robinson

Contact

ARCH
Discipline of Obstetrics and Gynaecology
The University of Adelaide
Women's and Children's Hospital
King William Road
North Adelaide South Australia 5006
Phone: 61 8 8161 7619
Fax: 61 8 8161 7652
Email: caroline.crowther@adelaide.edu.au

Research Centre Staff

Senior Trial Co-ordinators
Pat Ashwood
Andrea Deussen
Amy Earl

Data Management
Vincent Ball
Carol Holst
Kaye Robinson

Statistical Support
Kristyn Willson
Hannah Dent

Educators
Ruth Martis
Rebecca Tooher

Psychologist
Kim Pfitzner

Research Officer
Rachel Earl

Research Scholars
Chaturica Athukorala
Danielle Crosby
Joanna Tieu

Research Support Staff
Lisa Evele
Melissa Ewens
Natalie Thomas
Jacki Smith
Freya McDougall
Hong Ju
Mary Paleologos

ARCH:Australian Research Centre for Health and Wellbeing for Women and Babies has staff working in

• ARCTURUS (Australasian Randomised Clinical Trials Uniquely aRe US-Research Benefiting Babies and Mothers) formally the Maternal Perinatal Clinical Trials Unit (MPCTU) that co-ordinates single and multi-centre randomised clinical trials.

• The National Centre for the Australian Reviewers Group for the Cochrane Pregnancy and Childbirth Collaborative Review Group (ARG-PC CRG).

• Research Translation Group.

• The South Australian node for SEA-ORCHID (South East Asia Optimising Reproductive and Child Health In Developing Countries ).

• The national co-ordinating centre for The WOMBAT Collaboration (Women and Babies Wellbeing Action through Trials).

• SHRP: Strategic Health Research Project: Infant mortality research synthesis.

ARCH has 10 key objectives

• identify clinical research of relevance to women's and babies' health, their carers and health policy makers
• conduct high quality systematic reviews in women's and babies' health
• promote, support, design, conduct and analyse clinical research studies, including randomised controlled trials, in women's and babies' health
• maintain a research team in all disciplines involved in women's and babies' health
• maintain a highly skilled research group with expertise in systematic reviews, trial protocol development, clinical practice guideline preparation, consumer involvement, translational research, data management, computer programming, biostatistics, and trial coordination.
• continue to establish and strengthen existing collaborative research links with health care professionals within Australia and internationally to complete priority clinical research in women's and babies' health
• develop and maintain links with Cochrane Collaborative Review Groups and Fields within the Cochrane Collaboration of relevance to maternal and perinatal health.
• secure peer-reviewed funding for clinical research of relevance to women's and babies' health
• continue to provide supervision and research training for midwives, neonatal nurses, medical students, residents, registrars, graduate and postgraduate students, and postdoctoral fellows
• assist in bringing research evidence into clinical practice by promoting effective research translation.

Research is carried out within clearly identified priority areas. Currently these include interventions to improve the health outcomes of infants born preterm, care for women with borderline gestational diabetes, prevention of pre-eclampsia, prevention of preterm birth, complementary and alternative medicine in women's health and during pregnancy and childbirth, support for women in pregnancy who are overweight or obese, management of the induction of labour, care for women after a previous caesarean section, surgical techniques at caesarean section, care of women with a multiple pregnancy and impact of health and care in pregnancy and childbirth and later maternal and child health.

Current multicentre randomised trials include:

ARCTURUS (Australasian Randomised Clinical Trials Uniquely aRe US: Research Benefiting Babies and Mothers.
Formally the Maternal Perinatal Clinical Trials Unit (MPCTU)

ARCTURUS has wide collaborative links; within the University of Adelaide , with over 44 key maternity institutions in all States and Territories within Australia , major maternity hospitals in New Zealand and overseas.

Specific trials in progress co-ordinated by ARCTURUS (formally the MPCTU) are:

ACTS:	Australasian Collaborative Trial of Supplements with vitamin C and vitamin E for the prevention of pre-eclampsia – a randomised controlled trial
ACHOIS:	Australian Carbohydrate Intolerance Study in Pregnancy
ACTORDS:	Australasian Collaborative Trial of Repeat doses of prenatal Steroids to women at risk of preterm birth to reduce neonatal morbidity
BAC:	Birth After Caesarean: Planned vaginal birth or planned elective repeat caesarean for women at term with a single previous caesarean section.
Borderline Gestational Diabetes Recruiting Open for other centres to join the study	Dietary and lifestyle advice for women with borderline gestational diabetes.
DAT:	The influence of acupuncture stimulation of reducing period pain in young women: a randomised controlled trial
Dental Study	Is periodontal disease a risk factor for preterm birth?
MgSO4	What is the optimal timing of administration for Magnesium Sulphate prior to preterm birth?
PROGRESS: Recruiting Open for other centres to join the study	PROGesterone after previous preterm birth for prevention of neonatal RESpiratory distress Syndrome
Obesity Open for other centres to join the study	Limiting weight gain in overweight and obese women during pregnancy to improve health outcomes: a randomised trial.
TILT Open for other centres to join the study	Timing of Induction of Labour at Term
TWINS Recruiting Open for other centres to join the study	Timing of Birth at Term- A randomised controlled trial.

Trials in progress for which the ARCTURUS is a Collaborating Centre

PPROMPT Recruiting Open for other centres to join the study

PRETERM PRELABOUR RUPTURE OF MEMBRANES close to TERM

TWINS BIRTH STUDY Recruiting	This trial is co-ordinated by the University of Toronto Maternal, Infant and Reproductive Health Research Unit at The Centre for Research in Women's Health.
PLUTO	Percutaneous Shunting for Lower-Urinary Tract Obstruction. PLUTO Trial A multi-centre randomised controlled trial comparing intra-uterine vesico-amniotic shunting vs not shunting in the treatment of congential bladder outflow obstruction

Australasian Reviewers Group for the Collaborative Review Group (ARG-PC-CRG)

The Australian Cochrane Pregnancy and Childbirth Central Office is funded by the Department of Health to support Australian authors, prepare and maintain Cochrane Systematic Reviews relating to women’s and infant's health. Ms Philippa Middleton is the National Co-ordinator for the group supported by the research leaders. There are 135 Cochrane Pregnancy and Childbirth review authors within Australia who are supported by staff in the research office and their work accounts for 66 Cochrane Systematic Reviews, over 26% of all pregnancy and childbirth reviews in The Cochrane Library. The implications for clinical practice provide guidance for effective clinical care. The implications for research prioritise our research agenda, locally and at the national level.

Research Translational Group

The Translational Research Group, led by Philippa Middleton, is investigating ways in which maternal and perinatal research is, or can be, translated into policy and practice; as well as developing generic methods and standards for translating and reporting research. Current topics, projects and collaborations include:

• Members of the NHMRC Guideline Assessment Register, which involves helping to develop or update clinical practice guidelines
• Members of a team developing new national standards for guidelines (including levels of evidence and grading of recommendations) for the NHMRC
• Collaborating on the updating of the CONSORT statement (CONsolidated Standards Of Reporting Trials)
• Represented on the steering committee developing a CONSORT statement for Abstracts
• Research comparing citation analysis with other methods of dissemination of knowledge from maternal and perinatal randomised trials
• Research investigating sources of uncertainty in systematic reviews

SEA-ORCHID

SEA-ORCHID (South East Asia Optimising Reproductive and Child Health In Developing Countries) is a joint research initiative with The University of Sydney (Professor David Henderson-Smart), The University of Melbourne (Associate Professor Sally Green) and The University of Adelaide (Professor Caroline Crowther) to build evidence-based capacity for reproductive and child health in South East Asia in collaboration with colleagues in Thailand (Professor Pisake Lumbiganon, Khon Kaen University), The Philippines (Professor Mario Festin, University of the Philippines, Manila), Indonesia (Professor Mohammad Hakimi, Gadjah Mada University, Jokjakarta) and Malaysia (Professor Jackie Ho, Perak College of Medicine, Ipoh). This five-year interrupted time series project aims to find out if the health of mothers and babies in Thailand, Indonesia, the Philippines and Malaysia can be improved by increasing the capacity for research synthesis, improving the implementation of effective interventions and identifying gaps in knowledge needing further research.

THE WOMBAT Collaboration

The WOMBAT (Women and Babies Wellbeing: Action through Trials) Collaboration promotes and supports high quality randomised clinical trials in the perinatal area in order to improve the health and wellbeing of women and their children. The Australian perinatal researchers and practitioners who act as the WOMBAT Collaboration Advisory Board have been awarded an NHMRC enabling grant to enhance the national health and medical research effort.

The WOMBAT Collaboration aims are to:

• Provide high level support to researchers undertaking multicentre trials in the perinatal area.
  This support spans assistance with formulating trial questions, to trial design, methods and conduct, through to dissemination of the results of the trial.
• Identify research areas and encouraging appropriate clinical and methodological trials.
  Cochrane reviews and other sources will be systematically used to identify research gaps in perinatal evidence and WOMBAT will assist researchers to develop trial protocols to address these gaps.
• Provide education and training in trial design and conduct.
  WOMBAT offers workshops and other educational resources on the various aspects of trial design

Wombat Collaboration Advisory Committee

The terms of reference for this committee are

• Oversee the operation of the WOMBAT Collaboration, in order for the objectives of the Collaboration to be fulfilled.
• Monitor the progress of the WOMBAT Collaboration towards its stated targets.
• Promote cooperative planning and conduct of high quality multicentre randomised trials at international, national and regional levels.
• Ensure that there is comprehensive and equitable access to the services and facilities of the WOMBAT Collaboration by people with an interest in conducting perinatal clinical trials within Australia.
• Provide a process for individuals or groups who wish to appeal about obtaining access to WOMBAT Collaboration services and facilities.
• Oversee the direction of the WOMBAT Collaboration’s educational program and ensure that the educational needs of Australian perinatal researchers regarding clinical trials are being addressed.
• Ensuring research gaps for perinatal trials are identified and accessible.
• Identify opportunities for sustaining the services and facilities provided by the WOMBAT Collaboration beyond the initial grant period.
• Ensure that the WOMBAT Collaboration operates without conflicts of interest.
• Promote involvement of consumers in the WOMBAT Collaboration.
• Promote the conduct of methodological research relating to perinatal clinical trials.
  

Advisory Committee Board Members

SHRP: Strategic Health Research Project: Infant mortality research synthesis.

We are currently conducting a research synthesis on 'Preventing infant mortality among Aboriginal and teenage women' for the Strategic Health Research Program of the SA Department of Health. The synthesis, which is due for completion in early 2009, will address six questions:

Question 1: RISK FACTORS - What are the attributable risks for infant mortality, particularly in relation to prematurity and small for gestational age births?

Question 2: MODELS AND STRATEGIES - What models and strategies, including prevention and early intervention service strategies (and non health-system based social strategies) have proved successful in improving the antecedents of infant mortality, and thus reducing the IMR in Australia and overseas (particularly developed countries with indigenous populations)?

Question 3: CONTEXT AND TRANSFERABILITY - Taking into account cultural differences and other contextual factors, which successful approaches could be transferred to our local context to reduce infant mortality in high risk groups? This research will examine universal, population and targeted approaches.

Question 4: MATERNAL EDUCATION - What role does the education level of mothers play in infant mortality rates?

Question 5: COMMUNITY RESILIENCE - Does community resilience have a significant bearing on infant mortality rates?

Question 6: UNPLANNED TEENAGE PREGNANCY - What are the factors that impact on unplanned pregnancies among non-Aboriginal teenage women? What strategies have been successful in reducing the number of unplanned pregnancies among the teenagers?

Investigators on the project are:

• Philippa Middleton (Chief Investigator), Caroline Crowther, Jeffrey Robinson, Rebecca Tooher from The University of Adelaide
• Peter Baghurst, Karen Glover, Anne Nixon, Rima Staugas from the Children, Youth and Women's Health Services, Adelaide
• Annabelle Chan, Kim Morey from the South Australian Department of Health
• Inge Kowanko from Flinders University of South Australia
• Donna Weetra from Southern Primary Health, Adelaide
• Ruth Martis from the Christchurch Polytechnic Institute of Technology , New Zealand

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