Research Interests
The Neonatal Medicine Group is led by Professor Andrew Whitelaw (contact details) who moved from the University of Oslo to Bristol in 1998. The group has focused their research on the mechanisms and treatment of brain injury in newborn infants translating laboratory findings into clinical trials. Professor Whitelaw and Prof Marianne Thoresen worked together in Oslo in this field and moved as a team to Bristol. Dr Thoresen was awarded a personal chair in Neonatal Neuroscience in 2003 in the Dept of Clinical Science at South Bristol now part of the newly formed School of Clinical Sciences.
Major research topics :
Mechanisms and new treatments for premature babies who haemorrhage into the ventricles of the brain.
The group has pioneered a new treatment (Drainage, Irrigation and Fibrinolytic Therapy - known as DRIFT) for hydrocephalus after intraventricular haemorrhage. The object of this treatment is to remove old blood and toxic substances from the ventricular system as well as to decompress the brain early. A small randomised trial of 77 babies showed a significant reduction in severe cognitive disability at 2 years. (Paediatrics 2010) A larger, multicentre trial is being planned and this has the provisional name of DRIFT 2.
DRIFT 2
Mild hypothermia for infants at term who suffer brain injury as a result of lack of oxygen during labour and delivery.
Neonatal Medicine in Bristol was one of the three centres in the world to pioneer selective head cooling for such babies in 1998. Bristol was then one of the leading centres in the first large randomised trial which reported therapeutic benefit with this new treatment in 2004 with a significant reduction in disability at 18 months of age. The CoolCap Trial - Lancet paper 18 month Follow up BMJ article
The group are investigators in an MRC funded trial of a simpler hypothermia technique involving a cooling mattress, the TOBY trial.
Programming the software of the immature brain
Many premature infants have learning and behaviour problems without having cerebral palsy. This may be due more to the 'programming' of the 'software' of the brain than to damage to the 'hardware'. The environment for infants who spend 3 or more months in a neonatal intensive care unit is very unphysiological. Chrissie Israel has developed the 'Parent-Baby Interaction Programme' to optimise the environment for premature infants. This is now being tested in a large randomised trial (The Preterm Infant Parenting Study - The PIP Study) to see whether this can reduce maternal stress and depression in the short term and infant developmental delay in the long term.
The long term cognitive effects of poor birth condition
In conjunction with the Departments of Social Medicine and Community Based Medicine this group with Dr David Odd is investigating the impact of poor condition at birth on the long term cognitive and education achievements in later childhood and early adulthood.The genetic basis of brain injury in preterm infants
The group has shown that different forms (Polymorphisms) of the gene for the inflammatory cytokine Interleukin 6 affect brain injury and disability in premature infants. Together with Dr David Harding (St Michael's Hospital) the group are investigating other cytokine genes and their links with brain injury and disability.
The Neonatal Medicine Group is part of the Institute of Clinical Neurosciences and Professor Seth Love (Neuropathology) has been central to the group's laboratory research which also takes place in the School of Veterinary Sciences.