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Medical pioneers need a visit

08 July, 2010

A life-saving blood transfusion technique to treat babies with anaemia while still in the womb was pioneered in New Zealand nearly fifty years ago, and now researchers are looking for people who survived as a result of the treatment to understand how anaemia before birth may have affected the development of their hearts.

The study at the University of Auckland's Liggins Institute is part of a wider programme of research into how early life events can affect life-long health – an area in which New Zealand is again leading the way internationally.

"No studies have been carried out to investigate how fetal anaemia may influence long-term health in humans, but there is experimental evidence to suggest that it can cause changes in the arteries that supply blood to the heart," says paediatrician Dr Alexandra Wallace who is conducting the research.

By examining people who survived fetal anaemia, the researchers hope to learn whether or not the disease affected the development of their hearts and what this might mean for their health in later life. For instance, if survivors of fetal anaemia are found to have altered cardiac function or be at increased risk of heart disease then they may need to be monitored more closely than other people.

The research may also be relevant for babies born preterm. Many preterm babies become anaemic and the research may provide information about how often these babies should receive blood transfusions to optimise their heart development.

Fetal anaemia is typically due to an incompatibility in blood types that causes a mother's immune system to identify her baby's red blood cells as foreign and destroy them. The loss of these oxygen-carrying cells means that the baby's heart must work much harder to try and pump oxygen around the body. Without treatment, the heart may fail before the baby is born.

The condition was a leading cause of death and illness in babies until 1963 when pioneering New Zealand doctor Sir William Liley developed a procedure to transfuse healthy red blood cells into babies through the mother's abdominal wall.

In most cases, it is now possible to prevent fetal anaemia by giving at-risk mothers antibody injections during pregnancy. However, the technique of fetal transfusion was developed in New Zealand before the preventive therapy was available and was the first treatment that helped babies with fetal anaemia survive in the womb long enough to be born.

"It was a major medical achievement that has saved the lives of countless babies around the world," says Dr Wallace.

The research team would like to make contact with New Zealanders over 18 years of age who received blood transfusions before birth for the treatment of fetal anaemia, to invite them to take part in a study comparing their health and heart function with that of a brother or sister unaffected by the disease.

Most mothers and babies would have received treatment at National Women's Hospital in Auckland, although some transfusions were given in Wellington and Christchurch.

Participating in the research would involve siblings travelling to The University of Auckland at the expense of the research team to have an MRI scan and blood tests. The tests are standard procedures that take half a day to complete.

Anyone who thinks that they and their brother or sister may be eligible to take part in the study is invited to contact Dr Alexandra Wallace on 0800 500 194 or email fetalanaemiastudy@auckland.ac.nzThis e-mail address is being protected from spam bots, you need JavaScript enabled to view it for further information.

The research is being undertaken by Dr Wallace as part of her doctoral thesis, under the supervision of Deputy Vice-Chancellor (Research) Professor Jane Harding and fellow paediatrician Dr Stuart Dalziel. It is funded by grants from the Health Research Council of New Zealand and the New Zealand Lottery Grant Board.

Source: University of Auckland

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