Analysis of the course of labour following induction in uncomplicated first births
Mary-Ann Davey and Judith Lumley in collaboration with James King, Chair, Consultative Council on Obstetric and Paediatric Mortality and
Morbidity, Victoria Department of Human Services and Consultant in Perinatal Medicine, Royal Women’s Hospital, University of Melbourne
Induction of labour is a valuable intervention that has the potential to improve outcomes for both mothers and babies when used in
pregnancies that have become dangerous to continue. However there is some evidence to suggest that its use is increasing, and
that it is used fairly often in pregnancies with no apparent indication for induction.
These changes prompted the following research questions:
• Are there differences between spontaneous and induced labours in nulliparous Victorian women admitted as public patients with
uncomplicated pregnancies, with regard to events during labour and method of birth, and in the condition of the mother and baby at birth?
• Does this differ for private patients or for older women?
• To what extent are other factors associated with induction of labor influencing outcomes?
Data collected by the Victorian Perinatal Data Collection Unit (PDCU) are used to investigate these questions. The analysis includes all
births between 2000 and 2005 to women 20-34 years old, free of obstetric or specified medical complications, giving birth at term
(37-40 weeks), with a singleton pregnancy, a cephalic presentation (head first) and a baby who is not small or large for gestational age.
FUNDING: Australian Postgraduate Award (until July 2004)
STATUS: Analysis completed, doctoral thesis submitted
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Early Births – a case-control study of very preterm birth
Lyn Watson, Judith Lumley and Jo Rayner in collaboration with David Henderson-Smart, Director, Centre for Perinatal Health Services
Research; and James King, Chair, Consultative Council on Obstetric and Paediatric Mortality and Morbidity
This study aims to describe the social and demographic associations of very preterm birth in singletons and twins in Victoria
(including those with gestational age); to describe the clinical subtypes of very preterm birth in both singletons and twins in
Victoria; and to provide preliminary information on the contributions of exposure to violence, infertility and infertility treatment and neighbourhood level factors to very preterm birth in Victoria. The cases are mothers of babies born between 20 and 32 weeks
gestation and their characteristics will be compared with those of the control mothers selected from the Victorian population whose babies are born at 37 weeks gestation or later. Data collection includes a semi-structured interview, either face-to-face or by telephone, and medical record data extraction.
Analysis of the data is now complete. Papers published include evaluation of the data collection process, response issues and
the ethics approval process. A paper on the study findings is in preparation.
FUNDING: NHMRC project grant 2001-2003, SIDS & Kids Victoria 2003-2004 and Faculty Health Sciences Research Enhancement Grant, La Trobe University 2003,
Telstra Community Development Fund 2003
STATUS: Data collection complete, data analysis complete, four papers published, two in preparation
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Perinatal outcomes following treatment for cervical dysplasia
Fiona Bruinsma and Judith Lumley in collaboration with Michael Quinn, Gynaecological Oncologist, Royal Women’s Hospital
The aim of this project was to measure preterm birth, perinatal death and low birthweight in births to women who were referred to the Dysplasia Clinic at the Royal Women’s Hospital from 1982-2000 after a diagnosis of biopsy-proven precancerous changes of the cervix, and to compare their risk of these outcomes with the risks in the whole Victorian population. The study was a retrospective cohort study in which records from the Dysplasia Clinic were linked to birth records in the Victorian Data Collection for the years 1983-2002. The analysis of the linked data files took into account other risk factors for preterm birth present in the birth data (e.g. maternal age at birth, country of birth, parity, gravidity, socio-economic status) as well as the severity of the cervical lesions, the extent of treatment required and the treatment modality. The study found that diagnosis of pre-cancerous changes in the cervix (regardless of treatment) was associated with an increased risk of preterm birth.
FUNDING: NHMRC project grant (2003-2004)
STATUS: One paper published, thesis in preparation
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Collaborative Work
The Women and Babies Wellbeing: Action through Trials (WOMBAT) Collaboration
The WOMBAT Collaboration Advisory Group: Caroline Crowther, Jodie Dodd, Jeffrey Robinson and Philippa Middleton, Adelaide; Lex
Doyle and Judith Lumley Melbourne; Vicki Flenady, Brisbane; David Henderson-Smart, William Tarnow-Mordi, Christine Roberts and
Jonathon Morris (Chair, IMPACT Committee), Sydney; and Karen Simmer, Perth; Vic/Tas coordinator: Michelle Kealy
The specific aim of the WOMBAT Collaboration is to promote and support high quality randomised clinical trials in the perinatal area
in order to improve the health and wellbeing of women and their children. It does this through identifying national priority research areas and encouraging appropriate clinical and methodological trials; providing high level support to researchers undertaking multicentre trials at national and regional levels; providing education and training in trial design and conduct.
The WOMBAT Collaboration organised a series of workshops for perinatal researchers and clinicians across five states in 2007.
FUNDING: NHMRC Enabling grant 2005-2010
STATUS: National database of current and recently completed maternal and perinatal trials; research gaps identified; up-to-date
website for news and events; training and education workshops ongoing; trial coordinators’ network established
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