WIRF has driven a policy change in Western Australia that lowered the preterm birth rate by eight per cent in its first year and then led the implementation of a targeted initiative for the indigenous community which has significant beneficial outcomes. It is now working with health departments across the country to roll out the program nationally, working on educating medical specialists as well as those who are expecting to have a child.
A key risk factor for very early preterm birth is a shortened cervix. According to Professor Newnham, testing for this is simple as it can be done with normal ultrasound checks and, when discovered, a natural hormonal treatment has proven benefits. A different issue is reducing the amount of unnecessary deliveries prior to 39 weeks.
Professor Newnham said the view that 37 weeks was full term was incorrect and that it took significant education and reinforcing of that view to highlight that full term for most mothers should be 39 weeks at least. He said there were significant long-term health and behavioural issues that could be mitigated by ensuring all pregnancies that could went to 39 weeks.
WIRF is not just a research leader it is in a technological race to develop an artificial womb in order to allow extremely preterm babies the opportunity to develop more fully in conditions that simulated a natural pregnancy.
Intriguingly, the COVID-19 pandemic has created the conditions for community wide studies. Unexpectedly, preterm birth rate fell markedly in several countries, the reverse of what the medical experts were bracing for. The Australian data is not yet available but anecdotally Professor Newnham said there was not an obvious trend in WA. It appears the extreme lockdowns due to the virus may have had a beneficial impact on the factors that influence full term pregnancy.
Professor Newnham is forthright in his views that WA has many great attributes for conducting medical research, notably a small and isolated community with a well-developed health system. He said he was told by overseas colleagues that his decision to return to WA in the 1980s would be the “end of his career”. However, the opportunities for research here were considerable and his career flourished as a result.