Baby steps
The BABY1000 project tracks the progress of babies during their first 1000 days, but significantly, the tracking starts prior to conception. This makes it a rare study internationally, as it works to identify ways to ensure the best lifelong health outcomes for babies.
Tendencies to some health outcomes can be set before birth. Dr Adrienne Gordon works to understand how to make these outcomes positive.聽
Dr Adrienne Gordon (MPH(Hons) 鈥�05 PhD 鈥�12) clearly remembers getting her start as a neonatologist in a Glasgow hospital. 鈥淭hat first day, I had to fight past about 20 very pregnant women, standing at the front door in the freezing cold, all of them smoking.鈥�
It was the 1990s and poverty was part of the Glasgow landscape. Dr Gordon gained powerful insights into how social and economic disadvantage could shape health and wellbeing from early childhood. 鈥淎 lot was going on there medically,鈥� says Dr Gordon in her bright, Edinburgh accent. 鈥淭he stories behind who ended up with babies in intensive care were often complicated by social disadvantage.鈥�
鈥淭he stories behind who ended up with babies in intensive care were often complicated by social disadvantage,鈥� she says. The Glasgow experience shaped Dr Gordon鈥檚 career and world view. Today, she is a recognised authority on risk and prevention of stillbirth and improving perinatal outcomes.
She is a senior lecturer in obstetrics, gynaecology and neonatology at the University of Sydney鈥檚 Central Clinical School as well as an NHMRC Early Career Fellow at the University鈥檚 , which is dedicated to stemming the global epidemics of modern lifestyle diseases such as obesity, diabetes, and cardiovascular disease.聽
A key focus is the BABY1000 project. The project aims to track the progress of babies for 1000 days. Significantly, the tracking starts prior to conception.
鈥淭here are many studies around the world looking at babies at birth or a few weeks after, then following them through life,鈥� Dr Gordon says, 鈥渂ut there are virtually none that start before pregnancy.鈥澛�
The BABY1000 project aims to give every child the potential for a healthy life.
New technologies are showing that the way people respond to health risk factors during their lifetimes can be set prior to conception. Things like undernutrition or over-nutrition in pregnancy, maternal diabetes, maternal stress and anxiety affect how DNA functions. The result can be a child pre-programmed to respond in a certain way.
These effects have already been observed in communities around the world. In Ghana, for example, it has been shown that women who conceive during the wet season have children who live longer and are healthier than those conceived in the dry season, most likely because in the wet season people eat more green, leafy vegetables.
Similarly, around the end of the Second World War, in the occupied Netherlands, food was scarce and severely rationed. Depending on when during her pregnancy a woman was malnourished, her child would have a different tendency towards cardiovascular disease and obesity.聽
The BABY1000 project aims to measure such effects in a clinical setting. The ultimate goal is to assess the modifiable risks and interventions for pregnant women and those considering pregnancy, to ensure the best lifelong health outcomes for their babies. It鈥檚 about starting preventative medicine extra early.聽
This ambitious, cross-disciplinary project involves collaboration across various University sites and faculties, and other external stakeholders. The鈥� project also includes data linkage鈥� research and in keeping with its鈥� emphasis on translating knowledge鈥� into practice and policy, it will test 鈥╥nterventions through randomised鈥� controlled trials.
鈥淭he Charles Perkins Centre really wanted to have a flagship longitudinal study that could answer novel questions as well as harness all the scientific infrastructure and people who are at the University,鈥� Dr Gordon says. 鈥淏ut also have a public health and clinical outlook and affect real health outcomes.鈥�
The Bod Pod measures body fat through air displacement. A smaller version is used for babies.
In many ways, the BABY1000 project combines Dr Gordon鈥檚 passion for research-informed practice as well as practice-informed research.
The challenge is connecting with women who are still only thinking about getting pregnant. To do that, Dr Gordon and her colleagues have set up a clinical service centre where, in鈥� a single visit, prospective mothers see multiple specialists including a dietitian, midwife, and obstetrician. The big hook is that this one-stop shop is free.鈥ㄢ�淭he idea is that if we build it, they will come,鈥� says Dr Gordon. 鈥淭his will allow us not only to offer a clinical service but a point of recruitment for the BABY1000 project. We plan initially to invite those who attend the service to鈥� be involved. Then, when we have enough funding, we鈥檒l advertise really widely using social media for the main project to make sure we鈥檙e not excluding any part of the population.鈥�
The target is to track 10,000 babies across four Sydney hospitals: Royal Prince Alfred, Westmead, Nepean, and Royal North Shore, where there are a total of 20,000 births annually. This will tap into parental experiences across ethnicities, regions and socioeconomic groups.
Researchers have raised enough money for a pilot study later this year focused on a set of key research questions. The questions have been developed with input from 70 researchers, clinicians, community and health service providers.
The questions include whether a mother鈥檚 pre-conception weight loss can improve her baby鈥檚 outcomes, what aspects鈥� of socio-economic disadvantage can be mitigated with information or guidance, and how receptive pregnant mothers are to health messages coming through social media.聽
This last point relates to another of Dr Gordon鈥檚 projects. She has been collaborating with a charity in the United Kingdom in designing a mobile app called Baby Buddy. 鈥淚t鈥檚 about giving women easy access to information that can help them understand risks. It also embeds with the UK healthcare system,鈥� says Dr Gordon. 鈥淲e鈥檙e now looking at creating an Australian version.鈥�
Early evidence suggests the app 鈥╥s reaching people who don鈥檛 want to engage with the healthcare system. It also appears to increase breastfeeding rates and antenatal visits.
In an ideal world, Dr Gordon would like to see greater community education about pre-conception health and for that education to begin in high school. 鈥淢any people do more to plan their holiday than to plan a baby,鈥� she says.聽
Starting her research career with a focus on preventing stillbirths, Dr Gordon quickly came to see the importance of public health approaches in creating healthy parents and pregnancies, which leads to more happy and healthy babies.
鈥淵ou do make a difference as a doctor. And by doing public health research, you have the ability to make a difference on a much bigger scale,鈥� she says.
Follow Dr Gordon on Twitter at
How to get involved
You can help the BABY1000 project as it works to improve health outcomes for babies and communities. If you鈥檇 like to offer support or learn more, contact Flora Grant on +61 2 2 8627 4650 or email flora.grant@sydney.edu.au.
To apply to take part in the study contact:
You can also follow @BABY1000study on聽聽and join the conversation on聽Twitter聽using #BABY1000.
Photography by Matthew Vasilescu and Victoria Baldwin (BA 鈥�14)
