Monash research improving neonatal outcomes in India

Improving neonatal outcomes using a naturally occurring hormone, melatonin, is the focus of a collaborative research project between MIMR-PHI Insitute and Lucknow’s Community Empowerment Lab in Uttar Pradesh, northern India.

Neonatal paediatrician at Monash Children’s Hosptial, Dr Atul Malhotra and Associate Professor Michael Fahey from The Ritchie Centre, MIMR-PHI Institute are aiming to significantly improve outcomes in rural India. One in four of the 3 million babies that die each year do so in India, most of these in rural Uttar Pradesh.

Melatonin is a powerful antioxidant that researchers at The Ritchie Centre have found can neutralise the effects of birth asphyxia,  a lack of oxygen caused by complications such as umbilical cord entanglement or obstructed delivery.

“We have been collaborating with researchers at University College London to develop a Melatonin Patch that can deliver the neuroprotective agent through the skin, avoiding the need for needles or complex technology,” said Associate Professor Fahey.

The research has advanced to the point that the team is now planning a melatonin pilot study with an Indian partner hospital, the King George’s Medical Centre in Lucknow.

Beyond the Lucknow hospital, the research team recognises the need to engage and include rural communities in this project.

Dr Malhotra originally trained with Dr Vishwajeet Kumar, Head of the Community Empowerment Lab, an Uttar Pradesh facility with long-established links with more than 3400 villages around Lucknow.

“In rural areas surrounding Lucknow health workers are being taught to recognise birth asphyxia through a focussed education program so that melatonin containing patches, similar to a “Band Aid”, can also be applied to babies that have suffered birth asphyxia out in the community,” said Dr Malhotra. The first of these “mobile” education programs gets underway later this month when a team led by Dr Malhotra will travel to India to facilitate its roll out.

Dr Kumar describes this area in India as among the most dangerous in the world for babies and mothers.

“My ultimate dream is to establish a permanent centre for cerebral palsy, which may be caused by birth asphyxia in Lucknow,” said Associate Professor Fahey.

“Extending beyond the scope of the current projects, it would provide ongoing training and education as well as operating as a monitoring facility for babies treated with melatonin and as a therapy centre for children with cerebral palsy,” he added.

This much-needed project is funded by the Bill and Melinda Gates Foundation. The proposal to establish a cerebral palsy clinic in Lucknow also has the support of the Australian High Commissioner to India, Mr Patrick Suckling, who recently visited Monash Health to be briefed on the proposal.