PhD projects

Mapping hospital health records in Victoria, Australia for tracking pregnancy medicines use

Project description: More than 80% of pregnant women and infants receive a prescribed medicine during their pregnancy and early-life time. For many medicines it is unknown whether there are important impacts on fetal and childhood outcomes from in-utero exposure. Within the consented ‘Generation Victoria’ cohort, targeting all 150,000 births over two years beginning in 2021 at all 70 birthing hospitals in the state of Victoria, this PhD candidate will assist to map the health records information through a common data model, address the research challenges of prescribed medicines during pregnancy and early infants and the related impact on children’s health outcomes. When considered with GenV’s outcomes data, this unique evidence base can quantify the impacts on mother and offspring of variation in prescribed medicine during pregnancy, including both under- and over-utilization, at the individual and policy level. This project offers immense opportunities to establish a career with leadership in pharmacovigilance and pregnancy health research.

Supervisors: Dr Jessika Hu, Prof Melissa Wake, Dr Daniel Capurro

Pre/perinatal antibiotics use related polices impact on child health outcomes

Project description: At least one in five pregnant women receive an antibiotic during pregnancy, and many more in the lead up to or during labour. There is a lack of detailed studies on policies’ impact of prescribed antibiotics on health and developmental outcomes in early childhood, both at the individual and the population level. There is evidence for example that antibiotic use during pregnancy influences the frequency of childhood infections. The consented ‘Generation Victoria’ cohort is targeting all 150,000 births over two years beginning in 2021 at all 70 birthing hospitals in the state of Victoria; it will eventually contain both GenV-collected exposure and outcomes data as well as linked clinical and administrative data, for example from the Pharmaceutical Benefits Scheme (PBS), Medicare Benefits Schedule (MBS), hospitals prescribing and neonatal health outcomes. This PhD candidate will focus on investigating associations of hospital antibiotic stewardship and prescribing policies with pregnancy and newborn outcomes in the 70 hospitals over GenV’s first 3-6 months of operation. The landmark GenV platform thus offers immense opportunities to establish a career with leadership in pregnancy pharmacovigilance and child health research.   

Supervisors: Dr Jessika Hu, Prof Melissa Wake

Why are babies in SCNs/NICUs at higher risk of permanent hearing loss?

Project description:

This PhD offers potential for practice changes that could improve lifelong hearing for infants admitted to SCNs/NICUs. Supervised by leading researchers in children’s hearing loss, epidemiology, paediatrics and audiology, it offers immense opportunities to establish a career and leadership in transformative newborn and child hearing loss research within the GenV initiative and beyond. 

Around one in five liveborn babies require admission to a special care nursery (SCN) or neonatal care unit (NICU). Admission to SCN/NICU is a known risk factor for permanent hearing loss. Compared to healthy babies, those admitted to NICUs are at 8 times the risk of hearing loss, with many hypothesized and interacting causal factors including immaturity, anaemia, infection/inflammation, ototoxic drugs, environmental noise, jaundice, intracranial haemorrhage/encephalopathy, hypoxia and genetic susceptibility. Large sample sizes and variations in care that equate to natural experiments are needed to clarify causal pathways and thence effective prevention and treatment. 

This PhD project will be conducted within the ‘Generation Victoria’ cohort, the only mega-birth cohort now recruiting internationally, targeting all 150,000 Victorian births over two years from 2021 and encompassing Victoria’s 5 NICUs and 40 SCNs. You will help set up a new statewide SCN data registry within GenV within which you will study critical SCN/NICU causal to hearing loss, including objective measurement of noise in each SCN/NICU. 

Supervisors: A/Prof Valerie Sung, Dr Jing Wang, Dr Peter Carew, Prof Melissa Wake 

Improving lifetime outcomes for babies in special care nurseries

Project description: More than 10% of newborns are admitted to special care nurseries (SCN), many experiencing lifelong adverse outcomes. Within the ‘Generation Victoria’ cohort, targeting all 150,000 Victorian births over two years from 2021 and encompassing all 28 SCNs, this PhD will assist in setting up a new statewide SCN registry. It will overcome research challenges of dispersed care and difficulties in long-term outcomes measurement to build an evidence base for better physical, mental and developmental outcomes. GenV’s linked datasets, digital ‘ePhenome’ will support exploration of the impacts of variations in care and comparisons with the general population. It offers immense opportunities to establish a career and leadership in transformative newborn and child health services research. 

Supervisors: Prof Melissa Wake, A/Prof Jeanie Cheong, Dr Jing Wang 

Investigating ‘silent’ newborn viral infections and outcomes in the GenV cohort

Project description: We are seeking a PhD candidate to examine the prevalence and outcomes of ‘silent’ newborn viral infections in the statewide GenV cohort. This PhD offers exciting potential for significant discovery in Australia’s landmark cohort study, and a research career in population health, epidemiology, infectious diseases and/or child health and development. 

Generation Victoria (GenV), Australia’s most ambitious longitudinal study, is a whole-of-state cohort targeting all 150,000 newborns born in Victoria Oct 2021-Oct 2023 and their parents, designed to explore how environmental exposures and genetics interact with biology to determine outcomes across the lifecourse. 

It is now known that viruses can establish lasting inflammatory/immune effects and/or dormant or low-grade persistence within infected individuals. Large-n population research is now showing paths from virus to disease, such as the recent discovery that Epstein Barr virus (EBV) causes subsequent multiple sclerosis. There is reason for concern that newborn viruses could precede a range of lifecourse conditions such as autism, allergy, schizophrenia and immune disorders, over and above viruses already known to cause intellectual disability and deafness. 

This project will build on a successful NHMRC grant (2021-25) with GenV and the Walter and Eliza Hall Institute (WEHI), which uses novel CRISPR gene-editing technology to determine the population prevalence of a single virus (congenital cytomegalovirus, CMV) in GenV’s newborn saliva samples.  This PhD will add to this body of research by identifying additional viruses to add to the testing panel, reporting the prevalence of ‘silent’ newborn viruses within a Victorian sample of newborns, and to explore child health/development outcomes in the first 2 years of life and beyond. 

Supervisors: A/Prof Valerie Sung, A/Prof Gabrielle Haeusler, Prof Melissa Wake