A new study published in The Lancet finds that survival for babies born with a birth defect – otherwise known as a congenital anomaly – is dependent on where they are bornSource: Global Paediatric Research Collaboration, King’s College London, and RI-MUHC.A study published this month in The Lancet examined the risk of mortality for nearly 4,000 babies born with birth defects in 264 hospitals around the world. The study found babies born with birth defects involving the intestinal tract have a two in five chance of dying in a low-income country compared to one in five in a middle-income country and one in twenty in a high-income country.Gastroschisis, a birth defect where the baby is born with intestines protruding through a hole by the umbilicus, has the greatest difference in mortality, with 90% of babies dying in low-income countries compared with 1% in high-income countries. In high-income countries, most of these babies will be able to live a full life without disability.A new study published in The Lancet finds that survival for babies born with a birth defect – otherwise known as a congenital anomaly – is dependent on where they are bornThe study was conducted by the Global Paediatric Research Collaboration, a multicentre research collaboration of surgeons, anaesthetists and allied health professionals caring for neonates and children requiring surgery across the globe. Dan Poenaru, MD, PhD, an investigator in the Child Health and Human Development Program (CHHD) at the Research Institute of the McGill University Health Centre (RI-MUHC), is a member of the steering committee for this global research group and one of the authors of the publication. Other RI-MUHC contributors are Sherif Emil, MD, also an investigator in the CHHD program, and Pramod Puligandla, MD, an associate investigator in the Translational Research in Respiratory Diseases Program. The Montreal Children’s Hospital contributors include Eileen Duggan, Elena Guadagno, Jean-Martin Laberge, Nadia Safa, Kenneth Shaw, Etienne St-Louis and Hussein Wissanji.“To address the current scarcity of research on congenital anomalies, particularly from low- and middle-income countries, we have completed the first large series, geographically comprehensive multicentre prospective cohort study of congenital anomalies across the globe,” says Dr. Poenaru. “Such data is vital to inform advocacy efforts and global health prioritization.”The team of researchers stresses the need for a focus on improving surgical care for newborns in low- and middle-income countries globally. Over the last 25 years, while there has been great success in reducing deaths in children under five years by preventing and treating infectious diseases, there has been little focus on improving surgical care for babies and children, and indeed, the proportion of deaths related to surgical diseases continues to rise. Birth defects are now the fifth leading cause of death in children under five years of age globally, with most deaths occurring in the newborn period.The researchers found that improving survival from these conditions in low- and middle-income countries involves three key elements:improving antenatal diagnosis and delivery at a hospital with children’s surgical care,improving surgical care for babies born in district hospitals, with safe and quick transfer to the children’s surgical centre,improved perioperative care for babies at the children’s surgical centre.They acknowledge that this requires strong teamwork and planning between midwifery and obstetric teams, newborn and paediatric teams, and children’s surgical teams at the children’s surgical centre, alongside outreach education and networking with referring hospitals.The researchers urge that alongside local initiatives, surgical care for newborns and children needs to be integrated into national and international child health policy and should no longer be neglected in the context of global child health.Infographic from the publication in The Lancet. About the study:Read the publication in The LancetJuly 28, 2021

RI-MUHC researcher Thao Huynh has been awarded a grant from Pfizer to conduct the IMPACT QUEBEC COVID-19 Long Haul StudyMontreal, July 21, 2021— Sixteen months into the pandemic, testimonies from people suffering from long-term effects of COVID-19 are multiplying, but knowledge in this regard remains limited. A new transdisciplinary, multicentre prospective cohort study of adults previously infected with COVID-19 in Quebec aims to fill this gap. Winner of an international competition, the IMPACT QUEBEC COVID-19 Long Haul Study is supported by a grant from Pfizer Inc. Led by Thao Huynh, MD, PhD, an investigator at the Research Institute of the McGill University Health Centre (RI-MUHC) and an epidemiologist and cardiologist at the MUHC, the study will assess the health of 200 participants over a one-year period.According to statistics from the Johns Hopkins University, the number of confirmed cases of COVID-19 worldwide approaches 200 million. Of these, a significant but unquantified proportion is experiencing long-term symptoms.“Considering the magnitude of the current pandemic and the exponentially growing number of people with persistent symptoms suggestive of long haul COVID-19 and a possible heart problem, it is crucial to acquire in-depth knowledge of the extent and duration of cardiovascular and other complications from COVID-19 infection,” says Dr. Huynh.Dr. Thao Huynh, investigator in the Cardiovascular Health Across the Lifespan Program at the RI-MUHCWhile the primary focus of the study is to measure cardiovascular complications, researchers will also look at the impacts of the infection on the neurocognitive, gastrointestinal and urinary systems. In addition, they will compare the severity and type of symptoms in older versus younger participants, as well as by sex and gender. They will record and analyze all major adverse events such as deaths, acute coronary syndromes, hospitalizations for heart failure, influenza or respiratory disease, strokes, thrombosis and acute kidney injuries requiring dialysis or hospitalization.“By conducting this long-term follow-up study, we hope to develop our capacity to detect and mitigate potential long-term complications of the viral infection," adds Dr. Huynh, who is part of the Cardiovascular Health Across the Lifespan Program at the RI-MUHC and also an Associate Professor in the Department of Medicine at McGill University.The investigators aim to recruit adults who have been diagnosed with COVID-19 in Quebec and have experienced symptoms suggestive of cardiac dysfunction such as shortness of breath, palpitation, dizziness or chest pain during or after COVID-19 infection. Participants must have been diagnosed with COVID-19 at least two months before enrollment in the study.At a participant’s first visit, researchers will obtain their medical history, body mass index and blood pressure. They will also collect information about their cognitive function, quality of life and nutritional habits, and take certain renal, hematologic and immunologic measurements. In addition, participants will undergo non-invasive tests such as an electrocardiogram, cardiac imaging, and chest x-ray. Except for the cardiac magnetic resonance imaging, all other tests will be repeated one year after the initial visit.Dr. Thao Huynh with Caroline Boudreault, nurse and project manager and team leader in cardiovascular researchThe IMPACT QUEBEC COVID-19 Long Haul Study is being conducted in collaboration with researchers at McGill University, Université de Sherbrooke and the Clinical Research Institute of Montreal. It was designed as a pilot study to collect data for a future larger cohort study.For more information about this study, please contact IMPACT.COVID@MUHC.MCGILL.CA.About the RI-MUHCThe Research Institute of the McGill University Health Centre (RI-MUHC) is a world-renowned biomedical and healthcare research centre. The institute, affiliated with the Faculty of Medicine of McGill University, is the research arm of the McGill University Health Centre (MUHC) – an academic health centre located in Montreal, Canada, that has a mandate to focus on complex care within its community. The RI-MUHC supports over 450 researchers and around 1,200 research trainees devoted to a broad spectrum of fundamental, clinical and health outcomes research at the Glen and the Montreal General Hospital sites of the MUHC. Its research facilities offer a dynamic multidisciplinary environment that fosters collaboration and leverages discovery aimed at improving the health of individual patients across their lifespan. The RI-MUHC is supported in part by the Fonds de recherche du Québec – Santé (FRQS). rimuhc.caMedia contactAnnie-Claire Fournierannie-claire.fournier@muhc.mcgill.ca

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