About STARFISH

Prematurity is the principal cause of death in children under 5 years of age worldwide. 15 million births are premature, and worldwide incidence of increasing. Prematurity has also been shown to have an increased association with multiorgan injury and dysregulated inflammation. It can also lead to long term chronic neurological and cognitive morbidity. Dysregulated inflammatory responses are common preterm infant responses to sepsis and necrotising enterocolitis. In children with dysregulatory immune responses in early stages of life such as neonatal encephalopathy and cerebral palsy, we have shown that persistent inflammation later in life has been associated also with adverse developmental outcome. There has been an urgent need to help map the future of preterm infants and avoid complications in later childhood and adulthood by investigating if sustained inflammation exists in this cohort.

To date, Professor Molloy and our team in Trinity University College have previously characterised and investigated dysregulated inflammatory response in a cohort of over 100 preterm infants and evaluated the role of gender and multiorgan dysfunction assessment and neurological outcomes. We have developed tools for multi organ dysfunction assessment and correlation with outcomes. We plan to follow up these highly phenotyped infants to test our hypothesis that early multiorgan and inflammatory dysfunction in preterm neonates may persist in later childhood and correlated with developmental outcomes, sepsis, neuro-imaging and multi-organ function to help improve outcome. STARFISH will also investigate the association of perinatal inflammation such as placenta, maternal sepsis and neonatal sepsis episodes with outcomes and create and inflammatory biomarker panel for prediction on outcome.

The aims of the STARFISH project are:

1. To understand mechanisms of sustained inflammation and tertiary level of damage caused by inflammation in preterm infants.
2. Use this understanding to assist in developing immunomodulator therapies and help predict outcomes and inform families using biomarkers.
3. Work with families, multidisciplinary stakeholders and international collaborators and develop educational information for families and a consensus based definition of neonatal sepsis.

Selected presentations:

Stewart, P.; Branagan, A.; Isaza-Correa, J.; Kelly, L.; Meehan, J; Semberova,J.; Molloy, E.;  Anakinra (IL1 Receptor Antagonist) and Immune Dysfunction in Preterm Infants. 5^th jENS Congress 2023: joint European Neonatal Societies, Rome 19-23^rd September 2023