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Ms Philippa Middleton
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Philippa is a perinatal epidemiologist. She is Executive Director of ARCH (Australian Research for Health of Women and Babies), within the Robinson Institute.
Philippa's research encompasses the spectrum of maternal and child health with the ultimate aims of ‘Every parent prepared, every pregnancy wanted, every birth safe, every child healthy'. She uses the evidence-based methodologies of clinical trials, research synthesis, clinical practice and public health guidelines, research into practice translation and implementation research. Special research themes include diabetes in pregnancy, stillbirth, pre-pregnancy, pregnancy and lactation nutrition, preterm birth, and fetal, neonatal and child neuroprotection and development.
She is the leader of the Robinson Institute's research priority relating to preterm birth "Born too soon".
In 2011, Philippa received the Robinson Institute Director's award for her contribution to research, and she also received the School of Paediatrics and Reproductive Health award for the ‘Most outstanding publications in Obstetrics and Gynaecology'.
MPH, Grad Dip Lib St, BSc(Hons)
Philippa is nearing completion of her PhD which is looking at the impact of Australian maternal and perinatal trials and systematic reviews.
Philippa is an investigator on five current NHMRC project grants and has held continuous NHMRC research funding since 2005:
Since 2005, Philippa has been one of the investigators of the (now) NHMRC program to support Cochrane review activity in Australia. This has been a highly effective program with over 200 Australians consistently contributing to and maintaining one-third of the total worldwide output of the Cochrane Pregnancy and Childbirth Group (120 Cochrane reviews). Philippa has been an AI on another national capacity building project, the Women and Babies Wellbeing: Action Through Trials (WOMBAT Collaboration), funded by the NHMRC as a clinical trials enabling grant.
In 2010, Philippa led a team which was successful in being appointed to the newly constituted NHMRC Evidence Panel (panel of ‘Providers with expertise relevant to the development and presentation of health advice'); and the team was also recently successful in the 2013-16 round for this scheme. This enables the team access to a selective tendering system for NHMRC guideline development and other evidence-based projects. She is or has been involved in the development of 14 clinical practice or public health guidelines. She is a named author on four NHMRC endorsed guidelines (Melanoma, Venous Thromboembolism, Perinatal Mental Health and Antenatal Magnesium for Neuroprotection), which count as ERA applied measures. Philippa also led a multidisciplinary and multisite team which prepared a systematic review of studies evaluating dietary intake of pregnant and breastfeeding women; this work informed the recent update of the Australian Dietary Guidelines.
In 2012, she was appointed to the Australian and New Zealand guideline development committee for 'Antenatal steroids for women at risk of preterm birth' and she is an ex-officio member of the Screening, diagnosis and management of gestational diabetes in New Zealand Guideline Development Team. She is also providing methodological expertise for the Australian antenatal care guidelines and for updating of a series of breast cancer guidelines for Cancer Australia.
She has also been at the forefront of developing standards and methods for NHMRC clinical practice guidelines, specifically around how to formulate and grade recommendations. Other methodological research has centred around reporting standards (CONSORT), critical appraisal of research (Cochrane risk of bias tool) and citation analysis.
Philippa recently led an international team which won a highly competitive bid for an AUSAID funded research synthesis looking at the impact of nutrition or nutrition sensitive programs maternal mortality and morbidity in low and middle income countries (relating to Millennium Goal 5).
Together with Associate Professor Vicki Flenady from Mater Medical Research Institute and other international colleagues, Philippa has been working on several international projects investigating the causes of stillbirth, effective interventions to reduce rates of stillbirths, strategies for implementation and determining research priorities. Part of this work was published in the 2011 Lancet series and has received extensive media coverage worldwide.
In 2012 she was invited to join the working team of two modules of the Harmonized Reproductive Health Registries, a joint Norwegian Institute of Public Health and WHO Department of Reproductive Health and Research project.
Bain S Emily, Middleton F Philippa, Crowther A Caroline. Maternal adverse effects of different antenatal magnesium sulphate regimens for improving maternal and infant outcomes: a systematic review. BMC Pregnancy and Childbirth 2013, 13:195.
Brownfoot FC, Gagliardi DI, Bain E, Middleton P, Crowther CA. Different corticosteroids and regimens for accelerating fetal lung maturation for women at risk of preterm birth. Cochrane Database of Systematic Reviews 2013, Issue 8
Crowther CA, Harding JE, Middleton PF, Andersen CC, Ashwood P, Robinson JS; A*STEROID Study Group. Australasian randomised trial to evaluate the role of maternal intramuscular dexamethasone versus betamethasone prior to preterm birth to increase survival free of childhood neurosensory disability (A*STEROID): study protocol.
Bain E, Goodchild L, Lontis R, McIntyre S, Ashwood P, Bubner T, Middleton P, Crowther C.
Bain E, Pierides KL, Middleton P, Clifton VL, Hodyl NA, Stark MJ, Crowther CA. Interventions for managing asthma in pregnancy (Protocol). Cochrane Database of Systematic Reviews 2013, Issue 7
Reid SM, Middleton P, Cossich MC, Crowther CA, Bain E. Interventions for clinical and subclinical hypothyroidism pre-pregnancy and during pregnancy. Cochrane Database of Systematic Reviews 2013, Issue 5.
McDonald SJ, Middleton P, Dowswell T, Morris PS. Effect of timing of umbilical cord clamping of term infants on maternal and neonatal outcomes. Cochrane Database of Systematic Reviews 2013, Issue 7.
Tieu J, Bain E, Middleton P, Crowther CA. Interconception care for women with a history of gestational diabetes for improving maternal and infant outcomes. Cochrane Database of Systematic Reviews 2013, Issue 6.
Gurung V, Middleton P, Milan SJ, Hague W, Thornton JG. Interventions for treating cholestasis in pregnancy. Cochrane Database of Systematic Reviews 2013, Issue 6.
Heatley E, Middleton P, Hague B, Crowther C. The DIAMIND study: postpartum SMS reminders to women who have had gestational diabetes mellitus to test for type 2 diabetes: a randomised controlled trial - study protocol. BMC Pregnancy Childbirth 2013;epub (April 12).
Magnesium sulphate at 30 to 34 weeks' gestational age: neuroprotection trial (MAGENTA) - study protocol. BMC Pregnancy Childbirth 2013;epub (April 12).
Han S, Crowther CA, Middleton P, Heatley E. Different types of dietary advice for women with gestational diabetes mellitus. Cochrane Database of Systematic Reviews 2013, Issue 3
Crane M, Bain E, Tieu J, Han S, Middleton P, Crowther CA. Diet and exercise interventions for preventing gestational diabetes mellitus (Protocol). Cochrane Database of Systematic Reviews 2013, Issue 3
National Health and Medical Research Council (Middleton P, Makrides M, Collins C, Rumbold A, Zhou J, Crowther C, Flenady V.) Review: Nutritional requirements and dietary advice targeted for pregnant and breastfeeding women. Canberra: National Health and Medical Research Council, 2012.
Dodd JM, Crowther CA, Middleton P. Oral betamimetics for maintenance therapy after threatened preterm labour. Cochrane Database of Systematic Reviews 2012, Issue 12.
Bain E, Bubner T, Ashwood P, Crowther CA, Middleton P; The WISH Project Team. Implementation of a clinical practice guideline for antenatal magnesium sulphate for neuroprotection in Australia and New Zealand. Aust N Z J Obstet Gynaecol. 2012 Oct 29. doi: 10.1111/ajo.12008. [Epub ahead of print]
Crowther CA, Hague WM, Middleton PF, Baghurst PA, McPhee AJ, Tran TS, Yelland LN, Ashwood P, Han S, Dodd JM, Robinson JS, Ideal Study Group. The IDEAL study: investigation of dietary advice and lifestyle for women with borderline gestational diabetes: a randomised controlled trial - study protocol. BMC Pregnancy Childbirth. 2012 Oct 9;12(1):106. [Epub ahead of print]
Tieu J, Middleton P, Crowther CA. Interconception care for women with a history of gestational diabetes for improving maternal and infant outcomes (Protocol). Cochrane Database of Systematic Reviews 2012, Issue 11
Madden K, Middleton P, Cyna AM, Matthewson M, Jones L. Hypnosis for pain management during labour and childbirth. Cochrane Database of Systematic Reviews 2012, Issue 11
Schneeberger C, Geerlings SE, Middleton P, Crowther CA. Interventions for preventing recurrent urinary tract infection during pregnancy. Cochrane Database of Systematic Reviews 2012, Issue 11.
Moher D, Hopewell S, Schulz KF, Montori V, Gøtzsche PC, Devereaux PJ, Elbourne D, Egger M, Altman DG; CONSORT. Collaborators (28): Altman DG, Barbour V, Berlin JA, Boutron I, Devereaux PJ, Dickersin K, Elbourne D, Ellenberg S, Gebski V, Goodman S, Gøtzsche PC, Groves T, Grunberg S, Haynes B, Hopewell S, James A, Juhn P, Middleton P, Minckler D, Moher D, Montori VM, Mulrow C, Pocock S, Rennie D, Schriger DL, Schulz KF, Simera I, Wager E. CONSORT 2010 explanation and elaboration: updated guidelines for reporting parallel group randomised trials. International Journal of Surgery 2012;10(1):28-55
Middleton P, Crowther CA, Simmonds L. Different intensities of glycaemic control for pregnant women with pre-existing diabetes. Cochrane Database of Systematic Reviews 2012, Issue 8
Han S, Middleton P, Crowther CA. Exercise for pregnant women for preventing gestational diabetes mellitus. Cochrane Database of Systematic Reviews 2012, Issue 7.
Gülmezoglu AM, Crowther CA, Middleton P, Heatley E. Induction of labour for improving birth outcomes for women at or beyond term. Cochrane Database of Systematic Reviews 2012, Issue 6.
Mori R, Ota E, Middleton P, Tobe-Gai R, Mahomed K, Bhutta ZA. Zinc supplementation for improving pregnancy and infant outcome. Cochrane Database Syst Rev. 2012 Jul 11;7:CD000230.
The AMICABLE Group (Crowther CA, Middleton PF, Askie LM, Doyle LW, Bubner TK, Voysey M). Antenatal magnesium individual participant data international collaboration: assessing the benefits for babies using the best level of evidence (AMICABLE). Systematic Reviews (accepted Feb 2012)
Crowther CA, Aghajafari F, Askie LM, Asztalos EV, Brocklehurst P, Bubner TK, Doyle LW, Dutta S, Garite TJ, Guinn DA, Hallman M, Hannah ME, Hardy P, Maurel K, Mazumder P, McEvoy C, Middleton PF, Murphy KE, Peltoniemi OM, Peters D, Sullivan L, Thom EA, Voysey M, Wapner RJ, Yelland L, Zhang S. Repeat prenatal corticosteroid prior to preterm birth: a systematic review and individual participant data meta-analysis for the PRECISE study group (prenatal repeat corticosteroid international IPD study group: assessing the effects using the best level of evidence) - study protocol. Systematic Reviews 2012, 1:12
McKinlay CJ, Crowther CA, Middleton P, Harding JE. Repeat antenatal glucocorticoids for women at risk of preterm birth: a Cochrane Systematic Review. American Journal of Obstetrics and Gynecology 2012 Mar;206(3):187-94.
Bain E, Middleton P, Crowther CA. Different magnesium sulphate regimens for neuroprotection of the fetus for women at risk of preterm birth. Cochrane Database of Systematic Reviews. 2012 Feb 15;2:CD009302.
Lambert P, Knight N, Middleton P, Cyna AM. Clonidine premedication for postoperative analgesia in children (Protocol). Cochrane Database of Systematic Reviews 2012, Issue 2.
Ota E, Souza JP, Tobe-Gai R, Mori R, Middleton P, Flenady V. Interventions during the antenatal period for preventing stillbirth: an overview of Cochrane systematic reviews (Protocol). Cochrane Database of Systematic Reviews 2012, Issue 1.
Han S, Crowther CA, Middleton P. Interventions for pregnant women with hyperglycaemia not meeting gestational diabetes and type 2 diabetes diagnostic criteria. Cochrane Database of Systematic Reviews. 2012 Jan 18;1:CD009037.
Austin MP, Middleton P, Reilly NM, Highet NJ. Detection and management of mood disorders in the maternity setting: The Australian Clinical Practice Guidelines. Women Birth. 2012 Jan 2. [Epub ahead of print]
Middleton P, Crowther CA. Reminder systems for women with previous gestational diabetes mellitus to increase uptake of testing for type 2 diabetes or impaired glucose tolerance (Protocol). Cochrane Database of Systematic Reviews 2012, Issue 1
Schulz KF, Altman DG, Moher D; CONSORT Group. Collaborators (28)
Madden K, Middleton P, Cyna AM, Matthewson M. Hypnosis for pain management during labour and childbirth (Protocol). Cochrane Database of Systematic Reviews 2011, Issue 10
Schneeberger C, Geerlings SE, Middleton P, Crowther CA. Interventions for preventing recurrent urinary tract infection during pregnancy (Protocol). Cochrane Database of Systematic Reviews 2011, Issue 8
Cyna AM, Costi D, Middleton P. Viewpoint: Randomised controlled trials using invasive 'placebo' controls are unethical and should be excluded from Cochrane Reviews. Cochrane Database Syst Rev. 2011 Jun 14;(8):ED000029.
Austin MP, Middleton PF, Highet NJ. Australian mental health reform for perinatal care. Med J Aust. 2011 Aug 1;195(3):112-3.
Doyle L, Crowther C, Middleton P, Voysey M, Marret S, Rouse D. Antenatal magnesium sulphate to prevent cerebral palsy in very preterm infants. BJOG. 2011 Jun;118(7):891-2; author reply 892-3. doi: 10.1111/j.1471-0528.2011.02971.x.
Rumbold A, Middleton P, Pan N, Crowther CA. Vitamin supplementation for preventing miscarriage. Cochrane Database of Systematic Reviews 2011, Issue 1 ERA A*
Han S, Crowther CA, Middleton P. Exercise for pregnant women for preventing gestational diabetes mellitus (Protocol). Cochrane Database of Systematic Reviews 2011, Issue 3.
Han S, Crowther CA, Middleton P. Interventions for pregnant women with hyperglycaemia not meeting gestational diabetes and type 2 diabetes diagnostic criteria (Protocol). Cochrane Database of Systematic Reviews 2011, Issue 3.
Crowther CA, McKinlay CJD, Middleton P, Harding JE. Repeat doses of prenatal corticosteroids for women at risk of preterm birth for improving neonatal health outcomes. Cochrane Database of Systematic Reviews 2011, Issue 6.
Austin M-P, Highet N, and the Guideline Expert Advisory Committee. The beyondblue Clinical Practice Guidelines for Depression and Related Disorders - Anxiety, Bipolar Disorder and Puerperal Psychosis - in the Perinatal Period. A Guideline for Primary Care Health Professionals Providing Care in the Perinatal Period. Melbourne: beyondblue: the national depression initiative; 2011. (NHMRC Perinatal mental health guidelines - P. Middleton was a member of the committee)
Hillier S, Grimmer-Somers K, Merlin T, Middleton P, Salisbury J, Tooher R, Weston A. FORM: An Australian method for formulating and grading recommendations in evidence-based clinical guidelines. BMC Medical Research Methodology 2011;11:23
Pattinson R, Kerber K, Buchmann E, Friberg IK, Belizan M, Lansky S, Weissman E, Mathai M, Rudan I, Walker N, Lawn JE; Lancet's Stillbirths Series steering committee.Collaborators (15) Frøen JF, Lawn JE, Bhutta ZA, Pattinson R, Flenady V, Goldenberg RL, Islam M, Friberg IK, Rizvi A, Kerber K, Walker N, Weismann E, Middleton P, Crowther C, Buchmann E. Stillbirths: how can health systems deliver for mothers and babies? Lancet. 2011 May 7;377(9777):1610-23. Epub 2011 Apr 13.
Bhutta ZA, Yakoob MY, Lawn JE, Rizvi A, Friberg IK, Weissman E, Buchmann E, Goldenberg RL; Lancet's Stillbirths Series steering committee. Collaborators (15)
Flenady V, Middleton P, Smith GC, Duke W, Erwich JJ, Khong TY, Neilson J, Ezzati M, Koopmans L, Ellwood D, Fretts R, Frøen JF; Lancet's Stillbirths Series steering committee. Stillbirths: the way forward in high-income countries. Lancet 2011 May 14;377(9778):1703-17. Epub 2011 Apr 13.
Flenady V, Koopmans L, Middleton P, Frøen JF, Smith GC, Gibbons K, Coory M, Gordon A, Ellwood D, McIntyre HD, Fretts R, Ezzati M. Major risk factors for stillbirth in high-income countries: a systematic review and meta-analysis. Lancet 2011 Apr 16;377(9774):1331-40.
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