Scholars@Duke
Patricia Lynn Ashley

Patricia Lynn Ashley

Associate Professor of Pediatrics
Pediatrics, Neonatology
ashle022@mc.duke.edu
Box 102509, Durham, NC 27710
2400 Pratt Street, 8th Floor, Durham, NC 27705

Selected Publications

Surgical Necrotizing Enterocolitis and Spontaneous Intestinal Perforation Lead to Severe Growth Failure in Infants.

Journal Article Ann Surg · September 1, 2024 OBJECTIVE: We aimed to determine the incidence of growth failure in infants with necrotizing enterocolitis (NEC) or spontaneous intestinal perforation (SIP) and whether initial laparotomy versus peritoneal drainage (PD) impacted the likelihood of growth fa ... Full text Link to item Cite

Progression of Enteral Feeding Volumes in Extremely Low Birth Weight Infants in the "Connection Trial".

Journal Article Am J Perinatol · May 2024 OBJECTIVE: Investigate daily feeding volumes and their association with clinical variables in the early postnatal care of premature infants of the "Connection Trial." STUDY DESIGN: A total of 641 infants of 510 to 1,000-g birth weight (BW, mean: 847 g) and ... Full text Link to item Cite

Neurodevelopmental Outcomes of Extremely Preterm Infants Fed Donor Milk or Preterm Infant Formula: A Randomized Clinical Trial.

Journal Article JAMA · February 20, 2024 IMPORTANCE: Maternal milk feeding of extremely preterm infants during the birth hospitalization has been associated with better neurodevelopmental outcomes compared with preterm formula. For infants receiving no or minimal maternal milk, it is unknown whet ... Full text Link to item Cite

Use of term reference infants in assessing the developmental outcome of extremely preterm infants: lessons learned in a multicenter study.

Journal Article J Perinatol · November 2023 OBJECTIVE: Extremely preterm (EP) impairment rates are likely underestimated using the Bayley III norm-based thresholds scores and may be better assessed relative to concurrent healthy term reference (TR) infants born in the same hospital. STUDY DESIGN: Bl ... Full text Link to item Cite

Early-Life Outcomes in Relation to Social Determinants of Health for Children Born Extremely Preterm.

Journal Article J Pediatr · August 2023 OBJECTIVE: To characterize the relationships between social determinants of health (SDOH) and outcomes for children born extremely preterm. STUDY DESIGN: This is a cohort study of infants born at 22-26 weeks of gestation in National Institute of Child Heal ... Full text Link to item Cite

Cortisol awakening response and developmental outcomes at 6-7 years in children born extremely preterm.

Journal Article Pediatr Res · February 2023 BACKGROUND: Extremely preterm (EPT) birth has been related to dysregulation of stress responses and behavioral/learning problems at school age. Early adverse experiences can blunt HPA axis reactivity. We hypothesized that an attenuated cortisol awakening r ... Full text Link to item Cite

The care of the premature infant

Chapter · January 1, 2023 All primary care pediatric providers will encounter patients who were born prematurely and be faced with the unique challenges this patient population holds. Medical advances in the Neonatal Intensive Care Unit (NICU) steadily increase survival rates of pr ... Full text Cite

Growth Rates of Infants Randomized to Continuous Positive Airway Pressure or Intubation After Extremely Preterm Birth.

Journal Article J Pediatr · October 2021 OBJECTIVE: To evaluate the effects of early treatment with continuous positive airway pressure (CPAP) on nutritional intake and in-hospital growth rates of extremely preterm (EPT) infants. STUDY DESIGN: EPT infants (240/7-276/7 weeks of gestation) enrolled ... Full text Link to item Cite

Limitations of Conventional Magnetic Resonance Imaging as a Predictor of Death or Disability Following Neonatal Hypoxic-Ischemic Encephalopathy in the Late Hypothermia Trial.

Journal Article J Pediatr · March 2021 OBJECTIVE: To investigate if magnetic resonance imaging (MRI) is an accurate predictor for death or moderate-severe disability at 18-22 months of age among infants with neonatal encephalopathy in a trial of cooling initiated at 6-24 hours. STUDY DESIGN: Su ... Full text Link to item Cite

Behavior Profiles at 2 Years for Children Born Extremely Preterm with Bronchopulmonary Dysplasia.

Journal Article J Pediatr · April 2020 OBJECTIVE: To characterize behavior of 2-year-old children based on the severity of bronchopulmonary dysplasia (BPD). STUDY DESIGN: We studied children born at 22-26 weeks of gestation and assessed at 22-26 months of corrected age with the Child Behavior C ... Full text Link to item Cite

Timing of postnatal steroids for bronchopulmonary dysplasia: association with pulmonary and neurodevelopmental outcomes.

Journal Article J Perinatol · April 2020 OBJECTIVE: To determine the associations between age at first postnatal corticosteroids (PNS) exposure and risk for severe bronchopulmonary dysplasia (BPD) and neurodevelopmental impairment (NDI). STUDY DESIGN: Cohort study of 951 infants born <27 weeks ge ... Full text Link to item Cite

Developmental Outcomes of Extremely Preterm Infants with a Need for Child Protective Services Supervision.

Journal Article J Pediatr · December 2019 OBJECTIVE: To evaluate neurodevelopmental outcomes of preterm infants with need for Child Protective Services (CPS) supervision at hospital discharge compared with those discharged without CPS supervision. STUDY DESIGN: For infants born at <27 weeks of ges ... Full text Link to item Cite

A Genocentric Approach to Discovery of Mendelian Disorders.

Journal Article Am J Hum Genet · November 7, 2019 The advent of inexpensive, clinical exome sequencing (ES) has led to the accumulation of genetic data from thousands of samples from individuals affected with a wide range of diseases, but for whom the underlying genetic and molecular etiology of their cli ... Full text Open Access Link to item Cite

Disrupted Maturation of the Microbiota and Metabolome among Extremely Preterm Infants with Postnatal Growth Failure.

Journal Article Sci Rep · June 3, 2019 Growth failure during infancy is a major global problem that has adverse effects on long-term health and neurodevelopment. Preterm infants are disproportionately affected by growth failure and its effects. Herein we found that extremely preterm infants wit ... Full text Link to item Cite

Outcomes of Extremely Preterm Infants With Birth Weight Less Than 400 g.

Journal Article JAMA Pediatr · May 1, 2019 IMPORTANCE: Birth weight (BW) is an important predictor of mortality and morbidity. At extremely early gestational ages (GAs), BW may influence decisions regarding initiation of resuscitation. OBJECTIVE: To characterize outcomes of liveborn infants with a ... Full text Link to item Cite

Neurodevelopmental outcomes among extremely premature infants with linear growth restriction.

Journal Article J Perinatol · February 2019 OBJECTIVE: To compare neurodevelopmental outcomes in linear growth-restricted (LGR) infants born <29 weeks with and without weight gain out of proportion to linear growth. STUDY DESIGN: We compared 2-year neurodevelopmental outcomes between infants with an ... Full text Open Access Link to item Cite

Mutations in NCAPG2 Cause a Severe Neurodevelopmental Syndrome that Expands the Phenotypic Spectrum of Condensinopathies.

Journal Article Am J Hum Genet · January 3, 2019 The use of whole-exome and whole-genome sequencing has been a catalyst for a genotype-first approach to diagnostics. Under this paradigm, we have implemented systematic sequencing of neonates and young children with a suspected genetic disorder. Here, we r ... Full text Open Access Link to item Cite

Behavioral Deficits at 18-22 Months of Age Are Associated with Early Cerebellar Injury and Cognitive and Language Performance in Children Born Extremely Preterm.

Journal Article J Pediatr · January 2019 OBJECTIVE: To investigate associations in toddlers born extremely preterm (<28 weeks) between neonatal neuroimaging and 18- to 22-month developmental and behavioral outcomes. STUDY DESIGN: Cohort analysis from the Eunice Kennedy Shriver National Institute ... Full text Link to item Cite

Behavioral problems are associated with cognitive and language scores in toddlers born extremely preterm.

Journal Article Early Hum Dev · January 2019 OBJECTIVE: To evaluate the relationship of parent-reported child behaviors on the Child Behavior Checklist (CBCL) to cognition, language, and motor skills on the Bayley Scales of Infant and Toddler Development - III (Bayley-III) in toddlers born extremely ... Full text Link to item Cite

Extreme Preterm Infant Rates of Overweight and Obesity at School Age in the SUPPORT Neuroimaging and Neurodevelopmental Outcomes Cohort.

Journal Article J Pediatr · September 2018 OBJECTIVE: To identify rates of overweight (body mass index [BMI] ≥85th percentile) and obesity (BMI ≥95th percentile) at 6-7 years of age and associated risk factors among extremely preterm infants born at <28 weeks of gestation. STUDY DESIGN: Anthropomet ... Full text Link to item Cite

Preterm Neuroimaging and School-Age Cognitive Outcomes.

Journal Article Pediatrics · July 2018 BACKGROUND AND OBJECTIVES: Children born extremely preterm are at risk for cognitive difficulties and disability. The relative prognostic value of neonatal brain MRI and cranial ultrasound (CUS) for school-age outcomes remains unclear. Our objectives were ... Full text Link to item Cite

Neurodevelopmental Impairment Among Extremely Preterm Infants in the Neonatal Research Network.

Journal Article Pediatrics · May 2018 OBJECTIVES: Evaluate the spectrum of neurodevelopmental outcome in a contemporary cohort of extremely preterm infants. We hypothesize that the rate of severe neurodevelopmental impairment (NDI) decreases over time. METHODS: Retrospective analysis of neurod ... Full text Link to item Cite

Outcome of Preterm Infants with Transient Cystic Periventricular Leukomalacia on Serial Cranial Imaging Up to Term Equivalent Age.

Journal Article J Pediatr · April 2018 OBJECTIVE: To determine the outcome of preterm infants whose cystic periventricular leukomalacia "disappeared" on serial screening cranial imaging studies. STUDY DESIGN: Infants ≤26 weeks of gestation born between 2002 and 2012 who had cranial imaging stud ... Full text Link to item Cite

Neurodevelopmental and Behavioral Outcomes in Extremely Premature Neonates With Ventriculomegaly in the Absence of Periventricular-Intraventricular Hemorrhage.

Journal Article JAMA Pediatr · January 1, 2018 IMPORTANCE: Studies of cranial ultrasonography and early childhood outcomes among cohorts of extremely preterm neonates have linked periventricular-intraventricular hemorrhage and cystic periventricular leukomalacia with adverse neurodevelopmental outcomes ... Full text Link to item Cite

Outcomes of Preterm Infants following Discussions about Withdrawal or Withholding of Life Support.

Journal Article J Pediatr · November 2017 OBJECTIVES: To describe the frequency of postnatal discussions about withdrawal or withholding of life-sustaining therapy (WWLST), ensuing WWLST, and outcomes of infants surviving such discussions. We hypothesized that such survivors have poor outcomes. ST ... Full text Link to item Cite

Survival and Neurodevelopmental Outcomes among Periviable Infants.

Journal Article N Engl J Med · February 16, 2017 BACKGROUND: Data reported during the past 5 years indicate that rates of survival have increased among infants born at the borderline of viability, but less is known about how increased rates of survival among these infants relate to early childhood neurod ... Full text Link to item Cite

Growth Outcomes of Preterm Infants Exposed to Different Oxygen Saturation Target Ranges from Birth.

Journal Article J Pediatr · September 2016 OBJECTIVE: To test whether infants randomized to a lower oxygen saturation (peripheral capillary oxygen saturation [SpO2]) target range while on supplemental oxygen from birth will have better growth velocity from birth to 36 weeks postmenstrual age (PMA) ... Full text Link to item Cite

Improved survival and neurodevelopmental outcomes among extremely premature infants born near the limit of viability.

Journal Article Early Hum Dev · April 2016 BACKGROUND: Infants born near the limit of viability are at high risk for death or adverse neurodevelopmental outcomes. It is unclear whether these outcomes have improved over the past 15 years. AIM: To determine if death and neurodevelopmental impairment ... Full text Link to item Cite

Early administration of oropharyngeal colostrum to extremely low birth weight infants.

Journal Article Breastfeed Med · December 2013 BACKGROUND: Human milk reduces morbidities in extremely low birth weight (ELBW) infants. However, clinical instability often precludes ELBW infants from receiving early enteral feeds. This study compared clinical outcomes before and after implementing an o ... Full text Link to item Cite

A functional mouse ornithine decarboxylase gene (Odc) maps to chromosome 12: further evidence of homoeology between mouse chromosome 12 and the short arm of human chromosome 2.

Journal Article Cytogenet Cell Genet · 1988 We have used a DNA probe specific for a functional mouse ornithine decarboxylase gene (Odc) in conjunction with a panel of Chinese hamster x mouse somatic cell hybrids to assign Odc to mouse chromosome 12. This assignment provides further evidence of genet ... Full text Link to item Cite

Chromosomal assignment of the murine Gi alpha and Gs alpha genes. Implications for the obese mouse.

Journal Article J Biol Chem · November 5, 1987 The G protein family of transmembrane signaling molecules includes Gs and Gi, the stimulatory and inhibitory regulators of adenylate cyclase. These and other characterized G proteins are comprised of beta, gamma, and alpha chains, the latter being the most ... Link to item Cite

The mouse homolog of the human amyloid beta protein (AD-AP) gene is located on the distal end of mouse chromosome 16: further extension of the homology between human chromosome 21 and mouse chromosome 16.

Journal Article Biochem Biophys Res Commun · April 29, 1987 The human amyloid beta protein is the major constituent of the brain amyloid plaques found in Alzheimer disease. The gene that encodes this protein is located on chromosome 21, and individuals with Down syndrome (trisomy 21) also exhibit an early onset for ... Full text Link to item Cite

Tissue-specific expression of kallikrein-related genes in the rat.

Journal Article Biochemistry · August 13, 1985 Four distinct kallikrein-related mRNAs (PS, S1, S2, and S3), encoded by members of a multigene family, are selectively expressed in various combinations in several rat tissues. Although closely related along most of the mRNA sequence, the four mRNAs can be ... Full text Link to item Cite

Kallikrein-related mRNAs of the rat submaxillary gland: nucleotide sequences of four distinct types including tonin.

Journal Article Biochemistry · August 13, 1985 We have determined the nucleotide sequence of four submaxillary gland mRNAs, designated PS, S1, S2, and S3, that encode kallikrein and kallikrein-like serine proteases. The four enzymes share between 74% and 86% amino acid sequence identity and are identic ... Full text Link to item Cite

Identification and characterization of cDNA clones specific for cholesterol side-chain cleavage cytochrome P-450.

Journal Article Proc Natl Acad Sci U S A · September 1984 Two overlapping cDNA clones (pBSCC-1 and pBSCC-2) bearing inserts approximately equal to 425 and approximately equal to 950 base pairs long, respectively, which are specific for bovine cholesterol side-chain cleavage cytochrome P-450 (P-450scc), have been ... Full text Link to item Cite

Evidence for a radical mechanism of halogenation of monochlorodimedone catalyzed by chloroperoxidase.

Journal Article Arch Biochem Biophys · August 15, 1984 A radical species of monochlorodimedone has been characterized by its high reactivity with molecular O2. Horseradish peroxidase greatly accelerated O2 uptake by acidic solutions of this substrate; the enzymatic reaction required exogenous H2O2 only with fr ... Full text Link to item Cite

Synthesis of single-stranded hybridization probes from reusable DNA templates bound to solid support.

Journal Article Anal Biochem · July 1984 A convenient and rapid technique for preparing radiolabeled single-stranded DNA hybridization probes has been developed. Single-stranded recombinant M13 phage DNA containing the mRNA strand of a cloned cDNA is bound to diazobenzyloxymethyl-cellulose in a m ... Full text Link to item Cite

Identification and characterization of cDNA clones specific for cholesterol side-chain cleavage cytochrome P-450

Journal Article Proceedings of the National Academy of Sciences of the United States of America · 1984 Two overlapping cDNA clones (pBSCC-1 and pBSCC-2) bearing inserts ~425 and ~950 base pairs long, respectively, which are specific for bovine cholesterol side-chain cleavage cytochrome P-450 (P-450(scc)), have been identified by using two differential hybri ... Cite

Rat pancreatic kallikrein mRNA: nucleotide sequence and amino acid sequence of the encoded preproenzyme.

Journal Article Proc Natl Acad Sci U S A · December 1982 We have cloned via recombinant DNA technology the mRNA sequence for rat pancreatic preprokallikrein. Four cloned overlapping double-stranded cDNAs gave a continuous mRNA sequence of 867 nucleotides beginning within the 5'-noncoding region and extending to ... Full text Link to item Cite