Scholars@Duke
Margarita Bidegain

Margarita Bidegain

Professor Emeritus of Pediatrics
Pediatrics, Neonatology
margarita.bidegain@duke.edu
DUMC 102509, Durham, NC 27710
2400 Pratt St, 8th Floor, Durham, NC 27705

Selected Publications

Families as partners in neonatal neuro-critical care programs.

Journal Article Pediatr Res · September 2024 Parents of neonates with neurologic conditions face a specific breadth of emotional, logistical, and social challenges, including difficulties coping with prognostic uncertainty, the need to make complex medical decisions, and navigating new hopes and fear ... Full text Link to item Cite

The Role of Perinatal Palliative Care in Fetal Neurology.

Journal Article Am J Perinatol · September 2023 OBJECTIVES: Many serious or life-threatening neurologic conditions are first diagnosed during the fetal period, often following a routine ultrasound or sonographic evaluation after an abnormal aneuploidy screen. Such conditions represent a worrisome or une ... Full text Link to item Cite

Neonatal neuropalliative care.

Journal Article Handb Clin Neurol · 2023 Neonatal neuropalliative care is directed toward patients and families impacted by serious, life limiting, or debilitating neurologic illness in the antenatal and newborn period. This chapter will outline key considerations for clinicians hoping to provide ... Full text Link to item Cite

Comparison of short-term outcomes of 35-weeks' gestation infants cared for in a level II NICU vs mother-baby, a retrospective study.

Journal Article J Neonatal Perinatal Med · 2022 BACKGROUND: Late preterm infants are at high risk for medical complications and represent a growing NICU population. While 34-weeks' gestation infants are generally admitted to the NICU and 36-weeks'gestation infants stay in mother-baby, there is wide prac ... Full text Link to item Cite

Respiratory Symptoms

Chapter · 2022 "We hope that the lives of all children will be filled with possibility, with open horizons and rainbows into the future. ... Cite

Physiologically Based Pharmacokinetic Modeling of Meropenem in Preterm and Term Infants.

Conference Clin Pharmacokinet · December 2021 BACKGROUND: Meropenem is a broad-spectrum carbapenem antibiotic approved by the US Food and Drug Administration for use in pediatric patients, including treating complicated intra-abdominal infections in infants < 3 months of age. The impact of maturation ... Full text Link to item Cite

Neuropalliative Care for Neonates.

Journal Article J Child Neurol · October 2021 Many childhood neurologic conditions are first diagnosed in the perinatal period and shorten or seriously alter the lives of affected infants. Neonatal neuropalliative care incorporates core practices and teachings of both neurology and palliative care and ... Full text Link to item Cite

Breast Milk and Saliva Lactoferrin Levels and Postnatal Cytomegalovirus Infection.

Journal Article Am J Perinatol · August 2021 OBJECTIVE: Very low birth weight preterm infants are at risk for life-threatening infections in the NICU. Breast milk protects against infections but carries the risk of infection by cytomegalovirus (CMV) shed in mother's milk. Lactoferrin is a breast milk ... Full text Link to item Cite

Withholding or withdrawing life-sustaining treatment in extremely low gestational age neonates.

Journal Article Arch Dis Child Fetal Neonatal Ed · May 2021 OBJECTIVE: To identify sociodemographic and clinical factors associated with withholding or withdrawing life-sustaining treatment (WWLST) for extremely low gestational age neonates. DESIGN: Observational study of prospectively collected registry data from ... Full text Link to item Cite

A Survey of Pediatric Professionals Before and After Racial Equity Training

Conference JOURNAL OF DEVELOPMENTAL AND BEHAVIORAL PEDIATRICS · 2021 Link to item Cite

A Survey of Pediatric Professionals Before and After Racial Equity Training

Conference JOURNAL OF DEVELOPMENTAL AND BEHAVIORAL PEDIATRICS · 2021 Cite

Racial/Ethnic Disparities Among Extremely Preterm Infants in the United States From 2002 to 2016.

Journal Article JAMA Netw Open · June 1, 2020 IMPORTANCE: Racial/ethnic disparities in quality of care among extremely preterm infants are associated with adverse outcomes. OBJECTIVE: To assess whether racial/ethnic disparities in major outcomes and key care practices were changing over time among ext ... Full text Link to item Cite

Disparities in the use of antenatal corticosteroids among women with hypertension in North Carolina.

Journal Article J Perinatol · March 2020 OBJECTIVE: To evaluate antenatal corticosteroids (ANS) use in pregnant women with hypertension. STUDY DESIGN: Retrospective analysis of ANS use in the Perinatal Quality Collaborative of North Carolina between 2015 and 2017. RESULTS: Twenty-five centers par ... Full text Link to item Cite

Opioid and benzodiazepine use during therapeutic hypothermia in encephalopathic neonates.

Journal Article J Perinatol · January 2020 OBJECTIVES: To evaluate the use of sedatives and analgesics during therapeutic hypothermia in encephalopathic neonates and assess associations between medication exposure and hospital outcomes. STUDY DESIGN: We identified neonates ≥35 weeks gestational age ... 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

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

Intranasal midazolam and fentanyl for procedural sedation and analgesia in infants in the neonatal intensive care unit.

Journal Article J Neonatal Perinatal Med · 2019 BACKGROUND: The intranasal route is a minimally invasive method for rapidly delivering midazolam and fentanyl to provide short-term analgesia and sedation in infants. However, intranasal use of midazolam and fentanyl is not labeled for infants and safety d ... Full text Link to item Cite

Effect of fluconazole prophylaxis on Candida fluconazole susceptibility in premature infants.

Journal Article J Antimicrob Chemother · December 1, 2018 OBJECTIVES: Extremely premature infants are at high risk of developing invasive candidiasis; fluconazole prophylaxis is safe and effective for reducing invasive candidiasis in this population but further study is needed. We sought to better understand the ... Full text Link to item Cite

Outcomes of preterm infants treated with hypothermia for hypoxic-ischemic encephalopathy.

Journal Article Early Hum Dev · October 2018 BACKGROUND: Therapeutic hypothermia reduces the risk of death, or moderate to severe neurodevelopmental impairment (NDI) in term infants with hypoxic-ischemic encephalopathy (HIE). Reports of its safety and efficacy in preterm infants are scarce. OBJECTIVE ... 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

A case of infant delirium in the neonatal intensive care unit.

Journal Article J Neonatal Perinatal Med · 2017 Infant delirium is an under-recognized clinical entity in neonatal intensive care, and earlier identification and treatment could minimize morbidities associated with this condition. We describe a case of a 6-month-old former 32 weeks gestation infant unde ... Full text Link to item Cite

Palliative care in neonatal neurology: robust support for infants, families and clinicians.

Journal Article J Perinatol · May 2016 Infants with neurological injury and their families face unique challenges in the neonatal intensive care unit. As specialty palliative care support becomes increasingly available, we must consider how to intentionally incorporate palliative care principle ... Full text Link to item Cite

Sustained Reduction in Bloodstream Infections in Infants at a Large Tertiary Care Neonatal Intensive Care Unit.

Journal Article Adv Neonatal Care · February 2016 BACKGROUND: Bloodstream infections (BSI) cause significant morbidity and mortality among hospitalized infants. PURPOSE: Reduction of BSIs has emerged as an important patient safety goal. Implementation of central line insertion bundles, standardized line c ... Full text Link to item Cite

Gabapentin Use in the Neonatal Intensive Care Unit.

Journal Article J Pediatr · February 2016 Gabapentin was used for the treatment of term and preterm infants with suspected visceral hyperalgesia caused by a variety of neurologic and gastrointestinal morbidities. Improved feeding tolerance and decreased irritability were seen, as well as decreased ... Full text Link to item Cite

Association between positive urine cultures and necrotizing enterocolitis in a large cohort of hospitalized infants.

Journal Article Early Hum Dev · October 2015 OBJECTIVE: We used a large research database to examine the association between urinary tract infections and necrotizing enterocolitis (NEC) in premature infants. METHODS: This retrospective data analysis included infants ≤32week gestational age and ≤1500g ... Full text Link to item Cite

Sedatives and Analgesics Given to Infants in Neonatal Intensive Care Units at the End of Life.

Journal Article J Pediatr · August 2015 OBJECTIVE: To describe the administration of sedatives and analgesics at the end of life in a large cohort of infants in North American neonatal intensive care units. STUDY DESIGN: Data on mortality and sedative and analgesic administration were from infan ... Full text Link to item Cite

Comfort care vs palliative care: Is there a difference in neonates?

Journal Article Neoreviews · June 1, 2015 The integration of palliative care principles in the neonatal intensive care unit (NICU) remains challenging. This article describes different models of providing neonatal palliative care and explores management of pain and other symptoms, end-of-life care ... Full text Cite

Impact of a palliative care program on end-of-life care in a neonatal intensive care unit.

Journal Article J Perinatol · March 2015 OBJECTIVE: Evaluate changes in end-of-life care following initiation of a palliative care program in a neonatal intensive care unit. STUDY DESIGN: Retrospective study comparing infant deaths before and after implementation of a Palliative Care Program comp ... Full text Link to item Cite

Pulmonary artery thrombus in a premature neonate treated with recombinant tissue plasminogen activator.

Journal Article J Perinatol · July 2014 Pulmonary artery thrombus is a rarely reported complication in premature neonates. The management of life-threatening thrombotic events in neonates is controversial, especially regarding the use of thrombolytics versus anticoagulation alone for treatment. ... Full text Link to item Cite

Effect of fluconazole prophylaxis on candidiasis and mortality in premature infants: a randomized clinical trial.

Journal Article JAMA · May 7, 2014 IMPORTANCE: Invasive candidiasis in premature infants causes death and neurodevelopmental impairment. Fluconazole prophylaxis reduces candidiasis, but its effect on mortality and the safety of fluconazole are unknown. OBJECTIVE: To evaluate the efficacy an ... Full text Link to item Cite

Perinatal Palliative Care: An Interdisciplinary Team Approach

Journal Article CLINICAL NURSE SPECIALIST · March 1, 2014 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

Safety and effectiveness of meropenem in infants with suspected or complicated intra-abdominal infections.

Journal Article Clin Infect Dis · December 2012 BACKGROUND: Intra-abdominal infections are common in young infants and lead to significant morbidity and mortality. Meropenem is a broad-spectrum antimicrobial with excellent activity against pathogens associated with intra-abdominal infections. The purpos ... Full text Link to item Cite

Population pharmacokinetics of meropenem in plasma and cerebrospinal fluid of infants with suspected or complicated intra-abdominal infections.

Journal Article Pediatr Infect Dis J · October 2011 BACKGROUND: Suspected or complicated intra-abdominal infections are common in young infants and lead to significant morbidity and mortality. Meropenem is a broad-spectrum antimicrobial agent with excellent activity against pathogens associated with intra-a ... Full text Link to item Cite

Recombinant activated factor VIIa treatment for refractory hemorrhage in infants.

Journal Article J Perinatol · March 2011 OBJECTIVE: Report clinical response to recombinant factor VIIa in a cohort of critically ill infants. STUDY DESIGN: We identified all infants who received factor VIIa in the Duke Neonatal Intensive Care Unit between January 2005 and July 2008. Hematologica ... Full text Link to item Cite

Vasopressin for refractory hypotension in extremely low birth weight infants.

Journal Article J Pediatr · September 2010 Intravenous vasopressin at 0.01 to 0.04 units/kg/h increased median mean blood pressure from 26 mm Hg (range 18-44) to 41 mm Hg (range 17-90) by 12 hours of infusion (P=.002) and allowed weaning of catecholamines in a group of extremely low birth weight in ... Full text Link to item Cite

Calcitonin gene-related peptide (CGRP) in the developing mouse limb.

Journal Article Endocr Res · November 1995 Featured Publication The mitogenic effects of neuropeptides and their localization to developing tissues suggest an important role for these peptides during gestation. We examined the expression and action of the neuropeptide calcitonin gene-related peptide (CGRP) in the devel ... Full text Link to item Cite