Journal articleJCI Insight · August 10, 2026
Postnatal growth faltering is a pervasive problem among extremely preterm infants that is independently associated with adverse neurodevelopmental outcomes. We previously observed that preterm infants with poor postnatal growth have altered development of ...
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Journal articleJ Hum Lact · August 3, 2026
BACKGROUND: Early pumping frequency is strongly correlated with achieving coming to volume (CTV) and having increased milk volume production. A model was created to predict CTV using early pumping frequency, achievement of early morning pumping, and birth ...
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Journal articleJAMA Ophthalmol · July 1, 2026
IMPORTANCE: Limiting the stress of retinopathy of prematurity (ROP) assessments may be beneficial for preterm infants. OBJECTIVE: To compare stress in preterm infants from noncontact optical coherence tomography (OCT) vs contact fundus photography during R ...
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Journal articleJAMA Ophthalmol · July 1, 2026
IMPORTANCE: If noninvasive optical coherence tomography (OCT) retinal imaging could predict 2-year neurodevelopment of very preterm (VPT; <32 weeks' gestational age) infants in neonatal intensive care, it might help to guide management. OBJECTIVE: To evalu ...
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Journal articleJ AAPOS · June 2026
BACKGROUND: Current United States retinopathy of prematurity (ROP) screening guidelines may be overly broad at the cost of undue preterm infant stress and physician workload. Our proof-of-concept study aimed to optimize screening criteria at our institutio ...
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Journal articleJAMA · February 17, 2026
IMPORTANCE: The management of patent ductus arteriosus (PDA) in preterm infants is controversial. OBJECTIVE: To determine whether expectant management compared with active treatment of a protocol-defined PDA in preterm infants decreases the incidence of de ...
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Journal articleJ Pediatr · January 2026
OBJECTIVE: To describe the neonatal intensive care unit outcomes of infants born extremely preterm to mothers who test positive for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) during pregnancy. STUDY DESIGN: Prospective study (March 1, 202 ...
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Journal articleJAMA · October 28, 2025
IMPORTANCE: Extremely preterm infants are at high risk for bronchopulmonary dysplasia (BPD) and death. Multiple small randomized clinical trials showed that a combination of budesonide with surfactant compared with surfactant alone reduced BPD or death. OB ...
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Journal articleJAMIA Open · October 2025
OBJECTIVES: To develop a data harmonization framework for neonatal hypoxic-ischemic encephalopathy (HIE) studies and demonstrate its suitability for prognostic biomarker development. MATERIALS AND METHODS: Variables were first categorized by chronological ...
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Journal articleJ Perinatol · September 8, 2025
Intestinal perforation occurring in extremely low gestational age neonates is a devastating complication, associated with high mortality and morbidity. Multiple phenotypes of bowel perforation in premature infants have been described, with the most common ...
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Journal articleAm J Obstet Gynecol · August 2025
BACKGROUND: Preterm prelabor rupture of membranes before or around the limit of fetal viability is associated with serious maternal and neonatal complications, including chorioamnionitis, extremely preterm birth, and pulmonary hypoplasia. OBJECTIVE: This s ...
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Journal articleAm J Perinatol · August 2025
This study aimed to characterize the cerebrospinal fluid (CSF) of infants with stroke and compare those findings to the CSF of infants with bacterial meningitis and neither condition in the first 14 postnatal days.Cohort study of 30,092 infants who receive ...
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Journal articleJAMA Pediatr · August 1, 2025
IMPORTANCE: Previous studies suggest that administration of erythropoiesis-stimulating agents darbepoetin or erythropoietin to preterm infants results in fewer transfusions, fewer donor exposures, and improved neurodevelopmental outcome. OBJECTIVE: To dete ...
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Journal articleJAMA · June 24, 2025
IMPORTANCE: Hospitalization of moderately preterm infants may be prolonged while waiting for apnea of prematurity to resolve after discontinuing caffeine. OBJECTIVE: To evaluate whether extending caffeine treatment reduces the duration of hospitalization. ...
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Journal articleArch Dis Child Fetal Neonatal Ed · April 17, 2025
OBJECTIVE: To examine whether changes in survival without moderate or severe neurodevelopmental impairment (NDI) at 18-26 months' corrected age from 1999 to 2018 differed between male and female infants. DESIGN: This retrospective cohort study used data fr ...
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Journal articleArch Dis Child Fetal Neonatal Ed · April 17, 2025
OBJECTIVE: This study investigates whether and to what extent cerebral injury is associated with bilateral blindness in extremely preterm infants, which has been attributed mainly to retinopathy of prematurity (ROP). DESIGN: Multicentre analysis of childre ...
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Journal articleJAMA Pediatr · April 1, 2025
IMPORTANCE: Hypothermia begun less than 6 hours after birth reduces death or disability in infants with encephalopathy due to hypoxia-ischemia at 36 or more weeks' gestation. Trials of hypothermia for infants younger than 36 weeks' gestation are lacking. O ...
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Journal articleJAMA Pediatr · April 1, 2025
IMPORTANCE: The neonatal brain injury score on magnetic resonance imaging following moderate or severe hypoxic-ischemic encephalopathy developed by the National Institute of Child Health and Human Development Neonatal Research Network has been revised to s ...
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Journal articlePediatrics · February 1, 2025
OBJECTIVES: To compare incidence of late-onset sepsis (LOS) among extremely preterm infants before and during the COVID-19 pandemic. METHODS: Multicenter cohort study of infants with birthweight 401 to 1000 g or gestational age 22 to 28 weeks. LOS was defi ...
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Journal articleAm J Perinatol · January 2025
OBJECTIVE: Extremely preterm infants are at high risk of neonatal mortality and morbidity. Extreme preterm birth (PTB) may result from spontaneous preterm labor or preterm premature rupture of membranes or may be indicated due to preeclampsia, eclampsia, h ...
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Journal articleJ Perinatol · January 2025
OBJECTIVE: Characterize C-reactive protein (CRP) within 72 postnatal hours in early-onset sepsis (EOS). STUDY DESIGN: Secondary analysis of a prospective surveillance study of neonates with EOS 2015-2017. We examined CRP use by center and neonatal characte ...
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Journal articleJ Perinatol · September 2024
OBJECTIVE: Evaluate the association between results of the room air (RA) challenge and death, respiratory morbidity, and neurodevelopmental impairment (NDI) at 2 years' corrected age. STUDY DESIGN: Cohort study of infants born <27 weeks' gestational age wh ...
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Journal articleAnn 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 ...
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Journal articlePediatrics · August 1, 2024
BACKGROUND AND OBJECTIVES: Packed red blood cell transfusions (pRBCT) in preterm infants have been associated with significant morbidity. Although infants <26 weeks' gestational age typically require several pRBCT, preterm infants born between 26 and 34 we ...
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Journal articleAm J Perinatol · July 2024
OBJECTIVE: Little is known about the hospital outcomes of moderately preterm (MPT; 29 0/7-33 6/7 weeks gestational age) infants born to insulin-dependent diabetic mothers (IDDMs). We evaluated characteristics and outcomes of MPT infants born to IDDMs compa ...
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Journal articleJ Perinatol · July 2024
HYPOTHESIS: Increased social distancing was associated with a lower incidence of extremely preterm live births (EPLB) during the initial COVID-19 pandemic period. STUDY DESIGN: Prospective study at the NICHD Neonatal Research Network sites comparing EPLB ( ...
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Journal articleJ Perinatol · June 2024
OBJECTIVE: To compare the rates of death or survival with severe neurodevelopmental impairment (sNDI) at 2 years among extremely preterm infants in relation to pre-pregnancy or first-trimester maternal body mass index (BMI). METHODS: This retrospective coh ...
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Journal articleAm J Perinatol · May 2024
OBJECTIVE: Our objective was to examine changes in the use of indomethacin prophylaxis in the neonatal intensive care unit (NICU) between 2008 and 2018. STUDY DESIGN: The design of the study included cohort of 19,715 infants born between 220/7 and 266/7 we ...
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Journal articleAm J Perinatol · May 2024
OBJECTIVE: This study aimed to evaluate whether there are genetic variants associated with adverse neurodevelopmental outcomes in extremely low birth weight (ELBW) infants. STUDY DESIGN: We conducted a candidate gene association study in two well-defined c ...
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Journal articleCell Stem Cell · April 4, 2024
Brain injury is highly associated with preterm birth. Complications of prematurity, including spontaneous or necrotizing enterocolitis (NEC)-associated intestinal perforations, are linked to lifelong neurologic impairment, yet the mechanisms are poorly und ...
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Journal articleJAMA · 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 ...
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Journal articleOphthalmol Sci · 2024
PURPOSE: To characterize changes in subfoveal choroidal thickness in preterm infants from 30 to 60 weeks' postmenstrual age (PMA). DESIGN: The prospective, observational Study of Eye Imaging in Preterm infantS (BabySTEPS) enrolled infants eligible for reti ...
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Journal articleJ Pediatric Infect Dis Soc · December 26, 2023
BACKGROUND: Little is known about late-onset sepsis (LOS) evaluations in extremely low gestational age newborns (ELGANs). We describe frequencies of LOS evaluation in ELGANs, infant characteristics, and empiric therapy choices during evaluations. METHODS: ...
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Journal articleJ 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 ...
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Journal articleJAMA Netw Open · September 5, 2023
IMPORTANCE: Preterm infants with varying degrees of anemia have different tissue oxygen saturation responses to red blood cell (RBC) transfusion, and low cerebral saturation may be associated with adverse outcomes. OBJECTIVE: To determine whether RBC trans ...
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Journal articleJ 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 ...
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Journal articleStem Cells Transl Med · June 15, 2023
Hypoxic ischemic encephalopathy (HIE) in neonates causes increased mortality and long-term morbidity in surviving babies. Hypothermia (HT) has improved outcomes, however, mortality remains high with ~half of surviving babies developing neurological impairm ...
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Journal articlePediatr Res · June 2023
Outcomes of neonatal encephalopathy (NE) have improved since the widespread implementation of therapeutic hypothermia (TH) in high-resource settings. While TH for NE in term and near-term infants has proven beneficial, 30-50% of infants with moderate-to-se ...
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Journal articleJ Perinatol · May 2023
OBJECTIVE: To identify daily pumping frequencies associated with coming to volume (CTV: producing > 500 milliliters of milk per day by postnatal day 14) for mothers of infants in the neonatal intensive care unit (NICU). STUDY DESIGN: We compared demographi ...
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Journal articleBr J Ophthalmol · February 2023
BACKGROUND/AIMS: Neonatal insults from systemic diseases have been implicated in the pathway of impaired neurodevelopment in preterm infants. We aimed to investigate the associations between systemic health factors and retinal nerve fibre layer (RNFL) thic ...
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Journal articlePediatr 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 ...
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Journal articleSemin Perinatol · November 2022
The Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD) Neonatal Research Network (NRN) has been a leader in neonatal research since 1986. In this chapter we review its history and achievements in (1) continuing observat ...
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Journal articleSemin Perinatol · November 2022
Despite improvements in the care and outcomes of infants born extremely preterm, bronchopulmonary dysplasia (BPD) remains a common and frustrating complication of prematurity. This review summarizes the BPD-focused research conducted by the Eunice Kennedy ...
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Journal articlePediatr Res · October 2022
BACKGROUND: Extremely low birth weight (ELBW) infants are at risk for end-organ hypoxia and ischemia. Regional tissue oxygenation of the brain and gut as monitored with near-infrared spectroscopy (NIRS) may change with postnatal age, but normal ranges are ...
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Journal articleAm J Perinatol · September 29, 2022
OBJECTIVE: Our objective was to examine changes in the use of indomethacin prophylaxis in the neonatal intensive care unit (NICU) between 2008 and 2018. STUDY DESIGN: The design of the study included cohort of 19,715 infants born between 220/7 and 266/7 ...
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Journal articleJAMA Ophthalmol · July 1, 2022
IMPORTANCE: Early diagnosis of plus disease is critical in the management of retinopathy of prematurity (ROP). However, there is substantial interexpert disagreement in the diagnosis of plus disease based on vascular changes alone. Information derived from ...
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Journal articleEarly Hum Dev · July 2022
BACKGROUND: Neonatal herpes simplex virus (HSV) disease has been treated with high-dose (20 mg/kg/dose) acyclovir since 1991. AIMS: Determine the safety of acyclovir in infants with neonatal HSV treated with high-dose acyclovir; examine the association bet ...
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Journal articleArch Dis Child Fetal Neonatal Ed · June 21, 2022
OBJECTIVE: Develop an online estimator that accurately predicts bronchopulmonary dysplasia (BPD) severity or death using readily-available demographic and clinical data. DESIGN: Retrospective analysis of data entered into a prospective registry. SETTING: I ...
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Journal articleBJOG · May 24, 2022
OBJECTIVE: Test the hypothesis potential missed opportunities for antenatal corticosteroids increase as gestational age decreases and are associated with adverse outcomes. DESIGN: Observational cohort study. SETTING: 24 US centers in the Neonatal Research ...
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Journal articlePediatr Res · May 2022
BACKGROUND: There is increased risk of cardiovascular, metabolic, and hypertensive disorders in later life in the preterm population. We studied school-age children who had been born extremely premature who had undergone endocrine, cardiovascular, and anth ...
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Journal articleJ Perinatol · April 2022
OBJECTIVE: To determine whether the duration of noninvasive respiratory support exposure is associated with bronchopulmonary dysplasia (BPD) or death in preterm infants. METHODS: Multicenter, retrospective study of infants born at <29 weeks' gestation. The ...
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Journal articleN Engl J Med · March 24, 2022
BACKGROUND: Bronchopulmonary dysplasia is a prevalent complication after extremely preterm birth. Inflammation with mechanical ventilation may contribute to its development. Whether hydrocortisone treatment after the second postnatal week can improve survi ...
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Journal articleJ Perinatol · March 2022
OBJECTIVE: Determine whether blanket temperatures during therapeutic hypothermia (TH) are associated with 18-22 month outcomes for infants with hypoxic ischemic encephalopathy (HIE). STUDY DESIGN: Retrospective cohort study of 181 infants with HIE who rece ...
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Journal articleJAMA · January 18, 2022
IMPORTANCE: Despite improvement during recent decades, extremely preterm infants continue to contribute disproportionately to neonatal mortality and childhood morbidity. OBJECTIVE: To review survival, in-hospital morbidities, care practices, and neurodevel ...
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Journal articleJAMA Neurol · December 1, 2021
IMPORTANCE: Compared with normothermia, hypothermia has been shown to reduce death or disability in neonatal hypoxic ischemic encephalopathy but data on seizures during rewarming and associated outcomes are scarce. OBJECTIVE: To determine whether electrogr ...
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Journal articleJAMA Neurol · October 18, 2021
IMPORTANCE: Compared with normothermia, hypothermia has been shown to reduce death or disability in neonatal hypoxic ischemic encephalopathy but data on seizures during rewarming and associated outcomes are scarce. OBJECTIVE: To determine whether electrogr ...
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Journal articleSemin Fetal Neonatal Med · October 2021
In term and near-term neonates with neonatal encephalopathy, therapeutic hypothermia protocols are well established. The current focus is on how to improve outcomes further and the challenge is to find safe and complementary therapies that confer additiona ...
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Journal articleJ 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 ...
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Journal articleAnn Surg · October 1, 2021
OBJECTIVE: The aim of this study was to determine which initial surgical treatment results in the lowest rate of death or neurodevelopmental impairment (NDI) in premature infants with necrotizing enterocolitis (NEC) or isolated intestinal perforation (IP). ...
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Journal articleArch Dis Child Fetal Neonatal Ed · September 2021
OBJECTIVE: Determine risk of death or neurodevelopmental impairment (NDI) in infants with late-onset sepsis (LOS) versus late-onset, antibiotic-treated, blood culture-negative conditions (LOCNC). DESIGN: Retrospective cohort study. SETTING: 24 neonatal cen ...
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Journal articleAm 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 ...
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Journal articleJ Perinatol · August 2021
OBJECTIVE: This study evaluates the 24-month follow-up for the NICHD Neonatal Research Network (NRN) Inositol for Retinopathy Trial. STUDY DESIGN: Bayley Scales of Infants Development-III and a standardized neurosensory examination were performed in infant ...
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Journal articleJ Perinatol · July 2021
OBJECTIVE: Determine the associations between neonatal intensive care unit (NICU) medication safety practices, laboratory-based adverse events (lab-AEs), and death. STUDY DESIGN: We combined data from a 2016 survey of Pediatrix NICUs on use of medication s ...
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Journal articleOphthalmol Retina · June 2021
PURPOSE: To report our ability to capture,-grade reliably, and analyze bedside macular OCT images from preterm infants and relate OCT findings to biological factors and retinopathy of prematurity (ROP) status at a single time window in the Study of Eye Ima ...
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Journal articlePediatr Infect Dis J · June 1, 2021
BACKGROUND: In premature infants, complicated intraabdominal infections (cIAIs) are a leading cause of morbidity and mortality. Although universally prescribed, the safety and effectiveness of commonly used antibiotic regimens have not been established in ...
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Journal articlePediatrics · June 2021
BACKGROUND AND OBJECTIVES: Early determination of prognosis is important in neonates with hypoxic-ischemic encephalopathy (HIE). Our objective was to test scoring systems developed earlier (original scoring system) and develop new prognostic models. METHOD ...
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Journal articleArch 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 ...
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Journal articleJAMA Ophthalmol · May 1, 2021
IMPORTANCE: Binocular indirect ophthalmoscopy (BIO) examination for retinopathy of prematurity (ROP) is a well-known cause of repeated preterm infant stress. OBJECTIVE: To compare stress during investigational optical coherence tomography (OCT) imaging to ...
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Journal articleJ 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 ...
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Journal articleJ Perinatol · February 2021
OBJECTIVE: To describe relationship between cord blood (representing fetal) myo-inositol concentrations and gestational age (GA) and to determine trends of blood concentrations in enterally and parenterally fed infants from birth to 70 days of age. DESIGN/ ...
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Journal articleJ Perinatol · February 2021
OBJECTIVE: To test associations between grades 3 or 4 (severe) intraventricular hemorrhage (IVH) and single nucleotide polymorphisms (SNPs) associated with coagulation, inflammation, angiogenesis, and organ development in an exploratory study. STUDY DESIGN ...
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Journal articlePediatr Res · January 2021
The next phase of clinical trials in neonatal encephalopathy (NE) focuses on hypothermia adjuvant therapies targeting alternative recovery mechanisms during the process of hypoxic brain injury. Identifying infants eligible for neuroprotective therapies beg ...
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Journal articleN Engl J Med · December 31, 2020
BACKGROUND: Limited data suggest that higher hemoglobin thresholds for red-cell transfusions may reduce the risk of cognitive delay among extremely-low-birth-weight infants with anemia. METHODS: We performed an open, multicenter trial in which infants with ...
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Journal articleSemin Perinatol · December 2020
Suspected or proven late onset sepsis, necrotizing enterocolitis, urinary tract infections, and ventilator associated pneumonia occurring after the first postnatal days contribute significantly to the total antibiotic exposures in neonatal intensive care u ...
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Journal articleAm J Perinatol · October 2020
The novel coronavirus disease 2019 (COVID-19) pandemic is affecting care for high-risk newborns in ways that will likely be sustained beyond the initial pandemic response. These novel challenges present an urgent imperative to understand how COVID-19 impac ...
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Journal articleProc Mach Learn Res · August 2020
Seizures are a common emergency in the neonatal intesive care unit (NICU) among newborns receiving therapeutic hypothermia for hypoxic ischemic encephalopathy. The high incidence of seizures in this patient population necessitates continuous electroencepha ...
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Journal articleJAMA Pediatr · July 1, 2020
IMPORTANCE: Early-onset sepsis (EOS) remains a potentially fatal newborn condition. Ongoing surveillance is critical to optimize prevention and treatment strategies. OBJECTIVE: To describe the current incidence, microbiology, morbidity, and mortality of EO ...
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Journal articleDev Med Child Neurol · June 2020
AIM: To determine if genetic variation associated with decreased dopamine neurotransmission predicts a decrease in motor development in a convenience cohort study of infants born extremely-low-birthweight (ELBW). METHOD: Four hundred and ninety-eight infan ...
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Journal articleJ Pediatr · June 2020
OBJECTIVE: To evaluate the hypothesis that early-onset sepsis increases risk of death or neurodevelopmental impairment (NDI) among preterm infants; and that among infants without early-onset sepsis, prolonged early antibiotics alters risk of death/NDI. STU ...
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Journal articlePediatr Pulmonol · April 2020
RATIONALE: Bronchopulmonary dysplasia (BPD) is associated with post-prematurity respiratory disease (PRD) in survivors of extreme preterm birth. Identifying early biomarkers that correlate with later development of BPD and PRD may provide insights for inte ...
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Journal articleJ 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 ...
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Journal articleJ 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 ...
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Journal articleJ 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 ...
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Journal articleJ 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 ...
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Journal articleJ 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 ...
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Journal articleAm 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 ...
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Journal articleJ Pediatr · November 2019
OBJECTIVE: To assess the frequency of gastrostomy tube (GT) placement in extremely low birth weight (ELBW) infants, associated comorbidities, and long-term outcomes. STUDY DESIGN: Analysis of ELBW infants from 25 centers enrolled in the National Institute ...
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Journal articleJ Perinatol · November 2019
OBJECTIVE: Quantify the risk of treatment for retinopathy of prematurity (ROP) among infants meeting current U.S. screening guidelines. STUDY DESIGN: Among infants ≤1500 g birth weight or ≤30 weeks gestation screened for ROP from 2006-2015, we developed a ...
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Journal articleJ Perinatol · September 2019
OBJECTIVES: The objectives describe the frequency that inadequate oral feeding (IOF) is the reason why moderately preterm (MPT) infants remain hospitalized and its association with neonatal morbidities. STUDY DESIGN: Prospective study using the NICHD Neona ...
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Journal articleSci 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 ...
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Journal articlePediatr Res · June 2019
BACKGROUND: Prolonged early antibiotics in extremely premature infants may have negative effects. We aimed to assess prevalence and outcomes of provision of prolonged early antibiotics to extremely premature infants in the absence of culture-confirmed infe ...
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Journal articleAntimicrob Agents Chemother · June 2019
Rifampin is active against methicillin-resistant staphylococcal species and tuberculosis (TB). We performed a multicenter, prospective pharmacokinetic (PK) and safety study of intravenous rifampin in infants of <121 days postnatal age (PNA). We enrolled 27 ...
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Journal articleJ Pediatr · June 2019
OBJECTIVE: To determine the impact of policy changes for pulse oximetry oxygen saturation (SpO2) alarm limits on neonatal mortality and morbidity among infants born very preterm. STUDY DESIGN: This was a retrospective cohort study of infants born very pret ...
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Journal articleBr J Clin Pharmacol · May 2019
Ticarcillin-clavulanate covers a broad spectrum of pathogens that are common in premature infants. In infants <30 weeks gestational age, pharmacokinetic data to guide ticarcillin-clavulanate dosing are lacking. We enrolled 15 premature infants <30 weeks ge ...
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Journal articleJ Pediatr · April 2019
OBJECTIVE: To use a large current prospective cohort of infants <29 weeks to compare bronchopulmonary dysplasia (BPD) rates in black and white infants. STUDY DESIGN: The Prematurity and Respiratory Outcome Program (PROP) enrolled 835 infants born in 2011-2 ...
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Journal articleJ Perinatol · March 2019
OBJECTIVE: Patent ductus arteriosus (PDA) is a commonly observed condition in preterm infants. Prior studies have suggested a role for genetics in determining spontaneous ductal closure. Using samples from a large neonatal cohort we tested the hypothesis t ...
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Journal articleClin Perinatol · March 2019
Multicenter groups have reported reductions in the incidence of necrotizing enterocolitis (NEC) among preterm infants over the past 2 decades. These large-scale prevalence studies have coincided with reports from multicenter consortia and single centers of ...
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Journal articleJ 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 ...
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Journal articleAm 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 ...
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Journal articleJ 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 ...
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Journal articleJ Pediatr · January 2019
OBJECTIVE: To assess whether length of hospital stay is decreased among moderately preterm infants weaned from incubator to crib at a lower vs higher weight. STUDY DESIGN: This trial was conducted in the Eunice Kennedy Shriver National Institute of Child H ...
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Journal articleJ 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 ...
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Journal articleAm J Perinatol · December 2018
OBJECTIVE: We conducted a detailed survey to identify medication safety practices among a large network of United States neonatal intensive care units (NICUs). METHODS: We created a 53-question survey to assess 300 U.S. NICU's demographics, medication safe ...
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Journal articleJ Pediatr · November 2018
OBJECTIVE: To identify factors associated with prolonged maternal breast milk (BM) provision in very low birth weight (VLBW) infants. STUDY DESIGN: This was a cohort study of VLBW infants who initially received maternal BM and were born at one of 197 neona ...
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Journal articleJ Perinatol · November 2018
OBJECTIVE: Diazoxide is used to treat infants with persistent hypoglycemia, but the prevalence of its use and adverse effects are not well described. We report demographic and clinical characteristics of infants treated with diazoxide in neonatal intensive ...
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Journal articleJAMA · October 23, 2018
IMPORTANCE: Previous studies of myo-inositol in preterm infants with respiratory distress found reduced severity of retinopathy of prematurity (ROP) and less frequent ROP, death, and intraventricular hemorrhage. However, no large trials have tested its eff ...
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Journal articleBMC Genet · October 20, 2018
BACKGROUND: Previous studies have identified genetic variants associated with bronchopulmonary dysplasia (BPD) in extremely preterm infants. However, findings with genome-wide significance have been rare, and not replicated. We hypothesized that whole exom ...
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Journal articleEarly 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 ...
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Journal articlePediatr Infect Dis J · September 2018
BACKGROUND: Invasive candidiasis is an important cause of sepsis in extremely low birth weight infants (ELBW, < 1000 g), is often fatal, and frequently results in neurodevelopmental impairment (NDI) among survivors. We sought to assess the antifungal minim ...
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Journal articleJ 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 ...
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Journal articleRetina · August 2018
PURPOSE: The authors investigated feasibility of undilated handheld spectral domain optical coherence tomography (SDOCT) retinal imaging in preterm infants and children with neurologic abnormalities. METHODS: Under an institutional review board-approved pr ...
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Journal articleLab Med · July 5, 2018
The three major causes of anemia in neonates are blood loss, decreased red blood cell production, and increased degradation of erythrocytes. Establishing the cause of anemia in a neonate born prematurely can be challenging. Clinically, fetomaternal hemorrh ...
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Journal articlePediatrics · 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 ...
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Journal articleJ Pediatr · June 2018
OBJECTIVE: To determine if daily respiratory status improved more in extremely low gestational age (GA) premature infants after diuretic exposure compared with those not exposed in modern neonatal intensive care units. STUDY DESIGN: The Prematurity and Res ...
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Journal articlePediatr Res · May 2018
BackgroundTwin studies suggest that genetic factors may account for up to 50% increased risk for necrotizing enterocolitis (NEC), but genome-wide association studies for NEC are lacking.MethodsGenotyping was done on Illumina BeadChip, followed by analysis ...
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Journal articleJ 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 ...
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Journal articleJ Pediatr · April 2018
OBJECTIVES: To describe the frequency and extent of delivery room resuscitation and evaluate the association of delivery room resuscitation with neonatal outcomes in moderately preterm (MPT) infants. STUDY DESIGN: This was an observational cohort study of ...
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Journal articleJ Pediatr · January 2018
OBJECTIVE: To evaluate the temperature distribution among moderately preterm (MPT, 29-33 weeks) and extremely preterm (EPT, <29 weeks) infants upon neonatal intensive care unit (NICU) admission in 2012-2013, the change in admission temperature distribution ...
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Journal articleJAMA 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 ...
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Journal articleJ Perinat Med · December 20, 2017
Ventilation practices have changed significantly since the initial reports in the mid 1980 of successful use of permissive hypercapnia and spontaneous ventilation [often called gentle ventilation (GV)] in infants with congenital diaphragmatic hernia (CDH). ...
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Journal articleJ 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 ...
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Journal articleJ Perinatol · November 2017
OBJECTIVE: To analyze reasons for low enrollment in a randomized controlled trial (RCT) of the effect of hydrocortisone for cardiovascular insufficiency on survival without neurodevelopmental impairment (NDI) in term/late preterm newborns. STUDY DESIGN: Th ...
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Journal articlePediatrics · November 2017
BACKGROUND: Premature infants are at high risk of early-onset sepsis (EOS) relative to term infants, and most are administered empirical antibiotics after birth. We aimed to determine if factors evident at birth could be used to identify premature infants ...
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Journal articleJAMA · October 24, 2017
IMPORTANCE: Hypothermia initiated at less than 6 hours after birth reduces death or disability for infants with hypoxic-ischemic encephalopathy at 36 weeks' or later gestation. To our knowledge, hypothermia trials have not been performed in infants present ...
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Journal articleJ Pediatr · October 2017
OBJECTIVES: To identify variables associated with successful elective extubation, and to determine neonatal morbidities associated with extubation failure in extremely preterm neonates. STUDY DESIGN: This study was a secondary analysis of the National Inst ...
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Journal articleArch Dis Child Fetal Neonatal Ed · September 2017
OBJECTIVE: To identify genetic variants associated with sepsis (early-onset and late-onset) using a genome-wide association (GWA) analysis in a cohort of extremely premature infants. STUDY DESIGN: Previously generated GWA data from the Neonatal Research Ne ...
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Journal articleAm J Respir Crit Care Med · August 1, 2017
RATIONALE: Mechanisms contributing to chronic lung disease after preterm birth are incompletely understood. OBJECTIVES: To identify antenatal risk factors associated with increased risk for bronchopulmonary dysplasia (BPD) and respiratory disease during ea ...
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Journal articlePediatr Res · August 2017
BackgroundExtremely preterm infants (EPT, <29 weeks' gestation) represent only 0.9% of births in the United States; yet these infants are the focus of most published research. Moderately preterm neonates (MPT, 29-336/7 weeks) are an understudied group of h ...
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Journal articlePediatr Infect Dis J · August 2017
BACKGROUND: Late-onset sepsis (LOS) is an important cause of death and neurodevelopmental impairment in premature infants. The purpose of this study was to assess overall incidence of LOS, distribution of LOS-causative organisms and center variation in inc ...
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Journal articleSemin Fetal Neonatal Med · August 2017
To survive the transition to extrauterine life, newborn infants must have lungs that provide an adequate surface area and volume to allow for gas exchange. The dynamic activities of fetal breathing movements and accumulation of lung luminal fluid are key t ...
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Journal articleJ Pediatr · August 2017
OBJECTIVE: To assess the utility of clinical predictors of persistent respiratory morbidity in extremely low gestational age newborns (ELGANs). STUDY DESIGN: We enrolled ELGANs (<29 weeks' gestation) at ≤7 postnatal days and collected antenatal and neonata ...
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Journal articleJAMA · July 4, 2017
IMPORTANCE: Hypothermia for 72 hours at 33.5°C for neonatal hypoxic-ischemic encephalopathy reduces death or disability, but rates continue to be high. OBJECTIVE: To determine if cooling for 120 hours or to a temperature of 32.0°C reduces death or disabili ...
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Journal articleJ Pediatr · July 2017
OBJECTIVE: To assess the association between prophylactic indomethacin and bronchopulmonary dysplasia (BPD) in a recent, large cohort of extremely preterm infants. STUDY DESIGN: Retrospective cohort study using prospectively collected data for infants with ...
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Journal articleJ Pediatr · July 2017
OBJECTIVE: To characterize actual achieved patterns of oxygenation in infants born appropriate vs small for gestational age (SGA) randomized to a lower (85-89%) vs higher (91%-95%) oxygen saturation target in the Surfactant Positive Pressure and Oxygen Tri ...
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Journal articleAm J Perinatol · June 2017
Background Association studies of various gene variants in neonatal sepsis show conflicting results. Objective We performed a systematic review of candidate gene association studies in neonatal sepsis to provide pooled estimates of risk for selected gene v ...
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Journal articleJ Perinatol · June 2017
OBJECTIVE: The objective of this study is to determine whether antenatal exposure to magnesium is associated with spontaneous intestinal perforation (SIP) in extremely low birth weight (ELBW) infants (⩽1000 g). STUDY DESIGN: We identified all ELBW infants ...
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Journal articleN 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 ...
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Journal articleJ 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 ...
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Journal articleEarly Hum Dev · December 2016
BACKGROUND: Gastrostomy tube (G-tube) placement is a common intervention for newborns with severe feeding difficulties. Infants with congenital diaphragmatic hernia (CDH) are at high risk for feeding problems. Prevalence of G-tube placement and consequent ...
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Journal articleSemin Perinatol · October 2016
Despite remarkable improvements in survival of extremely premature infants, the burden of BPD among survivors remains a frustrating problem for parents and caregivers. Advances, such as antenatal steroids and surfactant replacement, which have dramatically ...
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Journal articleJ 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) ...
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Journal articlePediatr Res · August 2016
BACKGROUND: Preterm infants with respiratory distress syndrome (RDS) given inositol had reduced bronchopulmonary dysplasia (BPD), death and severe retinopathy of prematurity (ROP). We assessed the safety and pharmacokinetics of daily inositol to select a d ...
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Journal articleEarly Hum Dev · August 2016
BACKGROUND: Histamine-2 receptor (H2) blockers are often used in very low birth weight infants despite lack of population specific efficacy and safety data. AIMS: We sought to describe safety and temporal trends in histamine-2 receptor (H2) blocker use in ...
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Journal articleJ Pediatr · July 2016
OBJECTIVE: To explore differences in blood cytokine profiles among distinct bronchopulmonary dysplasia (BPD) patterns. STUDY DESIGN: We evaluated blood spots collected from 943 infants born at ≤1000 g and surviving to 28 days on postnatal days 1, 3, 7, 14, ...
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Journal articleBiochem Biophys Res Commun · May 13, 2016
BACKGROUND: Nitric oxide (NO) and its derivatives play important roles in the cardiopulmonary transition upon birth and in other oxygen-sensitive developmental milestones. One mechanism for the coupling of oxygen sensing and signaling by NO species is via ...
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Journal articleAntimicrob Agents Chemother · May 2016
Clindamycin may be active against methicillin-resistant Staphylococcus aureus, a common pathogen causing sepsis in infants, but optimal dosing in this population is unknown. We performed a multicenter, prospective pharmacokinetic (PK) and safety study of c ...
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Journal articleEarly Hum Dev · May 2016
BACKGROUND: Few studies have reported odds of mortality for hospitalized premature infants stratified by postnatal age and adjusted for severity of illness. Our objective was to examine day-by-day mortality of premature infants in a large multicenter cohor ...
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Journal articleAm J Surg · April 2016
BACKGROUND: Necrotizing enterocolitis (NEC) is a gastrointestinal disease of premature, very low birth weight neonates resulting in sepsis and death. Loop diuretics are widely used in neonates as a treatment for pulmonary fluid retention. An association be ...
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Journal articleCurr Opin Pediatr · April 2016
PURPOSE OF REVIEW: Antibiotics have not only saved lives and improved outcomes, but they also influence the evolving microbiome. This review summarizes reports on neonatal infections and variation in antibiotic utilization, discusses the emergence of resis ...
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Journal articleEarly 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 ...
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Journal articleAm J Perinatol · March 2016
OBJECTIVE: This study aims to determine the association between hyperglycemia, insulin therapy, and severe retinopathy of prematurity (ROP) in extremely low-birth-weight (ELBW) infants. STUDY DESIGN: In this retrospective database study, we included all EL ...
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Journal articleJ 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 ...
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Journal articleAm J Perinatol · January 2016
OBJECTIVE: To compare the left ventricular eccentricity index (EI) and tricuspid valve systolic-diastolic (SD) ratio in infants at risk of bronchopulmonary dysplasia (BPD) and pulmonary hypertension (PH). STUDY DESIGN: Review of echocardiograms performed o ...
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Journal articleSemin Perinatol · December 2015
Emerging data suggest intraventricular hemorrhage (IVH) of the preterm neonate is a complex disorder with contributions from both the environment and the genome. Environmental analyses suggest factors mediating both cerebral blood flow and angiogenesis con ...
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Journal articleSemin Perinatol · December 2015
Retinopathy of prematurity (ROP) is a complex disease that is influenced by both genetic and environmental factors. Several small studies have found genetic variants in EPAS1, VEGF, SOD, and members of the WNT family in association with ROP. Design in gene ...
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Journal articleAm J Ophthalmol · December 2015
PURPOSE: To assess retinal nerve fiber layer (RNFL) thickness at term-equivalent age in very preterm (<32 weeks gestational age) vs term-born infant cohorts, and compare very preterm infant RNFL thickness with brain anatomy and neurodevelopment. DESIGN: Co ...
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Journal articleSemin Perinatol · December 2015
Sepsis is a major cause of neonatal morbidity and mortality, especially in vulnerable preterm populations. Immature immune defenses, and environmental and maternal factors contribute to this risk, with as many as a third of very preterm infants experiencin ...
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Journal articleEur Heart J Cardiovasc Imaging · November 2015
AIMS: Infants with persistent pulmonary hypertension of the newborn (PPHN) have elevated pulmonary vascular resistance that can lead to right ventricular (RV) failure and death. Clinicians must decide which infants will fail conventional therapy and requir ...
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Journal articleRetina · October 2015
PURPOSE: The authors relate posterior segment microanatomy from perinatal spectral domain optical coherence tomography to visual acuity, brain abnormalities, and neurodevelopment. METHODS: Thirteen infants (11 preterm and 2 term birth), imaged in the nurse ...
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Journal articleEarly 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 ...
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Journal articleJAMA · September 8, 2015
IMPORTANCE: Extremely preterm infants contribute disproportionately to neonatal morbidity and mortality. OBJECTIVE: To review 20-year trends in maternal/neonatal care, complications, and mortality among extremely preterm infants born at Neonatal Research N ...
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Journal articleAm J Perinatol · July 2015
OBJECTIVE: Congenital diaphragmatic hernia (CDH) is fatal in 20 to 40% of cases, largely due to pulmonary dysmaturity, lung hypoplasia, and persistent pulmonary hypertension. Evidence for survival benefit of inhaled nitric oxide (iNO), extracorporeal membr ...
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Journal articleAm J Perinatol · June 2015
OBJECTIVE: Infants with congenital heart disease (CHD) receiving prostaglandins (PGEs) may be at an increased risk for necrotizing enterocolitis (NEC). Enteral feeding may further increase the risk of NEC in these patients. We evaluated the incidence of NE ...
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Journal articlePediatrics · June 2015
BACKGROUND AND OBJECTIVES: Extremely preterm infants and infants born to adolescent mothers are at risk for adverse developmental. The objectives were to evaluate development and behavior outcomes of extremely low birth weight (ELBW) infants born to adoles ...
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Journal articleN Engl J Med · May 7, 2015
BACKGROUND: Between-hospital variation in outcomes among extremely preterm infants is largely unexplained and may reflect differences in hospital practices regarding the initiation of active lifesaving treatment as compared with comfort care after birth. M ...
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Journal articleJ 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 ...
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Journal articleOphthalmology · March 2015
PURPOSE: To evaluate the association between cystoid macular edema (CME) observed in very preterm infants and developmental outcomes at 18 to 24 months corrected age. DESIGN: Cohort study. PARTICIPANTS: Infants born at or less than 1500 g or at or less tha ...
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Journal articleArch Dis Child Fetal Neonatal Ed · March 2015
OBJECTIVE: To determine the association of arterial partial pressure of carbon dioxide PaCO2 with severe intraventricular haemorrhage (sIVH), bronchopulmonary dysplasia (BPD), and neurodevelopmental impairment (NDI) at 18-22 months in premature infants. DE ...
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Journal articleJ Pediatr · March 2015
OBJECTIVE: To identify single-nucleotide polymorphisms (SNPs) and pathways associated with bronchopulmonary dysplasia (BPD) because O2 requirement at 36 weeks' postmenstrual age risk is strongly influenced by heritable factors. STUDY DESIGN: A genome-wide ...
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Journal articleClin Perinatol · March 2015
In 2010, the Centers for Disease Control and Prevention (CDC) provided updated guidelines for prevention of perinatal group B streptococcus disease. In 2012, the American Academy of Pediatrics' Committee on the Fetus and Newborn (COFN) provided a clinical ...
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Journal articleN Engl J Med · January 22, 2015
BACKGROUND: Understanding the causes and timing of death in extremely premature infants may guide research efforts and inform the counseling of families. METHODS: We analyzed prospectively collected data on 6075 deaths among 22,248 live births, with gestat ...
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Journal articlePediatrics · January 2015
OBJECTIVE: To evaluate the effect of anaerobic antimicrobial therapy for necrotizing enterocolitis (NEC) on clinical outcomes in very low birth weight (≤1500 g) infants. METHODS: We identified very low birth weight infants with NEC from 348 US NICUs from 1 ...
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Journal articleDev Neurosci · 2015
Cerebral palsy (CP) has a significant impact on both patients and society, but therapy is limited. Human umbilical cord blood cells (HUCBC), containing various stem and progenitor cells, have been used to treat various brain genetic conditions. In small an ...
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Journal articleAm J Obstet Gynecol · January 2015
OBJECTIVE: Antenatal magnesium (anteMg) is used for various obstetric indications including fetal neuroprotection. Infants exposed to anteMg may be at risk for respiratory depression and delivery room (DR) resuscitation. The study objective was to compare ...
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Journal articleTrials · December 12, 2014
BACKGROUND: Inhaled nitric oxide (INO), a selective pulmonary vasodilator, has revolutionized the treatment of neonatal hypoxemic respiratory failure (NHRF). However, there is lack of sustained improvement in 30 to 46% of infants. Aerosolized prostaglandin ...
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Journal articleJ Perinatol · November 2014
OBJECTIVE: Evaluate spontaneous intestinal perforation (SIP)/death among extremely low birthweight (ELBW) infants before, during and after initiation of an antenatal magnesium for neuroprotection protocol (MgPro). STUDY DESIGN: We tested associations betwe ...
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Journal articleTher Drug Monit · October 2014
BACKGROUND: Population pharmacokinetic (popPK) models derived from small pharmacokinetics (PK) studies in neonates are often underpowered to detect clinically important characteristics that drive dosing. External validation of such models is crucial. In th ...
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Journal articleOphthalmology · September 2014
PURPOSE: To evaluate effects of prematurity on early optic nerve (ON) development and the usefulness of ON parameters as indicators of central nervous system (CNS) development and pathology. DESIGN: Prospective, cross-sectional, longitudinal study. PARTICI ...
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Journal articleInvest Ophthalmol Vis Sci · August 12, 2014
PURPOSE: To determine genetic variants associated with severe retinopathy of prematurity (ROP) in a candidate gene cohort study of US preterm infants. METHODS: Preterm infants in the discovery cohort were enrolled through the Eunice Kennedy Shriver Nationa ...
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Journal articleJ 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. ...
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Journal articleJ Pediatr · May 2014
OBJECTIVE: To assess feasibility and safety of providing autologous umbilical cord blood (UCB) cells to neonates with hypoxic-ischemic encephalopathy (HIE). STUDY DESIGN: We enrolled infants in the intensive care nursery who were cooled for HIE and had ava ...
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Journal articleEarly Hum Dev · May 2014
AIMS: The objective of this study is to determine the incidence of and risk factors for necrotizing enterocolitis (NEC) and transfusion-associated NEC (TANEC) in very-low-birth-weight (VLBW) infants pre/post implementation of a peri-transfusion feeding pro ...
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Journal articlePediatr Res · March 2014
BACKGROUND: Adults with the apolipoprotein E (APOE) gene alleles e4 and e2 are at high risk of poor neurological outcome after brain injury. The e4 allele has been associated with cerebral palsy (CP), and the e2 allele has been associated with worse neurol ...
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Journal articlePediatrics · February 2014
OBJECTIVE: Little is known about how very low birth weight (VLBW) affects survival and morbidities among infants with trisomy 13 (T13) or trisomy 18 (T18). We examined the care plans for VLBW infants with T13 or T18 and compared their risks of mortality an ...
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Journal articleNewborn and Infant Nursing Reviews · January 1, 2014
Neonatal encephalopathy, a condition resulting from perinatal asphyxia, occurs in 2.0-6.0 of every 1000 live births. Without treatment, prognosis is poor and resulting complications such as intellectual delay and cerebral palsy are often severe. Therapeuti ...
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Journal articlePediatr Res · December 2013
BACKGROUND: Myo-inositol given to preterm infants with respiratory distress has reduced death, increased survival without bronchopulmonary dysplasia, and reduced severe retinopathy of prematurity in two randomized trials. Pharmacokinetic (PK) studies in ex ...
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Journal articleBreastfeed 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 ...
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Journal articleJ Perinatol · August 2013
OBJECTIVE: To determine the effects of low-dose dopamine on urine output (UOP) in very low birth weight premature neonates. STUDY DESIGN: Retrospective cohort study of all low-dose (3-5 μg kg(-1) per min) dopamine infusions >24-h duration in neonates 1500 ...
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Journal articleJ Perinatol · August 2013
OBJECTIVE: Sepsis in older children and adults modifies immune system function. We compared serotype-specific antibody responses to heptavalent pneumococcal conjugate vaccine (PCV7) in very low birth weight infants (<1500 g,VLBWs) with and without blood st ...
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Journal articleBone Marrow Transplant · July 2013
Brain injury resulting from perinatal hypoxic-ischemic encephalopathy (HIE) is a major cause of acute mortality in infants and chronic neurologic disability in surviving children. Recent multicenter clinical trials demonstrated the effectiveness of hypothe ...
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Journal articlePediatrics · July 2013
OBJECTIVE: To examine factors affecting center differences in mortality for extremely low birth weight (ELBW) infants. METHODS: We analyzed data for 5418 ELBW infants born at 16 Neonatal Research Network centers during 2006-2009. The primary outcomes of ea ...
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Journal articleJ Pediatr · June 2013
OBJECTIVES: To describe and compare the incidence of late-onset sepsis (LOS) and demographic and clinical characteristics associated with LOS in very low birth weight (VLBW) infants from singleton and multiple births, and to examine the heritability of sus ...
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Journal articleJ Pediatr · May 2013
OBJECTIVE: To examine whether preterm very low birth weight (VLBW) infants have an increased risk of late-onset sepsis (LOS) following early-onset sepsis (EOS). STUDY DESIGN: Retrospective analysis of VLBW infants (401-1500 g) born September 1998 through D ...
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Journal articleCurr Opin Pediatr · April 2013
PURPOSE OF REVIEW: Clinicians' adherence to the Centers for Disease Control guidelines to prevent group B Streptococcus (GBS) early-onset sepsis (EOS) has reduced GBS EOS. Although evidence-based testing and empirical antibiotic initiation are likely savin ...
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Journal articleJ Pediatr Surg · April 2013
OBJECTIVE: Determine predictors of neurocognitive outcome in early school age congenital diaphragmatic hernia (CDH) survivors. STUDY DESIGN: Prospective study of infants with CDH at Duke University Medical Center. Neurocognitive delay (NCD) at school age ( ...
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Journal articleJ Perinatol · January 2013
OBJECTIVE: To determine whether death and/or neurodevelopmental impairment (NDI) after severe intracranial hemorrhage (ICH; grade 3 or 4) differs by gestational age (GA) at birth in extremely low birth weight (ELBW) infants. STUDY DESIGN: Demographic, peri ...
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Journal articlePediatr Cardiol · December 2012
Little is known about the outcomes of extremely low birth weight (ELBW) preterm infants with congenital heart defects (CHDs). The aim of this study was to assess the mortality, morbidity, and early childhood outcomes of ELBW infants with isolated CHD compa ...
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Journal articleEarly Hum Dev · November 2012
BACKGROUND: Very low birth weight neonates (≤ 1500 g, VLBWs) have a high rate of infection and distinct baseline immune function compared with more mature populations. In critically ill children and adults, sepsis increases subsequent infection risk. It is ...
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Journal articleJ Pediatr · August 2012
OBJECTIVE: To assess the impact of empiric antifungal therapy for invasive candidiasis on subsequent outcomes in premature infants. STUDY DESIGN: This was a cohort study of infants with a birth weight ≤ 1000 g receiving care at Neonatal Research Network si ...
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Journal articlePediatrics · June 2012
OBJECTIVE: We sought to determine if a center's approach to care of premature infants at the youngest gestational ages (22-24 weeks' gestation) is associated with clinical outcomes among infants of older gestational ages (25-27 weeks' gestation). METHODS: ...
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Journal articleArch Ophthalmol · May 2012
OBJECTIVE: To investigate whether the severity of cystoid macular edema (CME) in neonates who were 31 to 36 weeks' postmenstrual age, as viewed by spectral-domain optical coherence tomography (SD-OCT)imaging, predicts the severity of retinopathy of prematu ...
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Journal articleClin Perinatol · March 2012
Neonatal sepsis causes significant morbidity and mortality, especially in preterm infants. Clinicians are compelled to treat with empiric antibiotics at the first signs of suspected sepsis. Broad-spectrum antibiotics and prolonged treatment with empiric an ...
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Journal articleClin Perinatol · March 2012
Pharmacotherapy for gastroesophageal reflux (GER) in neonates, aimed at interfering with this physiologic process and potentially reducing the negative sequelae that providers often attribute to GER, consists primarily of drugs that increase the viscosity ...
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Journal articleClin Infect Dis · February 1, 2012
BACKGROUND: Candidiasis carries a significant risk of death or neurodevelopmental impairment (NDI) in extremely low birth weight infants (ELBW; <1000 g). We sought to determine the impact of candiduria in ELBW preterm infants. METHODS: Our study was a seco ...
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Journal articleOphthalmology · December 2011
PURPOSE: To determine the dynamic morphologic development of the human fovea in vivo using portable spectral domain-optical coherence tomography (SD-OCT). DESIGN: Prospective, observational case series. PARTICIPANTS: Thirty-one prematurely born neonates, 9 ...
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Journal articleRetina · September 2011
PURPOSE: To compare vitreoretinal pathology imaged with portable handheld spectral-domain optical coherence tomography (SD-OCT) to conventional indirect ophthalmoscopic examination in neonates undergoing screening for retinopathy of prematurity. METHODS: S ...
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Journal articleNeoreviews · August 1, 2011
Management of congenital diaphragmatic hernia (CDH) remains challenging. Despite advances in technologic and therapeutic strategies such as high-frequency mechanical ventilation, inhaled nitric oxide (iNO), and delayed surgical repair, the condition contin ...
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Journal articleAm J Respir Crit Care Med · June 15, 2011
RATIONALE: Benefits of identifying risk factors for bronchopulmonary dysplasia in extremely premature infants include providing prognostic information, identifying infants likely to benefit from preventive strategies, and stratifying infants for clinical t ...
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Journal articleJ Perinatol · June 2011
OBJECTIVE: The purpose of this study is to examine the results of repeat lumbar puncture in infants with initial positive cerebrospinal fluid (CSF) cultures in order to determine the clinical characteristics and outcomes of infants with repeat positive cul ...
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Journal articleEarly Hum Dev · May 2011
BACKGROUND: Patent ductus arteriosus is a common occurrence among prematurely born neonates and is believed to play a role in the development of other complications of prematurity including intraventricular hemorrhage, bronchopulmonary dysplasia, and necro ...
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Journal articleJ 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 ...
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Journal articleJ AAPOS · February 2011
We present a case of bilateral severe retinal edema with subretinal fluid in an infant diagnosed with neonatal hemochromatosis and liver failure. A macular cherry-red spot in each eye mimicked the clinical appearance of many metabolic storage diseases. Bot ...
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Journal articlePLoS One · 2011
Extremely low birth weight (ELBW) infants have high morbidity and mortality, frequently due to invasive infections from bacteria, fungi, and viruses. The microbial communities present in the gastrointestinal tracts of preterm infants may serve as a reservo ...
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Journal articleJ Perinatol · October 2010
Intravenous immunoglobulin (IVIg) has been evaluated as an adjunctive therapy for neonatal sepsis with modest clinical success despite strong biological plausibility. Multiple factors contribute to this outcome, but perhaps none greater than the limited im ...
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Journal articleJ 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 ...
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Journal articleJ Pediatr Surg · June 2010
PURPOSE: Variable approaches to the care of infants with congenital diaphragmatic hernia (CDH) by multiple providers may contribute to inconsistent care. Our institution developed a comprehensive evidence-based protocol to standardize the management of CDH ...
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Journal articleJ Perinatol · June 2010
OBJECTIVE: Determine associations between left vocal cord paralysis (LVCP) and poor respiratory, feeding and/or developmental outcomes in extremely low birth weight (ELBW) infants following surgical closure of a patent ductus arteriosus (PDA). STUDY DESIGN ...
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Journal articleN Engl J Med · May 27, 2010
BACKGROUND: Previous studies have suggested that the incidence of retinopathy is lower in preterm infants with exposure to reduced levels of oxygenation than in those exposed to higher levels of oxygenation. However, it is unclear what range of oxygen satu ...
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Journal articleN Engl J Med · May 27, 2010
BACKGROUND: There are limited data to inform the choice between early treatment with continuous positive airway pressure (CPAP) and early surfactant treatment as the initial support for extremely-low-birth-weight infants. METHODS: We performed a randomized ...
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Journal articleAm J Perinatol · May 2010
We compared the rates of medical closure of patent ductus arteriosus (PDA) and complications (renal dysfunction, necrotizing enterocolitis, spontaneous intestinal perforation, and intraventricular hemorrhage) between infants treated with indomethacin and i ...
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Journal articleInvest Ophthalmol Vis Sci · May 2010
PURPOSE: To describe age-related considerations and methods to improve hand-held spectral domain optical coherence tomography (HH-SD OCT) imaging of eyes of neonates, infants, and children. METHODS: Based on calculated optical parameters for neonatal and i ...
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Journal articleJ Pediatr Surg · April 2010
BACKGROUND/PURPOSE: Congenital diaphragmatic hernia (CDH) is associated with mortality of 10% to 50%. Several investigators have reported outcomes from centers using high-frequency oscillatory ventilation in their management of CDH, but there are no recent ...
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Journal articleSemin Perinatol · April 2010
Expansion of newborn screening for inherited metabolic disorders using tandem mass spectrometry has generated interest in screening for other treatable conditions, including lysosomal storage diseases. Limitations to expansion include labor and equipment c ...
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Journal articleJ Perinatol · April 2010
OBJECTIVE: Our aim was to determine the incidence of anatomical abnormalities after a urinary tract infection (UTI) in infants <2 months of age hospitalized in the neonatal intensive care unit (NICU). STUDY DESIGN: This was a retrospective, single-center c ...
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Journal articleJ Pediatr · April 2010
OBJECTIVE: To evaluate the health benefits of an exclusively human milk-based diet compared with a diet of both human milk and bovine milk-based products in extremely premature infants. STUDY DESIGN: Infants fed their own mothers' milk were randomized to 1 ...
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Journal articleExpert Rev Obstet Gynecol · March 1, 2010
Moderate to severe hypoxic-ischemic injury in newborn infants, manifested as encephalopathy immediately or within hours after birth, is associated with a high risk of either death or a lifetime with disability. In recent multicenter clinical trials, hypoth ...
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Journal articlePediatrics · January 2010
BACKGROUND: As extremely preterm infant mortality rates have decreased, concerns regarding resource use have intensified. Accurate models for predicting time to hospital discharge could aid in resource planning, family counseling, and stimulate quality-imp ...
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Journal articlePediatr Infect Dis J · December 2009
BACKGROUND: Preterm birth is increasing worldwide, and late preterm births, which comprise more than 70% of all preterm births, account for much of the increase. Early and late onset sepsis results in significant mortality in extremely preterm infants, but ...
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Journal articleEarly Hum Dev · October 2009
OBJECTIVE: Describe cerebrospinal fluid parameters in infants with culture-proven Group B streptococcal meningitis in the era of intrapartum antibiotic prophylaxis. STUDY DESIGN: Cohort study of the first lumbar puncture from 13,495 infants cared for at 15 ...
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Journal articleJ Perinatol · May 2009
OBJECTIVE: Our aim was to assess the safety and efficacy of transpyloric tube feeding as a therapeutic option to reduce apnea and bradycardia in hospitalized very low birthweight (VLBW) infants with clinical signs suggestive of gastroesophageal reflux (GER ...
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Journal articlePediatrics · January 2009
OBJECTIVES: Our objectives were to identify factors associated with the duration of the first antibiotic course initiated in the first 3 postnatal days and to assess associations between the duration of the initial antibiotic course and subsequent necrotiz ...
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Journal articlePediatr Infect Dis J · December 2008
BACKGROUND: Cerebrospinal fluid (CSF) findings are often used to diagnose meningitis in neonates given antibiotics before the lumbar puncture is performed. Traumatic lumbar punctures are common and complicate interpretation of CSF white blood cell counts. ...
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Journal articleJ Perinatol · November 2008
Surgical closure of a patent ductus arteriosus (PDA) continues to be a frequent procedure among extremely preterm infants. Recent evidence indicates surgical closure is associated with worse outcomes than after medical closure. Left vocal fold paralysis is ...
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Journal articleN Engl J Med · October 30, 2008
BACKGROUND: It is unclear whether aggressive phototherapy to prevent neurotoxic effects of bilirubin benefits or harms infants with extremely low birth weight (1000 g or less). METHODS: We randomly assigned 1974 infants with extremely low birth weight at 1 ...
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Journal articleInfect Control Hosp Epidemiol · August 2008
OBJECTIVE: To estimate the risk of bloodstream infection associated with catheter dwell time in infants. DESIGN: Retrospective study. SETTING: Duke University Medical Center neonatal intensive care unit, an academic, level 3 nursery in Durham, North Caroli ...
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Journal articleThromb Res · 2008
INTRODUCTION: Peripherally inserted catheters are essential for infants in the neonatal intensive care nursery for administration of medications, parenteral nutrition and blood transfusions. We hypothesized that there is an association between catheter ass ...
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Journal articlePediatrics · January 2008
OBJECTIVES: Our goals were (1) to determine the use of medications to treat gastroesophageal reflux in extremely low birth weight infants (birth weight of < 1000 g) at discharge; (2) to identify risk factors associated with the use of medications to treat ...
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Journal articleNeonatology · 2008
BACKGROUND: Calprotectin is a cytosolic component of neutrophils. Fecal calprotectin (FC) level is a useful marker for exacerbation of inflammatory bowel disease in children. FC may be a useful marker for necrotizing enterocolitis (NEC). OBJECTIVE: To dete ...
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Journal articleJ Pediatr Surg · November 2007
BACKGROUND/PURPOSE: Infants with enterostomies frequently have signs of short bowel syndrome. Our goal was to assess the effect of dietary lipids on ostomy output and weight gain in infants with enterostomies. METHODS: We reviewed the medical records of 10 ...
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Journal articleJ Neurosurg · September 2007
OBJECT: Infection is a common and potentially devastating complication following placement of ventriculoperitoneal (VP) shunts and cerebrospinal fluid (CSF) reservoirs in neonates. The goal of this study was to determine the normal ranges for cell count pa ...
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Journal articleJ Perinatol · September 2007
OBJECTIVES: Recent reports suggest that specific care strategies improve survival of infants with congenital diaphragmatic hernia (CDH). This review presents details of care from centers reporting high rates of survival among CDH infants. STUDY DESIGN: We ...
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Journal articleSemin Pediatr Surg · May 2007
Most infants with congenital diaphragmatic hernia (CDH) require respiratory support. The goal of this report is to present an overview of mechanical ventilation strategies in the management of infants with CDH. The anatomic and physiologic limitations in t ...
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Journal articleJ Perinatol · February 2007
Candidemia is common in extremely low birth weight infants and is associated with substantial mortality and morbidity. Treatment options have traditionally been limited to amphotericin B deoxycholate or fluconazole. We present a case of a premature infant ...
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Journal articleJ Perinatol · February 2007
OBJECTIVE: The purpose of this study was to examine the frequency of normal cerebrospinal fluid (CSF) parameters in Candida meningitis and the proportion of candidemia associated with Candida meningitis. STUDY DESIGN: We evaluated the initial lumbar punctu ...
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Journal articlePediatrics · August 2006
OBJECTIVES: Previous studies have shown that incidence of invasive candidiasis varies substantially among centers, and previous use of broad-spectrum antibiotics is a risk factor for candidiasis in extremely low birth-weight infants. Differences in center ...
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Journal articleJ Perinatol · June 2006
Intestinal malrotation is a relatively uncommon condition with diverse outcomes. Familiarity with variations in the presentation of malrotation is imperative as early diagnosis and prompt subsequent surgical intervention are essential to optimizing outcome ...
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Journal articleJ Perinatol · May 2006
OBJECTIVES: Very low birth weight (VLBW) infants are vulnerable to nosocomial infections and subsequent morbidity; including infections caused by Staphylococcus aureus: 85% of nosocomial S. aureus infections are caused by capsular polysaccharide (CPS) type ...
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Journal articleJ Pediatr Surg · April 2006
BACKGROUND AND PURPOSE: Prenatal corticosteroids have been used in fetuses with congenital diaphragmatic hernia (CDH). We tested the utility of steroids by 2 methods. METHODS: Mothers carrying fetuses with CDH were randomized to 3 weekly doses of betametha ...
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Journal articlePediatrics · April 2006
BACKGROUND: Meningitis is a substantial cause of morbidity and mortality in neonates. Clinicians frequently use the presence of positive blood cultures to determine whether neonates should undergo lumbar puncture. Abnormal cerebrospinal fluid (CSF) paramet ...
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Journal articlePediatrics · February 2006
OBJECTIVE: We sought to determine if an association exists between the use of histamine-2 receptor (H2) blockers and the incidence of necrotizing enterocolitis (NEC) in infants of 401 to 1500 g in birth weight. STUDY DESIGN: Data from the National Institut ...
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Journal articleJ Perinatol · February 2006
OBJECTIVE: Neonatal meningitis is an illness with potentially devastating consequences. Early identification of potential risk factors for Gram-negative rod (GNR) infections versus Gram-positive cocci (GPC) infection prior to obtaining final culture result ...
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Journal articleN Engl J Med · October 13, 2005
BACKGROUND: Hypothermia is protective against brain injury after asphyxiation in animal models. However, the safety and effectiveness of hypothermia in term infants with encephalopathy is uncertain. METHODS: We conducted a randomized trial of hypothermia i ...
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Journal articleJ Perinatol · October 2005
OBJECTIVE: The first objective was to identify factors associated with prolonged hospital stay (PHS: hospitalized >42 weeks postmenstrual age) in extremely premature (EP: born less than or equal to 28 weeks gestation) infants. The second objective was to i ...
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Journal articleJ Perinatol · March 2004
OBJECTIVE: To describe survival following nosocomial bloodstream infections and quantify excess mortality associated with positive blood culture. STUDY DESIGN: Multicenter cohort study of premature infants. RESULTS: First blood culture was negative for 464 ...
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Journal articleJ Perinatol · March 2004
BACKGROUND: Neonatal nosocomial Gram-negative rod bacteremia (GNR-b) is considered ominous. DESIGN: Multi-center cohort study of premature infants (N=6172) who had a blood culture after day of life 3 and whose birthweight was < or =1250 g. RESULTS: A total ...
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Journal articleRespir Care Clin N Am · December 2001
Despite improvements in respiratory care, ventilator-induced lung injury remains an important cause of morbidity and mortality in neonates who require assisted ventilation. Animal data clearly demonstrate that high-frequency ventilation can be used success ...
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Journal articlePediatrics · June 2001
OBJECTIVES: Physicians who treat neonates who become bacteremic while dependent on central venous catheters face a serious and common dilemma. We sought 1) to evaluate the relationship between central venous catheter removal and outcome in bacteremic neona ...
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