Scholars@Duke
Noelle Elizabeth Younge

Noelle Elizabeth Younge

Jean and George W. Brumley, Jr., M.D. Assistant Professor of Pediatrics
Pediatrics, Neonatology
noelle.younge@duke.edu
2400 Pratt St, DUMC Box 2739, Durham, NC 27705

Selected Publications

Risk Assessment of Cognitive Impairment at 2 Years of Age in Infants Born Extremely Preterm Using the INTERGROWTH-21st Growth Standards.

Journal Article J Pediatr · August 19, 2024 OBJECTIVE: To assess the risk of cognitive impairment among infants born extremely preterm using the INTERGROWTH-21st standards. STUDY DESIGN: We analyzed anthropometric data at birth and 36 weeks postmenstrual age (PMA) from infants born extremely preterm ... Full text Link to item Cite

Indomethacin Prophylaxis in Preterm Infants: Changes over Time.

Journal Article Am 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 ... Full text Link to item Cite

Influence of infant microbiome on health and development.

Journal Article Clin Exp Pediatr · May 2024 The microbiome is a complex ecosystem comprising microbes, their genomes, and the surrounding environment. The microbiome plays a critical role in early human development, including maturation of the host immune system and gastrointestinal tract. Multiple ... Full text Link to item Cite

Neonatal Necrotizing Enterocolitis: An Update on Pathophysiology, Treatment, and Prevention.

Journal Article Paediatric drugs · May 2024 Necrotizing enterocolitis (NEC) is a life-threatening disease predominantly affecting premature and very low birth weight infants resulting in inflammation and necrosis of the small bowel and colon and potentially leading to sepsis, peritonitis, perforatio ... Full text Cite

Risk factors and epidemiology of spontaneous intestinal perforation among infants born at 22-24 weeks' gestational age.

Journal Article J Perinatol · January 2024 OBJECTIVE: To describe the epidemiology, risk factors, and timing of spontaneous intestinal perforation (SIP) among infants born at 22-24 weeks' gestational age (GA). STUDY DESIGN: Observational cohort study among infants born at 22-24 weeks' GA in 446 neo ... Full text Link to item Cite

A pilot study of fecal pH and redox as functional markers in the premature infant gut microbiome.

Journal Article PLoS One · 2024 The infant gut microbiome is a crucial factor in health and development. In preterm infants, altered gut microbiome composition and function have been linked to serious neonatal complications such as necrotizing enterocolitis and sepsis, which can lead to ... Full text Link to item Cite

The skin microbiota of preterm infants and impact of diaper change frequency.

Journal Article PLoS One · 2024 OBJECTIVE: To evaluate the impact of diaper change frequency, clinical characteristics, and skin health metrics on development of the skin microbiota in preterm infants. DESIGN: A randomized controlled parallel design was used. METHODS: Medically stable pr ... Full text Link to item Cite

Human milk fortification and use of infant formulas to support growth in the neonatal intensive care unit.

Journal Article Nutr Clin Pract · October 2023 Newborn infants require adequate nutrition to achieve full potential growth and development. Early life nutrition and health impacts long-term outcomes through adulthood. Human milk is the optimal source of nutrition during the first 6 months of life. Howe ... Full text Link to item Cite

Hormonal Determinants of Growth and Weight Gain in the Human Fetus and Preterm Infant.

Journal Article Nutrients · September 18, 2023 The factors controlling linear growth and weight gain in the human fetus and newborn infant are poorly understood. We review here the changes in linear growth, weight gain, lean body mass, and fat mass during mid- and late gestation and the early postnatal ... Full text Link to item Cite

20-αHydroxycholesterol, an oxysterol in human breast milk, reverses mouse neonatal white matter injury through Gli-dependent oligodendrogenesis.

Journal Article Cell Stem Cell · August 3, 2023 White matter injuries (WMIs) are the leading cause of neurologic impairment in infants born premature. There are no treatment options available. The most common forms of WMIs in infants occur prior to the onset of normal myelination, making its pathophysio ... Full text Link to item Cite

Antenatal Steroids, Prophylactic Indomethacin, and the Risk of Spontaneous Intestinal Perforation.

Journal Article J Pediatr · August 2023 OBJECTIVE: To estimate if the odds of spontaneous intestinal perforation (SIP) are increased when antenatal steroids (ANS) given close to delivery are combined with indomethacin on day 1 after birth (Indo-D1). STUDY DESIGN: A retrospective cohort study usi ... Full text Link to item Cite

The effect of sex on retinopathy of prematurity severity among premature mixed-sex multiple gestation infants.

Journal Article J AAPOS · June 2023 This retrospective study of 68 premature infants examined whether there was a difference between male and female mixed-sex multiple gestation infants with regard to stage of retinopathy of prematurity (ROP) developed or need for ROP treatment. We found tha ... Full text Link to item Cite

The gestational membrane microbiome in the presence or absence of intraamniotic infection.

Journal Article Am J Obstet Gynecol MFM · March 2023 BACKGROUND: Data regarding the microbiome of the gestational membranes are emerging and conflicting. Shifts in the microbial communities in the setting of labor, rupture of membranes, and intraamniotic infection are yet to be understood. OBJECTIVE: This st ... Full text Link to item Cite

Associations between systemic health and retinal nerve fibre layer thickness in preterm infants at 36 weeks postmenstrual age.

Journal Article Br 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 ... Full text Link to item Cite

Indomethacin Prophylaxis in Preterm Infants: Changes over Time.

Journal Article Am 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 ... Full text Link to item Cite

The gut microbiome of extremely preterm infants randomized to the early progression of enteral feeding.

Journal Article Pediatr Res · September 2022 BACKGROUND: Early progression of feeding could influence the development of the gut microbiome. METHODS: We collected fecal samples from extremely preterm infants randomized to receive either early (feeding day 2) or delayed (feeding day 5) feeding progres ... Full text Link to item Cite

Association of Antenatal Steroid Exposure at 21 to 22 Weeks of Gestation With Neonatal Survival and Survival Without Morbidities.

Journal Article JAMA Netw Open · September 1, 2022 IMPORTANCE: The provision of antenatal corticosteroids to pregnant patients at gestational age (GA) 22 6/7 weeks or less remains controversial and lacks support from randomized clinical trials. OBJECTIVE: To compare rates of survival and survival without m ... Full text Link to item Cite

Longitudinal medical needs for periviable NICU survivors.

Journal Article Early Hum Dev · June 2022 OBJECTIVE: To evaluate the technologies required, medications needed, and early intervention services utilized from discharge to 12 months post-discharge for periviable infants (22 0/7 to 24 6/7 weeks gestational age) followed in a comprehensive NICU follo ... Full text Link to item Cite

Impact of diaper change frequency on preterm infants' vital sign stability and skin health: A RCT.

Journal Article Early Hum Dev · January 2022 BACKGROUND: Bundling nurse caregiving interventions are promoted to minimize infant stress. PURPOSE: To evaluate impact of bundled nursing care and diaper change frequency on vital sign stability and skin health of preterm infants born ≤32 weeks gestation. ... Full text Link to item Cite

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

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

The Pediatric Obesity Microbiome and Metabolism Study (POMMS): Methods, Baseline Data, and Early Insights.

Journal Article Obesity (Silver Spring) · March 2021 OBJECTIVE: The purpose of this study was to establish a biorepository of clinical, metabolomic, and microbiome samples from adolescents with obesity as they undergo lifestyle modification. METHODS: A total of 223 adolescents aged 10 to 18 years with BMI ≥9 ... Full text Open Access Link to item Cite

Medications and in-hospital outcomes in infants born at 22-24 weeks of gestation.

Journal Article J Perinatol · May 2020 OBJECTIVE: To evaluate the most commonly used medications and in-hospital morbidities and mortality in infants born 22-24 weeks of gestation. STUDY DESIGN: Multicenter retrospective cohort study of infants born 22-24 weeks of gestation (2006-2016), without ... Full text Link to item Cite

Assessment of an Updated Neonatal Research Network Extremely Preterm Birth Outcome Model in the Vermont Oxford Network.

Journal Article JAMA Pediatr · May 1, 2020 IMPORTANCE: The Eunice Kennedy Shriver National Institute of Child Health and Human Development Neonatal Research Network (NRN) extremely preterm birth outcome model is widely used for prognostication by practitioners caring for families expecting extremel ... 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

Fetal exposure to the maternal microbiota in humans and mice.

Journal Article JCI Insight · October 3, 2019 Previous studies have demonstrated the presence of microbial DNA in the fetal environment. However, it remains unclear whether this DNA represents viable bacteria and how it relates to the maternal microbiota across body sites. We studied the microbiota of ... Full text Link to item Cite

Neurodevelopmental Outcomes of Preterm Infants With Retinopathy of Prematurity by Treatment.

Journal Article Pediatrics · August 2019 OBJECTIVE: Among extremely preterm infants, we evaluated whether bevacizumab therapy compared with surgery for retinopathy of prematurity (ROP) is associated with adverse outcomes in early childhood. METHODS: This study was a retrospective analysis of pros ... Full text Link to item Cite

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

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

Early-life skin microbiota in hospitalized preterm and full-term infants.

Journal Article Microbiome · May 31, 2018 BACKGROUND: The infant skin microbiota may serve as a reservoir of bacteria that contribute to neonatal infections and stimulate local and systemic immune development. The objectives of our study were to characterize the skin microbiota of preterm and full ... Full text Link to item Cite

Novel pathogenic variants in FOXP3 in fetuses with echogenic bowel and skin desquamation identified by ultrasound.

Journal Article Am J Med Genet A · May 2017 Immunodysregulation, Polyendocrinopathy, Enteropathy, X-linked (IPEX) syndrome is a rare, X-linked recessive disease that affects regulatory T cells (Tregs) resulting in diarrhea, enteropathy, eczema, and insulin-dependent diabetes mellitus. IPEX syndrome ... Full text Link to item Cite

Survival and Neurodevelopmental Outcomes among Periviable Infants.

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

Enteral High Fat-Polyunsaturated Fatty Acid Blend Alters the Pathogen Composition of the Intestinal Microbiome in Premature Infants with an Enterostomy.

Journal Article J Pediatr · February 2017 OBJECTIVE: To determine the effect of enteral fish oil and safflower oil supplementation on the intestinal microbiome in infants with an enterostomy born premature. STUDY DESIGN: Infants with an enterostomy born premature were randomized to receive early e ... Full text Link to item Cite

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

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

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

The relationship of poor linear growth velocity with neonatal illness and two-year neurodevelopment in preterm infants.

Journal Article Neonatology · 2012 BACKGROUND: Poor postnatal weight gain in very low birth weight (VLBW) preterm infants has been shown to have a negative effect on neurodevelopment. However, the dose-dependent neurodevelopmental consequences of linear stunting in this population have not ... Full text Link to item Cite

Body composition changes in preterm infants following hospital discharge: comparison with term infants.

Journal Article J Pediatr Gastroenterol Nutr · September 2011 BACKGROUND AND OBJECTIVES: Infants experiencing catch-up growth devote a greater proportion of their energy to fat deposition, potentially at the expense of gains in lean body mass. The objective of the present study was to compare the body composition of ... Full text Link to item Cite