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151. Association of prenatal modifiable risk factors with attention-deficit hyperactivity disorder outcomes at age 10 and 15 in an extremely low gestational age cohort

Author

Cochran, David M., Jensen, Elizabeth T., Frazier, Jean A., Jalnapurkar, Isha, Kim, Sohye, Roell, Kyle R., Joseph, Robert M., Hooper, Stephen R., Santos Jr., Hudson P., Kuban, Karl C. K., Fry, Rebecca C., and O’Shea, T. Michael

Subjects
Behavioral Neuroscience, Psychiatry and Mental health, Neuropsychology and Physiological Psychology, Neurology, Biological Psychiatry
Abstract

BackgroundThe increased risk of developing attention-deficit hyperactivity disorder (ADHD) in extremely preterm infants is well-documented. Better understanding of perinatal risk factors, particularly those that are modifiable, can inform prevention efforts.MethodsWe examined data from the Extremely Low Gestational Age Newborns (ELGAN) Study. Participants were screened for ADHD at age 10 with the Child Symptom Inventory-4 (N = 734) and assessed at age 15 with a structured diagnostic interview (MINI-KID) to evaluate for the diagnosis of ADHD (N = 575). We studied associations of pre-pregnancy maternal body mass index (BMI), pregestational and/or gestational diabetes, maternal smoking during pregnancy (MSDP), and hypertensive disorders of pregnancy (HDP) with 10-year and 15-year ADHD outcomes. Relative risks were calculated using Poisson regression models with robust error variance, adjusted for maternal age, maternal educational status, use of food stamps, public insurance status, marital status at birth, and family history of ADHD. We defined ADHD as a positive screen on the CSI-4 at age 10 and/or meeting DSM-5 criteria at age 15 on the MINI-KID. We evaluated the robustness of the associations to broadening or restricting the definition of ADHD. We limited the analysis to individuals with IQ ≥ 70 to decrease confounding by cognitive functioning. We evaluated interactions between maternal BMI and diabetes status. We assessed for mediation of risk increase by alterations in inflammatory or neurotrophic protein levels in the first week of life.ResultsElevated maternal BMI and maternal diabetes were each associated with a 55–65% increase in risk of ADHD, with evidence of both additive and multiplicative interactions between the two exposures. MSDP and HDP were not associated with the risk of ADHD outcomes. There was some evidence for association of ADHD outcomes with high levels of inflammatory proteins or moderate levels of neurotrophic proteins, but there was no evidence that these mediated the risk associated with maternal BMI or diabetes.ConclusionContrary to previous population-based studies, MSDP and HDP did not predict ADHD outcomes in this extremely preterm cohort, but elevated maternal pre-pregnancy BMI, maternal diabetes, and perinatal inflammatory markers were associated with increased risk of ADHD at age 10 and/or 15, with positive interaction between pre-pregnancy BMI and maternal diabetes.

Published
2022
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155. Extremely low gestational age and very low birthweight for gestational age are risk factors for autism spectrum disorder in a large cohort study of 10-year-old children born at 23-27 weeks’ gestation

Author

Ware, Janice, Coster, Taryn, Henson, Brandi, Wilson, Rachel, McGhee, Kirsten, Lee, Patricia, Asgarian, Aimee, Sadhwani, Anjali, Perrin, Ellen, Neger, Emily, Mattern, Kathryn, Walkowiak, Jenifer, Barron, Susan, Frazier, Jean, Venuti, Lauren, Powers, Beth, Foley, Ann, Dessureau, Brian, Wood, Molly, Damon-Minow, Jill, Ehrenkranz, Richard, Benjamin, Jennifer, Romano, Elaine, Tsatsanis, Kathy, Chawarska, Katarzyna, Kim, Sophy, Dieterich, Susan, Bearrs, Karen, O’Shea, T. Michael, Peters, Nancy, Brown, Patricia, Ansusinha, Emily, Waldrep, Ellen, Friedman, Jackie, Hounshell, Gail, Allred, Debbie, Engelke, Stephen C., Darden-Saad, Nancy, Stainback, Gary, Warner, Diane, Wereszczak, Janice, Bernhardt, Janice, McKeeman, Joni, Meyer, Echo, Pastyrnak, Steve, Burdo-Hartman, Wendy, Rathbun, Julie, Nota, Sarah, Crumb, Teri, Lenski, Madeleine, Weiland, Deborah, Lloyd, Megan, Hunter, Scott, Msall, Michael, Ramoskaite, Rugile, Wiggins, Suzanne, Washington, Krissy, Martin, Ryan, Prendergast, Barbara, Scott, Megan, Klarr, Judith, Kring, Beth, DeRidder, Jennifer, Vogt, Kelly, Joseph, Robert M., Korzeniewski, Steven J., Allred, Elizabeth N., Heeren, Tim, Frazier, Jean A., Hirtz, Deborah, Leviton, Alan, and Kuban, Karl

Published
2017
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156. Neurodevelopmental profiles of infants born <30 weeks gestation at 2 years of age

Author

Camerota, Marie, primary, McGowan, Elisabeth C., additional, Hofheimer, Julie A., additional, O’Shea, T. Michael, additional, Carter, Brian S., additional, Helderman, Jennifer B., additional, Check, Jennifer, additional, Neal, Charles R., additional, Pastyrnak, Steven L., additional, Smith, Lynne M., additional, Loncar, Cynthia M., additional, Sheinkopf, Stephen J., additional, Dansereau, Lynne M., additional, DellaGrotta, Sheri A., additional, and Lester, Barry M., additional

Published
2021
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157. Differential placental CpG methylation is associated with chronic lung disease of prematurity

Author

Jackson, Wesley M., primary, Santos, Hudson P., additional, Hartwell, Hadley J., additional, Gower, William Adam, additional, Chhabra, Divya, additional, Hagood, James S., additional, Laughon, Matthew M., additional, Payton, Alexis, additional, Smeester, Lisa, additional, Roell, Kyle, additional, O’Shea, T. Michael, additional, and Fry, Rebecca C., additional

Published
2021
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158. Association between Term Equivalent Brain Magnetic Resonance Imaging and 2-Year Outcomes in Extremely Preterm Infants: A Report from the Preterm Erythropoietin Neuroprotection Trial Cohort

Author

Mayock, Dennis E., primary, Gogcu, Semsa, additional, Puia-Dumitrescu, Mihai, additional, Shaw, Dennis W.W., additional, Wright, Jason N., additional, Comstock, Bryan A., additional, Heagerty, Patrick J., additional, Juul, Sandra E., additional, Wadhawan, Rajan, additional, Courtney, Sherry E., additional, Robinson, Tonya, additional, Ahmad, Kaashif A., additional, Bendel-Stenzel, Ellen, additional, Baserga, Mariana, additional, LaGamma, Edmund F., additional, Downey, L. Corbin, additional, Rao, Raghavendra, additional, Fahim, Nancy, additional, Lampland, Andrea, additional, Frantz, Ivan D., additional, Khan, Janine, additional, Weiss, Michael, additional, Gilmore, Maureen M., additional, Ohls, Robin K., additional, Lowe, Jean, additional, Srinivasan, Nishant, additional, Perez, Jorge E., additional, McKay, Victor, additional, Thomas, Billy, additional, Elhassan, Nahed, additional, Mulkey, Sarah, additional, Vijayamadhavan, Vivek K., additional, Mulrooney, Neil, additional, Yoder, Bradley, additional, Kase, Jordan S., additional, Check, Jennifer, additional, Osterholm, Erin, additional, George, Thomas, additional, Georgieff, Michael, additional, Martin, Camilia R., additional, O'Reilly, Deirdre, additional, deRegnier, Raye-Ann, additional, Porta, Nicolas, additional, Bazacliu, Catalina, additional, Northington, Frances, additional, Valdez, Raul Chavez, additional, Saurabhkumar, Patel, additional, Diaz-Barbosa, Magaly, additional, Richards, Todd, additional, Feltner, John B., additional, Esposito, Isabella, additional, Hauge, Stephanie, additional, Nikirk, Samantha, additional, Silvia, Amy, additional, Clopp, Bailey, additional, Ott, Debbie, additional, Mora, Ariana Franco, additional, Hedrick, Pamela, additional, Flynn, Vicki, additional, Wyatt, Andrea, additional, Loy, Emilie, additional, Sikes, Natalie, additional, Mason, Melanie, additional, McConnell, Jana, additional, Brown, Tiffany, additional, Harrison, Henry, additional, Pearson, Denise, additional, Drake, Tammy, additional, Wright, Jocelyn, additional, Walden, Debra, additional, Guy, Annette, additional, Nason, Jennifer, additional, Talbot, Morgan, additional, Lee, Kristen, additional, Penny, Sarah, additional, Boles, Terri, additional, Drummond, Melanie, additional, Kohlleppel, Katy, additional, Kathen, Charmaine, additional, Kaletka, Brian, additional, Gonzales, Shania, additional, Worwa, Cathy, additional, Fisher, Molly, additional, Richter, Tyler, additional, Ginder, Alexander, additional, Reich, Brixen, additional, Rau, Carrie, additional, Loertscher, Manndi, additional, Cole, Laura, additional, McGrath, Kandace, additional, Lewis, Kimberlee Weaver, additional, Burnett, Jill, additional, Schaefer, Susan, additional, Bird, Karie, additional, Giblin, Clare, additional, Daly, Rita, additional, Lanier, Kristi, additional, Warden, Kelly, additional, Wassenaar, Jenna, additional, Ericksen, Jensina, additional, Davern, Bridget, additional, Osborne, Mary Pat, additional, Talele, Neha, additional, Obregon, Evelyn, additional, Ziyeh, Tiglath, additional, Clarke, Molly, additional, Wegner, Rachel E., additional, Patel, Palak, additional, Schau, Molly, additional, Russow, Annamarie, additional, Curry, Kelly, additional, Barnhart, Lisa, additional, Parkinson, Charlamaine, additional, Beauman, Sandra, additional, Hanson, Mary, additional, Kuan, Elizabeth, additional, Lacy, Conra Backstrom, additional, Galvis, Edshelee M., additional, Bombino, Susana, additional, Martinez, Denise, additional, Bell, Suzi, additional, Long, Corrie, additional, Nefcy, Christopher, additional, Konodi, Mark A., additional, Vu, Phuong T., additional, Hartman, Adam, additional, O'Shea, T. Michael, additional, Ballard, Roberta, additional, O'Shea, Mike, additional, Kuban, Karl, additional, and Widness, John, additional

Published
2021
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162. 12. GENOME-WIDE GENETIC CONTROL OF FETAL PLACENTAL GENOMICS INFORMS THE DEVELOPMENT OF HEALTH, DISEASE, AND NEUROPSYCHIATRIC DISORDERS

Author

Bhattacharya, Arjun, primary, Freedman, Anastasia, additional, Avula, Vennela, additional, Liu, Weifang, additional, Pan, Calvin, additional, Lusis, Aldons, additional, Joseph, Robert, additional, Smeester, Lisa, additional, Hartwell, Hadley, additional, Kuban, Karl, additional, Marsit, Carmen, additional, Li, Yun, additional, O'Shea, T. Michael, additional, Fry, Rebecca, additional, and Santos, Hudson, additional

Published
2021
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163. Neonatal Cranial Ultrasound Findings among Infants Born Extremely Preterm: Associations with Neurodevelopmental Outcomes at 10 Years of Age

Author

Campbell, Heather, primary, Check, Jennifer, additional, Kuban, Karl C.K., additional, Leviton, Alan, additional, Joseph, Robert M., additional, Frazier, Jean A., additional, Douglass, Laurie M., additional, Roell, Kyle, additional, Allred, Elizabeth N., additional, Fordham, Lynn Ansley, additional, Hooper, Stephen R., additional, Jara, Hernan, additional, Paneth, Nigel, additional, Mokrova, Irina, additional, Ru, Hongyu, additional, Santos, Hudson P., additional, Fry, Rebecca C., additional, and O’Shea, T. Michael, additional

Published
2021
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164. Growth Rates of Infants Randomized to Continuous Positive Airway Pressure or Intubation After Extremely Preterm Birth

Author

Salas, Ariel A., primary, Carlo, Waldemar A., additional, Do, Barbara T., additional, Bell, Edward F., additional, Das, Abhik, additional, Van Meurs, Krisa P., additional, Poindexter, Brenda B., additional, Shankaran, Seetha, additional, Younge, Noelle, additional, Watterberg, Kristi L., additional, Higgins, Rosemary D., additional, Jobe, Alan H., additional, Caplan, Michael S., additional, Laptook, Abbot R., additional, Oh, William, additional, Vohr, Betty R., additional, Hensman, Angelita M., additional, Stephens, Bonnie E., additional, Alksninis, Barbara, additional, Andrews, Dawn, additional, Angela, Kristen, additional, Barnett, Susan, additional, Cashore, Bill, additional, Caskey, Melinda, additional, Francis, Kim, additional, Gingras, Dan, additional, Gargus, Regina A., additional, Johnson, Katharine, additional, Lainwala, Shabnam, additional, Leach, Theresa M., additional, Leonard, Martha R., additional, Lillie, Sarah, additional, Mehta, Kalida, additional, Moore, James R., additional, Noel, Lucy, additional, Ventura, Suzy, additional, Walden, Rachel V., additional, Watson, Victoria E., additional, Walsh, Michele C., additional, Fanaroff, Avroy A., additional, Newman, Nancy S., additional, Wilson-Costello, Deanne E., additional, Siner, Bonnie S., additional, Zadell, Arlene, additional, DiFiore, Julie, additional, Bhola, Monika, additional, Friedman, Harriet G., additional, Yalcinkaya, Gulgun, additional, Schibler, Kurt, additional, Donovan, Edward F., additional, Yolton, Kimberly, additional, Narendran, Vivek, additional, Bridges, Kate, additional, Alexander, Barbara, additional, Grisby, Cathy, additional, Mersmann, Marcia Worley, additional, Mincey, Holly L., additional, Hessling, Jody, additional, Gratton, Teresa L., additional, Goldberg, Ronald N., additional, Cotten, C. Michael, additional, Goldstein, Ricki F., additional, Ashley, Patricia, additional, Auten, Kathy J., additional, Fisher, Kimberley A., additional, Foy, Katherine A., additional, Freedman, Sharon F., additional, Gustafson, Kathryn E., additional, Lohmeyer, Melody B., additional, Malcolm, William F., additional, Wallace, David K., additional, Stoll, Barbara J., additional, Buchter, Susie, additional, Piazza, Anthony J., additional, Carlton, David P., additional, Adams-Chapman, Ira, additional, Black, Linda, additional, Blackwelder, Ann M., additional, Carter, Sheena, additional, Dinkins, Elisabeth, additional, Fritz, Sobha, additional, Hale, Ellen C., additional, Hutchinson, Amy K., additional, LaRossa, Maureen Mulligan, additional, Smikle, Gloria V., additional, Archer, Stephanie Wilson, additional, Lemons, James A., additional, Dusick, Anna M., additional, Wilson, Leslie D., additional, Hamer, Faithe, additional, Cook, Ann B., additional, Herron, Dianne E., additional, Lytle, Carolyn, additional, Minnich, Heike M., additional, Berberich, Mary Anne, additional, Blaisdell, Carol J., additional, Gail, Dorothy B., additional, Kiley, James P., additional, Poole, W. Kenneth, additional, Gantz, Marie G., additional, Newman, Jamie E., additional, Hastings, Betty K., additional, O'Donnell Auman, Jeanette, additional, Huitema, Carolyn Petrie, additional, Pickett, James W., additional, Wallace, Dennis, additional, Zaterka-Baxter, Kristin M., additional, Stevenson, David K., additional, Hintz, Susan R., additional, Ball, M. Bethany, additional, Bentley, Barbara, additional, Bruno, Elizabeth F., additional, Davis, Alexis S., additional, DeAnda, Maria Elena, additional, DeBattista, Anne M., additional, Kohn, Jean G., additional, Proud, Melinda S., additional, Pyle, Renee P., additional, St. John, Nicholas H., additional, Weiss, Hali E., additional, Frantz, Ivan D., additional, Fiascone, John M., additional, McGowan, Elisabeth C., additional, Furey, Anne, additional, MacKinnon, Brenda L., additional, Nylen, Ellen, additional, Brussa, Ana, additional, Sibley, Cecelia, additional, Ambalavanan, Namasivayam, additional, Collins, Monica V., additional, Cosby, Shirley S., additional, Peralta-Carcelen, Myriam, additional, Phillips, Vivien A., additional, Bailey, Kirstin J., additional, Biasini, Fred J., additional, Hopkins, Maria, additional, Johnston, Kristen C., additional, Krzywanski, Sara, additional, Nelson, Kathleen G., additional, Patterson, Cryshelle S., additional, Rector, Richard V., additional, Rodriguez, Leslie, additional, Soong, Amanda, additional, Whitley, Sally, additional, York, Sheree, additional, Finer, Neil N., additional, Rasmussen, Maynard R., additional, Wozniak, Paul R., additional, Vaucher, Yvonne E., additional, Rich, Wade, additional, Arnell, Kathy, additional, Barbieri-Welge, Rene, additional, Ben-Tall, Ayala, additional, Bridge, Renee, additional, Demetrio, Clarence, additional, Fuller, Martha G., additional, Ito, Elaine, additional, Lukasik, Meghan, additional, Pontillo, Deborah, additional, Posin, Donna, additional, Runyan, Cheryl, additional, Wilkes, James, additional, Zlotnik, Paul, additional, Widness, John A., additional, Klein, Jonathan M., additional, Colaizy, Tarah T., additional, Johnson, Karen J., additional, Acarregui, Michael J., additional, Eastman, Diane L., additional, Duara, Shahnaz, additional, Bauer, Charles R., additional, Everett-Thomas, Ruth, additional, Calejo, Maria, additional, Diaz, Alexis N., additional, Frade Eguaras, Silvia M., additional, Garcia, Andrea, additional, Hamlin-Smith, Kasey, additional, Berkowits, Michelle Harwood, additional, Hiriart-Fajardo, Sylvia, additional, Mathews, Elaine O., additional, Pierre, Helina, additional, Riguard, Arielle, additional, Stroerger, Alexandra, additional, Ohls, Robin K., additional, Fuller, Janell, additional, Rohr, Julie, additional, Lacy, Conra Backstrom, additional, Lowe, Jean, additional, Montman, Rebecca, additional, Laroia, Nirupama, additional, Phelps, Dale L., additional, Myers, Gary J., additional, Markowitz, Gary David, additional, Reubens, Linda J., additional, Hust, Diane, additional, Augostino, Lisa, additional, Johnson, Julie Babish, additional, Burnell, Erica, additional, Gelbard, Harris, additional, Jensen, Rosemary L., additional, Kushner, Emily, additional, Merzbach, Joan, additional, Mink, Jonathan, additional, Torres, Carlos, additional, Wang, David, additional, Yost, Kelley, additional, Sánchez, Pablo J., additional, Rosenfeld, Charles R., additional, Salhab, Walid A., additional, Heyne, Roy J., additional, Adams, Sally S., additional, Allen, James, additional, Grau, Laura, additional, Guzman, Alicia, additional, Hensley, Gaynelle, additional, Heyne, Elizabeth T., additional, Lepps, Melissa H., additional, Madden, Linda A., additional, Martin, Melissa, additional, Miller, Nancy A., additional, Morgan, Janet S., additional, Solis, Araceli, additional, Torres, Lizette E., additional, Boatman, Catherine Twell, additional, Vasil, Diana M., additional, Wilder, Kerry, additional, Kennedy, Kathleen A., additional, Tyson, Jon E., additional, Alaniz, Nora I., additional, Evans, Patricia W., additional, Harris, Beverly Foley, additional, Green, Charles, additional, Jiminez, Margarita, additional, Lis, Anna E., additional, Martin, Sarah, additional, McDavid, Georgia E., additional, Morris, Brenda H., additional, Poundstone, Margaret L., additional, Reddoch, Stacy, additional, Siddiki, Saba, additional, Pierce Tate, Patti L., additional, Whitely, Laura L., additional, Wright, Sharon L., additional, Yoder, Bradley A., additional, Faix, Roger G., additional, Baker, Shawna, additional, Bird, Karie, additional, Burnett, Jill, additional, Cole, Laura, additional, Osborne, Karen A., additional, Spencer, Cynthia, additional, Steffens, Mike, additional, Weaver-Lewis, Kimberlee, additional, Zanetti, Karen, additional, O'Shea, T. Michael, additional, Dillard, Robert G., additional, Washburn, Lisa K., additional, Peters, Nancy J., additional, Jackson, Barbara G., additional, Chiu, Korinne, additional, Allred, Deborah Evans, additional, Goldstein, Donald J., additional, Halfond, Raquel, additional, Peterson, Carroll, additional, Waldrep, Ellen L., additional, Welch, Cherrie D., additional, Morris, Melissa Whalen, additional, Hounshell, Gail Wiley, additional, Pappas, Athina, additional, Sood, Beena G., additional, Bara, Rebecca, additional, Billian, Elizabeth, additional, Goldston, Laura A., additional, Johnson, Mary, additional, Ehrenkranz, Richard A., additional, Bhandari, Vineet, additional, Jacobs, Harris C., additional, Cervone, Pat, additional, Gettner, Patricia, additional, Konstantino, Monica, additional, Poulsen, JoAnn, additional, Taft, Janet, additional, Butler, Christine G., additional, Close, Nancy, additional, Gilliam, Walter, additional, Greisman, Sheila, additional, Romano, Elaine, additional, and Williams, Joanne, additional

Published
2021
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167. Factors associated with collaboration among agencies serving children with complex chronic conditions

Author

Nageswaran, Savithri, Golden, Shannon L., Easterling, Douglas, O'Shea, T. Michael, Hansen, William B., and Ip, Edward H.

Subjects
Medical cooperation -- Research, Chronically ill children -- Care and treatment -- Research, Health care industry
Abstract

Our objective was to identify agency-level factors that increase collaborative relationships between agencies that serve children with complex chronic conditions (CCC). We hypothesized that an agency will collaborate with more partners in the network if the agency had a coordinator and participated in a community coalition. We surveyed representatives of 63 agencies that serve children with CCC in Forsyth County, North Carolina about their agencies' collaborations with other agencies. We used social network analytical methods and exponential random graph analysis to identify factors associated with collaboration among agencies. The unit of analysis was the collaborative tie (n = 3,658) between agencies in the network. Agencies participating in a community coalition were 1.5 times more likely to report collaboration than agencies that did not participate in a coalition. Presence of a coordinator in an agency was not associated with the number of collaborative relationships. Agencies in existence for a longer duration (≥11 vs. ≤ 10 years; adjusted odds ratio (aOR): 2.1) and those with a higher proportion of CCC clientele (aOR: 2.1 and 1.6 for 11-30 % and ≥ 31 % compared to ≤ 10 %) had greater collaboration. Care coordination agencies and pediatric practices reported more collaborative relationships than subspecialty clinics, home-health agencies, durable medical equipment companies, educational programs and family-support services. Collaborative relationships between agencies that serve children with CCC are increased by coalition participation, longer existence and higher CCC clientele. Future studies should evaluate whether interventions to improve collaborations among agencies will improve clinical outcomes of children with CCC. Keywords Children * Complex chronic conditions * Network analysis * Collaboration * Health services, Introduction An estimated 9.3 million children in the United States (13-18 % of all children) have special health care needs [1, 2]. A sub-group of children with special health care [...]

Published
2013
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173. Additional file 3 of Prenatal risk factors and neonatal DNA methylation in very preterm infants

Author

Camerota, Marie, Graw, Stefan, Everson, Todd M., McGowan, Elisabeth C., Hofheimer, Julie A., O’Shea, T. Michael, Carter, Brian S., Helderman, Jennifer B., Check, Jennifer, Neal, Charles R., Pastyrnak, Steven L., Smith, Lynne M., Dansereau, Lynne M., DellaGrotta, Sheri A., Marsit, Carmen J., and Lester, Barry M.

Subjects
embryonic structures
Abstract

Additional file 3. Differentially methylated regions (DMR) associated with prenatal risk. This table presents results from the results of the DMR analysis, including the location, estimates, p-values, and gene annotations associated with all significant DMRs.

Published
2021
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174. Additional file 2 of Prenatal risk factors and neonatal DNA methylation in very preterm infants

Author

Camerota, Marie, Graw, Stefan, Everson, Todd M., McGowan, Elisabeth C., Hofheimer, Julie A., O’Shea, T. Michael, Carter, Brian S., Helderman, Jennifer B., Check, Jennifer, Neal, Charles R., Pastyrnak, Steven L., Smith, Lynne M., Dansereau, Lynne M., DellaGrotta, Sheri A., Marsit, Carmen J., and Lester, Barry M.

Abstract

Additional file 2. Fit statistics for latent class analysis of prenatal risk factors. This table presents model fit statistics used to choose the optimal number of profiles in the latent class analysis.

Published
2021
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175. Neonatal outcomes of extremely preterm infants from the NICHD Neonatal Research Network

Author

Stoll, Barbara J., Hansen, Nellie I., Bell, Edward F., Shankaran, Seetha, Laptook, Abbot R., Walsh, Michele C., Hale, Ellen C., Newman, Nnacy S., Schibler, Kurt, Carlo, Waldemar A., Kennedy, Kathleen A., Poindexter, Brenda B., Finer, Neil N., Ehrenkranz, Richard A., Duara, Shahnaz, Sanchez, Pablo J., O'Shea, T. Michael, Goldberg, Ronald N., Van Meurs, Krisa P., Faix, Roger G., Phelps, Dale L., Frantz, Ivan D., III, Watterberg, Kristi L., Saha, Shampa, Das, Abhik, and Higgins, Rosemary D.

Subjects
Infants (Premature) -- Patient outcomes, Infants (Premature) -- Research, Prenatal care -- Patient outcomes, Prenatal care -- Research, Birth weight, Low -- Patient outcomes, Birth weight, Low -- Research, Infants -- Patient outcomes, Infants -- Reports
Published
2010

177. Dietary echium oil increases tissue (n-3) long-chain polyunsaturated fatty acids without elevating hepatic lipid concentrations in premature neonatal rats

Author

Yang, Qing and O'Shea, T. Michael

Subjects
Oils and fats -- Nutritional aspects, Lipids -- Properties, Unsaturated fatty acids -- Properties, Food/cooking/nutrition
Abstract

Echium oil (EO) contains notable quantities of both (n-6) and (n-3) PUFA and has not, to our knowledge, been studied in neonates. We compared growth, tissue PUFA concentrations, and liver lipid profiles in premature neonatal SpragueDawley rats that were fed an EO diet with those that were darn-fed (DF) or fed rat milk substitute (RMS) or a fish oil (FO) diet. EO or FO comprised 10% of dietary fat. Rats were delivered prematurely at d 21 of gestation by caesarean section and then DF or fed one of the diets for 6 d. Rats were killed and the fatty acid (FA) concentrations in brain, liver, ileum, and serum and liver lipid profiles were analyzed. All diet-fed rats had similar weight gain and tissue protein concentrations. Compared with DF rats, EO-fed rats had similar brain docosahexaenoic acid (DHA) levels, similar brain and liver arachidonic acid (ARA) levels, higher liver and ileal eicosapentaenoic acid (EPA) levels (P< 0.05), and similar ARA:(EPA+DHA) ratios in brain, liver, and serum. Compared with RMS-fed rats, EO-fed rats had lower liver triglyceride FA and cholesterol ester concentrations (P < 0.05), higher EPA and DHA levels in liver, ileum, and serum, a higher DHA level in brain, and lower tissue and serum ratios of total (n-6):(n-3) PUFA and ARA:(EPA + DHA) (P< 0.05). Compared with FO-fed rats, EO-fed rats had higher ARA levels in brain, liver, ileum, and serum. In conclusion, dietary EO increases tissue EPA and DHA without reducing ARA in brain and liver and without elevating hepatic lipid concentrations of premature neonatal rats.

Published
2009

178. Prenatal risk factors and neonatal DNA methylation in very preterm infants

Author

Camerota, Marie, primary, Graw, Stefan, additional, Everson, Todd M, additional, McGowan, Elisabeth C., additional, Hofheimer, Julie A, additional, O’Shea, T. Michael, additional, Carter, Brian S., additional, Helderman, Jennifer B., additional, Check, Jennifer, additional, Neal, Charles R., additional, Pastyrnak, Steven L., additional, Smith, Lynne M., additional, Dansereau, Lynne M., additional, DellaGrotta, Sheri A., additional, Marsit, Carmen J., additional, and Lester, Barry M., additional

Published
2021
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179. NEOage clocks - Epigenetic clocks to estimate post-menstrual and postnatal age in preterm infants

Author

Graw, Stefan, primary, Camerota, Marie, additional, Carter, Brian S., additional, Helderman, Jennifer, additional, Hofheimer, Julie A., additional, McGowan, Elisabeth C., additional, Neal, Charles R., additional, Pastyrnak, Steven L., additional, Smith, Lynne M., additional, DellaGrotta, Sheri A., additional, Dansereau, Lynne M., additional, Padbury, James F., additional, O’Shea, T. Michael, additional, Lester, Barry M., additional, Marsit, Carmen J., additional, and Everson, Todd M., additional

Published
2021
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180. Neurodevelopmental Profiles of Infants Born &lt; 30 Weeks Gestation at 2 Years of Age

Author

Camerota, Marie, primary, McGowan, Elisabeth C., additional, Hofheimer, Julie A, additional, O’Shea, T. Michael, additional, Carter, Brian S., additional, Helderman, Jennifer B., additional, Check, Jennifer, additional, Neal, Charles R., additional, Pastyrnak, Steven L., additional, Smith, Lynne M., additional, Loncar, Cynthia M., additional, Sheinkopf, Stephen J., additional, Dansereau, Lynne M., additional, DellaGrotta, Sheri A., additional, and Lester, Barry M., additional

Published
2021
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182. The Impact of Erythropoietin on Short- and Long-Term Kidney-Related Outcomes in Neonates of Extremely Low Gestational Age. Results of a Multicenter, Double-Blind, Placebo-Controlled Randomized Clinical Trial

Author

Askenazi, David J., primary, Heagerty, Patrick J., additional, Schmicker, Robert H., additional, Brophy, Patrick, additional, Juul, Sandra E., additional, Goldstein, Stuart L., additional, Hingorani, Sangeeta, additional, Comstock, Bryan A., additional, Wadhawan, Rajan, additional, Mayock, Dennis E., additional, Courtney, Sherry E., additional, Robinson, Tonya, additional, Ahmad, Kaashif A., additional, Bendel-Stenzel, Ellen, additional, Baserga, Mariana, additional, LaGamma, Edmund F., additional, Downey, L. Corbin, additional, Rao, Raghavendra, additional, Fahim, Nancy, additional, Lampland, Andrea, additional, Frantz, Ivan D., additional, Khan, Janine Y., additional, Weiss, Michael, additional, Gilmore, Maureen M., additional, Ohls, Robin, additional, Srinivasan, Nishant, additional, Perez, Jorge E., additional, McKay, Victor, additional, Vu, Phuong T., additional, Thomas, Billy, additional, Elhassan, Nahed, additional, Mulkey, Sarah, additional, Dydynski, Philip, additional, Vijayamadhavan, Vivek K., additional, Mulrooney, Neil, additional, Yoder, Bradley, additional, Kase, Jordan S., additional, Check, Jennifer, additional, Gogcu, Semsa, additional, Osterholm, Erin, additional, Ramel, Sara, additional, Bendel, Catherine, additional, Gale, Cheryl, additional, George, Thomas, additional, Georgieff, Michael, additional, Gisslen, Tate, additional, Guiang, Sixto, additional, Hall, Anne, additional, Johnson, Dana, additional, Pfister, Katie, additional, Podgorski, Heather, additional, Roberts, Kari, additional, Stepka, Erin, additional, Engel, Melissa, additional, Kamrath, Heidi, additional, Scheurer, Johannah, additional, Hanson, Angela, additional, Satrom, Katherine, additional, Pfister, Susan, additional, Simones, Ann, additional, Plummer, Erin, additional, Zorn, Elizabeth, additional, Martin, Camilia R., additional, O'Reilly, Deirdre, additional, Porta, Nicolas, additional, Bazacliu, Catalina, additional, Williams, Jonathan, additional, Rajderkar, Dhanashree, additional, Northington, Frances, additional, Valdez, Raul Chavez, additional, Beauman, Sandra, additional, Saurabhkumar, Patel, additional, Diaz-Barbosa, Magaly, additional, Serize, Arturo, additional, Jordan, Jorge, additional, Ott, Debbie, additional, Mora, Ariana Franco, additional, Hedrick, Pamela, additional, Flynn, Vicki, additional, Silvia, Amy, additional, Clopp, Bailey, additional, Feltner, John B., additional, Esposito, Isabella, additional, Hauge, Stephanie, additional, Nikirk, Samantha, additional, Purnell, Andrea, additional, Loy, Emilie, additional, Sikes, Natalie, additional, Mason, Melanie, additional, McConnell, Jana, additional, Brown, Tiffany, additional, Harrison, Henry, additional, Pearson, Denise, additional, Drake, Tammy, additional, Wright, Jocelyn, additional, Walden, Debra, additional, Guy, Annette, additional, Nason, Jennifer, additional, Talbot, Morgan, additional, Lee, Kristen, additional, Penny, Sarah, additional, Boles, Terri, additional, Drummond, Melanie, additional, Kohlleppel, Katy, additional, Kathen, Charmaine, additional, Kaletka, Brian, additional, Gonzales, Shania, additional, Worwa, Cathy, additional, Fisher, Molly, additional, Richter, Tyler, additional, Ginder, Alexander, additional, Reich, Brixen, additional, Rau, Carrie, additional, Loertscher, Manndi, additional, Bledsoe, Laura, additional, McGrath, Kandace, additional, Lewis, Kimberlee Weaver, additional, Burnett, Jill, additional, Schaefer, Susan, additional, Bird, Karie, additional, Giblin, Clare, additional, Daly, Rita, additional, Lanier, Kristi, additional, Warden, Kelly, additional, Wassenaar, Jenna, additional, Ericksen, Jensina, additional, Davern, Bridget, additional, Osborne, Mary Pat, additional, Gregorich, Brittany, additional, Talele, Neha, additional, Obregon, Evelyn, additional, Ziyeh, Tiglath, additional, Clarke, Molly, additional, Wegner, Rachel E., additional, Patel, Palak, additional, Schau, Molly, additional, Russow, Annamarie, additional, Curry, Kelly, additional, Sinnamon, Susan, additional, Barnhart, Lisa, additional, Parkinson, Charlamaine, additional, Hanson, Mary, additional, Kuan, Elizabeth, additional, Lacy, Conra Backstrom, additional, Galvis, Edshelee M., additional, Bombino, Susana, additional, Martinez, Denise, additional, Bell, Suzi, additional, Long, Corrie, additional, Longa, Cathy, additional, Westerveld, Michael, additional, McConkey, Stacy, additional, Hay, Anne, additional, Natarajan, Niranjana, additional, Gaudette, Shari, additional, Cobb, Sarah, additional, Sharp, Gregory, additional, Schumacher, Elizabeth, additional, Schuschke, Leslie, additional, Frey, Charlotte, additional, Fierro, Mario, additional, Gilmore, Lois, additional, Lundequam, Pamela, additional, Hoekstra, Ronald, additional, Ketko, Anastasia, additional, Perdue, Nina, additional, Cunningham, Sean, additional, Stout, Kelly, additional, Hall, Becky, additional, Morshedzadeh, Galina, additional, Ostrander, Betsy, additional, Winter, Sarah, additional, Cox, Lauren, additional, Rainaldi, Matthew A., additional, Hensley, Sarah, additional, Morris, Melissa, additional, Roberts, Dia, additional, Tuttle, Melissa, additional, Boys, Christopher, additional, Hultgren, Solveig, additional, Pierpont, Elizabeth I., additional, George, Tom, additional, King, Kelly E., additional, Bataglia, Katherine, additional, Neis, Cathy, additional, Bergeron, Mark, additional, Miller, Cristina, additional, Accomando, Cara, additional, Gavin, Jennifer Anne, additional, Maczek, Elizabeth, additional, Marakovitz, Susan, additional, Knorr, Aimee, additional, Smith, Vincent C., additional, Stewart, Jane E., additional, Weissbourd, Marie, additional, deRegnier, Raye-Ann, additional, Matoba, Nana, additional, Heaton, Shelly C., additional, Cascio, Erika M., additional, Brady, Janet, additional, Ghosh, Suman, additional, Ditto, Jessica, additional, Leppert, Mary, additional, Lowe, Jean, additional, Fuller, Janell, additional, DuPont, Tara, additional, Kloska, Pamela, additional, Patel, Saurabh, additional, Carbonell, Lauren, additional, Patino-Fernandez, Anna Maria, additional, de Lerma, Carmen, additional, McDonough, Kelly, additional, De Cortada, Maiana, additional, Chavis, Lacy, additional, Shannon, Jane, additional, Konodi, Mark A., additional, Nefcy, Christopher, additional, Kuban, Karl C.K., additional, Lowe, Jean R., additional, O'Shea, T. Michael, additional, Dighe, Manjiri, additional, Richards, Todd, additional, Shaw, Dennis W.W., additional, Studholme, Colin, additional, Traudt, Christopher M., additional, Ballard, Roberta, additional, Hartman, Adam, additional, Janis, Scott, additional, Ohls, T. Robin, additional, O'Shea, Michael, additional, Guillet, Ronnie, additional, Ball, M. Bethany, additional, Glass, Hannah, additional, Saville, Ben, additional, and Schreiber, Michael, additional

Published
2021
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183. Genetic control of fetal placental genomics contributes to development of health and disease

Author

Bhattacharya, Arjun, primary, Freedman, Anastasia N., additional, Avula, Vennela, additional, Harris, Rebeca, additional, Liu, Weifang, additional, Pan, Calvin, additional, Lusis, Aldons J., additional, Joseph, Robert M., additional, Smeester, Lisa, additional, Hartwell, Hadley J., additional, Kuban, Karl C.K., additional, Marsit, Carmen J., additional, Li, Yun, additional, O’Shea, T. Michael, additional, Fry, Rebecca C., additional, and Santos, Hudson P., additional

Published
2021
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184. Aggressive vs. conservative phototherapy for infants with extremely low birth weight

Author

Morris, Brenda H., Oh, William, Tyson, Jon E., Phelps, Dale L., Stevenson, David K., O'Shea, T. Michael, McDavid, Georgia E., Perritt, Rebecca L., Pedroza, Claudia, Das, Abhik, Poole, W. Kenneth, Carlo, Waldemar A., Duara, Shahnaz, Laptook, Abbot R., Sahlab, Walid A., Shankaran, Seetha, Poindexter, Brenda B., Fanaroff, Avroy A., Walsh, Michele C., Rasmussen, Maynard R., Stoll, Barbara J., Cotten, C. Michael, Donovan, Edward F., Ehrenkranz, Richard A., Guillet, Ronnie, and Higgins, Rosemary D.

Subjects
Phototherapy -- Methods, Phototherapy -- Patient outcomes, Neurotoxic agents -- Usage, Neurotoxic agents -- Health aspects, Birth weight, Low -- Care and treatment, Birth weight, Low -- Patient outcomes
Abstract

The study aims to compare the efficacy of aggressive phototherapy as compared to conservative phototherapy in preventing neurotoxic effects in infants with extremely low birth weight. Results indicate that aggressive phototherapy was not effective in reducing the rate of mortality.

Published
2008

185. Elevated temperature after hypoxic-ischemic encephalopathy: risk factor for adverse outcomes

Author

Laptook, Abbot, Tyson, Jon, Shankaran, Seetha, McDonald, Scott, Ehrenkranz, Richard, Fanaroff, Avroy, Donovan, Edward, Goldberg, Ronald, O'Shea, T. Michael, Higgins, Rosemary D., and Poole, W. Kenneth

Subjects
Encephalopathy -- Risk factors, Encephalopathy -- Patient outcomes, Body temperature -- Research, Body temperature -- Physiological aspects
Published
2008

188. Follow-up of a randomized, placebo-controlled trial of dexamethasone to decrease the duration of ventilator dependency in very low birth weight infants: neurodevelopmental outcomes at 4 to 11 years of age

Author

O'Shea, T. Michael, Washburn, Lisa K., Nixon, Patricia A., and Goldstein, Donald J.

Subjects
Dexamethasone -- Dosage and administration, Dexamethasone -- Complications and side effects, Artificial respiration -- Patient outcomes, Artificial respiration -- Research, Birth weight, Low -- Patient outcomes, Birth weight, Low -- Research, Child development deviations -- Risk factors, Child development deviations -- Research, Developmental disabilities -- Risk factors, Developmental disabilities -- Research
Published
2007

189. Factors associated with treatment for hypotension in extremely low gestational age newborns during the first postnatal week

Author

Laughon, Matthew, Bose, Carl, Allred, Elizabeth, O'Shea, T. Michael, Van Marter, Linda J., Bednarek, Francis, and Leviton, Alan

Subjects
Clinical trials -- Analysis, Hypotension -- Diagnosis, Hypotension -- Drug therapy, Cardiovascular agents -- Dosage and administration, Hypotension -- Dosage and administration, Children -- Health aspects, Children -- Research
Abstract

OBJECTIVE. The goals were to identify the blood pressures of extremely low gestational age newborns that prompt intervention, to identify other infant characteristics associated with receipt of therapies intended to increase blood pressure, and to assess the interinstitutional variability in the use of these therapies. METHODS. The cohort included 1507 extremely low gestational age newborns born at 23 weeks to 27 6/7 weeks of gestation, at 14 institutions, between March 2002 and August 2004; 1387 survived the first postnatal week. Blood pressures were measured as clinically indicated. Interventions were grouped as any treatment (ie, vasopressor and/or fluid boluses of >10 mL/kg) and vasopressor treatment, and logistic regression analyses were performed. RESULTS. At each gestational age, the lowest mean arterial pressures in treated and untreated infants tended to increase with advancing postnatal age. Infants who received any therapy tended to have lower mean arterial pressures than infants who did not, but uniform thresholds for treatment were not apparent. The proportion of infants receiving any treatment decreased with increasing gestational age from 93% at 23 weeks to 73% at 27 weeks. Treatment nearly always began during the first 24 hours of life. Lower gestational age, lower birth weight, male gender, and higher Score for Neonatal Acute Physiology-II values were associated with any treatment and vasopressor treatment. Institutions varied greatly in their tendency to offer any treatment and vasopressor treatment. Neither the lowest mean arterial pressure on the day of treatment nor other characteristics of the infants accounted for center differences in treatment. CONCLUSIONS. Blood pressure in extremely premature infants not treated for hypotension increased directly with both increasing gestational age and postnatal age. The decision to provide treatment was associated more strongly with the center where care was provided than with infant attributes. Key Words premature infant, blood pressure, hypotension, HYPOTENSION IS ONE of the most common diagnoses assigned to extremely low gestational age newborns (ELGANs), and treatments to increase blood pressure are often used in this population. (1) These [...]

Published
2007

190. Evidence for the placenta-brain axis: multi-omic kernel aggregation predicts intellectual and social impairment in children born extremely preterm.

Author

Santos, Hudson P, Santos, Hudson P, Bhattacharya, Arjun, Joseph, Robert M, Smeester, Lisa, Kuban, Karl CK, Marsit, Carmen J, O'Shea, T Michael, Fry, Rebecca C, Santos, Hudson P, Santos, Hudson P, Bhattacharya, Arjun, Joseph, Robert M, Smeester, Lisa, Kuban, Karl CK, Marsit, Carmen J, O'Shea, T Michael, and Fry, Rebecca C

Abstract

BackgroundChildren born extremely preterm are at heightened risk for intellectual and social impairment, including Autism Spectrum Disorder (ASD). There is increasing evidence for a key role of the placenta in prenatal developmental programming, suggesting that the placenta may, in part, contribute to origins of neurodevelopmental outcomes.MethodsWe examined associations between placental transcriptomic and epigenomic profiles and assessed their ability to predict intellectual and social impairment at age 10 years in 379 children from the Extremely Low Gestational Age Newborn (ELGAN) cohort. Assessment of intellectual ability (IQ) and social function was completed with the Differential Ability Scales-II and Social Responsiveness Scale (SRS), respectively. Examining IQ and SRS allows for studying ASD risk beyond the diagnostic criteria, as IQ and SRS are continuous measures strongly correlated with ASD. Genome-wide mRNA, CpG methylation and miRNA were assayeds with the Illumina Hiseq 2500, HTG EdgeSeq miRNA Whole Transcriptome Assay, and Illumina EPIC/850 K array, respectively. We conducted genome-wide differential analyses of placental mRNA, miRNA, and CpG methylation data. These molecular features were then integrated for a predictive analysis of IQ and SRS outcomes using kernel aggregation regression. We lastly examined associations between ASD and the multi-omic-predicted component of IQ and SRS.ResultsGenes with important roles in neurodevelopment and placental tissue organization were associated with intellectual and social impairment. Kernel aggregations of placental multi-omics strongly predicted intellectual and social function, explaining approximately 8% and 12% of variance in SRS and IQ scores via cross-validation, respectively. Predicted in-sample SRS and IQ showed significant positive and negative associations with ASD case-control status.LimitationsThe ELGAN cohort comprises children born pre-term, and generalization may be affected by unmeas

Published
2020

191. Psychiatric Symptoms: Prevalence, Co-Occurrence and Functioning Among Extremely Low Gestational Age Newborns at Age Ten Years

Author

Dvir, Yael, Frazier, Jean A., Joseph, Robert M., Mokrova, Irina, Moore, Phoebe S., O’Shea, T. Michael, Hooper, Stephen R., Santos, Hudson P, and Kuban, Karl

Subjects
Male, Education, Special, Infant, Extremely Premature, Mental Disorders, Academic Performance, Humans, Female, Gestational Age, Comorbidity, Child, Article, United States, Follow-Up Studies
Abstract

OBJECTIVE: To evaluate the percentage of children born extremely preterm who screen positive for ≥ one DSM-IV psychiatric disorder, the co-occurrence of and sex-related differences in these classifications, and the functional correlates of psychiatric symptoms. METHODS: The Extremely Low Gestational Age Newborns (ELGAN) Study is a prospective cohort follow-up of children born < 28 weeks gestation. For 871 10-year-old children, parents completed the Child Symptom Inventory-4 (CSI-4), a child educational/medical history questionnaire, and the Pediatric Quality of Life Inventory (PedsQL). RESULTS: At age 10 years, ELGANs were more likely to screen positive for a number of psychiatric disorders when compared to normative expectations on the CSI-4, with a few sex-related differences. Fifteen percent of participants screened positive for one disorder, 7% for two, 3% for three, and 4% for ≥ 4 psychiatric disorders. Compared to children who did not screen positive for psychiatric disorders, children who screened positive for ≥ 3 psychiatric disorders were approximately twice as likely to have repeated a grade, have an individualized educational program (IEP), have an individual school aide, and to require special remediation classes. Children who screened positive for any psychiatric disorder were four times more likely to use one or more psychotropic medication, and those who screened positive for ≥ 2 psychiatric disorder had lower PedsQL scores. CONCLUSION: Among 10-year-old children born extremely preterm, rates of psychiatric symptoms exceeded normative expectation, and children who screened positive for more than one psychiatric disorder were at increased risk for having multiple functional impairments.

Published
2019

193. Predicting outcomes of neonates diagnosed with hypoxemic-ischemic encephalopathy

Author

Ambalavanan, Namasivayam, Carlo, Waldemar A., Shankaran, Seetha, Bann, Carla M., Emrich, Steven L., Higgins, Rosemary D., Tyson, Jon E., O'Shea, T. Michael, Laptook, Abbot R., Ehrenkranz, Richard A., Donovan, Edward F., Walsh, Michele C., Goldberg, Ronald N., and Das, Abhik

Subjects
Encephalopathy -- Causes of, Encephalopathy -- Care and treatment, Encephalopathy -- Risk factors, Infants (Newborn) -- Diseases, Infants (Newborn) -- Risk factors, Infants (Newborn) -- Causes of, Infants (Newborn) -- Care and treatment, Infants -- Patient outcomes, Infants -- Causes of, Infants -- Prevention
Abstract

OBJECTIVE The goals were to identify predictor variables and to develop scoring systems and classification trees to predict death/disability or death in infants with hypoxic-ischemic encephalopathy. METHODS. Secondary analysis of data from the multicenter, randomized, controlled, National Institute of Child Health and Human Development Neonatal Research Network trial of hypothermia in hypoxioischemic encephalopathy was performed. Data for 205 neonates diagnosed as having hypoxic-ischemic encephalopathy were studied. Logistic regression analysis was performed by using clinical and laboratory variables available within 6 hours of birth, with death or moderate/ severe disability at 18 to 22 months or death as the outcomes. By using the identified variables and odds ratios, scoring systems to predict death/disability or death were developed, weighting each predictor in proportion to its odds ratio. In addition, classification and regression tree analysis was performed, with recursive partitioning and automatic selection of optimal cutoff points for variables. Correct classification rates for the scoring systems, classification and regression tree models, and early neurologic examination were compared. RESULTS. Correct classification rates were 78% for death/disability and 71% for death with the scoring systems, 80% and 77%, respectively, with the classification and regression tree models, and 67% and 73% with severe encephalopathy in early neurologic examination. Correct classification rates were similar in the hypothermia and control groups. CONCLUSIONS. Among neonates diagnosed as having hypoxic-ischemic encephalopathy, the classification and regression tree model, but not the scoring system, was superior to early neurologic examination in predicting death/disability. The 3 models were comparable in predicting death. Only a few components of the early neurologic examination were associated with poor outcomes. These scoring systems and classification trees, if validated, may help in assessments of prognosis and may prove useful for risk-stratification of infants with hypoxic-ischemic encephalopathy for clinical trials. Key Words logistic models, decision trees, asphyxia neonatorum, hypoxia-ischemia, brain, predictive value of tests Abbreviations CART--classification and regression tree GMFCS gross motor function classification system HIE--hypoxic-ischemic encephalopathy ROC--receiver operating characteristic NICHD--National Institute of Child Health and Human Development CI--confidence interval, HYPOXIC-ISCHEMIC ENCEPHALOPATHY (HIE) is a major contributor to neonatal death and morbidity. An estimated 23% of the 4 million neonatal deaths (1) and 8% of all deaths at A recent [...]

Published
2006

194. Follow-up of a randomized, placebo-controlled trial of postnatal dexamethasone: blood pressure and anthropometric measurements at school age

Author

Washburn, Lisa K., Nixon, Patricia A., and O'Shea, T. Michael

Subjects
Blood pressure -- Diagnosis, Blood pressure -- Care and treatment, Dexamethasone -- Dosage and administration, Birth weight, Low -- Risk factors, Infants (Premature) -- Health aspects
Abstract

OBJECTIVE The purpose of this work was to evaluate the effects of a 42-day tapering course of dexamethasone on blood pressure and anthropometric measurements in school-age children who were born with very low birth weight. METHODS. Sixty-eight children, who as neonates participated in a randomized placebo-controlled trial of a 42-day tapering course of dexamethasone (n = 38, dexamethasone; n = 30, placebo) to facilitate weaning from the ventilator, were seen at a median of 9 years of age. Participants underwent measurements of systolic blood pressure, diastolic blood pressure, mid-arm circumference, triceps skinfold thickness, height, and weight. Mann-Whitney U tests were used to compare groups, and Spearman coefficients were used to examine correlations between variables. RESULTS. Comparing dexamethasone- and placebo-treated children, we found no differences in systolic blood pressure, mid-arm circumference, triceps skinfold thickness, height, weight, or body mass index. Twenty-nine percent of all subjects had systolic blood pressure and/or diastolic blood pressure [greater than or equal to] 90th percentile for age and gender. Thirty percent of all subjects had body mass index [greater than or equal to] 85th percentile for age and gender. CONCLUSIONS. In a group of preterm very low birth-weight infants at high risk for chronic lung disease, we found no effects of dexamethasone on blood pressure or anthropometric measurements at 8 to 11 years of age. Of concern is that a high proportion in this sample had blood pressure [greater than or equal to] 90th percentile and/or body mass index [greater than or equal to] 85th percentile. Key Words prematurity, children, glucocorticoid, very low birth weight, growth Abbreviations VLBW--very low birth weight CLD--chronic lung disease GCRC--General Clinic Research Center BMI--body mass index SBP--systolic blood pressure DBP--diastolic blood pressure, IMPROVEMENTS IN NEONATAL care have resulted in an increased rate of survival of very low birth-weight (VLBW) infants; however, the frequency of neonatal chronic lung disease (CLD) also has increased. [...]

Published
2006

196. Heart rate characteristics: novel physiomarkers to predict neonatal infection and death

Author

Griffin, M. Pamela, Lake, Douglas E., Bissonette, Eric A., Harrell, Frank E., Jr., O'Shea, T. Michael, and Moorman, J. Randall

Subjects
Infants -- Health aspects, Sepsis -- Diagnosis, Sepsis -- Risk factors
Abstract

Objective. Monitoring of regulated physiologic processes using physiomarkers such as heart rate variability may be important in the early diagnosis of subacute, potentially catastrophic illness. Early in the course of neonatal sepsis, there are physiomarkers of reduced heart rate variability and transient decelerations 7similar to fetal distress. The goal of this study was to determine the degree of increased risk for sepsis, urinary tract infection (UTI), and death when these abnormal heart rate characteristics (HRC) were observed. 8 Methods. We monitored 1022 infants at 2 tertiary care NICUs, 458 of whom were very low birth weight. We calculated an HRC index from validated regression models relating mathematical features of heart rate time series and histograms to episodes of illness. We calculated the risks for adverse events of sepsis, UTI, and death for infants stratified by HRC measurements. Results. Compared with infants with low-risk HRC measurements, infants with high-risk HRC measurements had 5- to 6-fold increased risk for an adverse event in the next day and 3-fold increased risk in the next week. Laboratory tests that were relevant to infection added information to HRC measurements. Infants with both high-risk HRC and abnormal laboratory tests had 6- to 7-fold increased risk for an adverse event in the next day compared with infants who had neither. Conclusion. HRC are noninvasively monitored physiomarkers that identify infants in the NICU who are at high risk for sepsis, UTI, and death. Pediatrics 2005;116: 1070-1074; infant, mortality prediction, sepsis, urinary tract infections, physiomarker. ABBREVIATIONS. HRC, heart rate characteristics; UTI, urinary tract infection; UVA, University of Virginia; HR, heart rate; WFU, Wake Forest University; CONS, coagulase-negative Staphylococcus; NICHD, National Institute of Child Health and Human Development; VLBW, very low birth weight., The common clinical scenario of abrupt deterioration of a stable infant in the NICU usually prompts the consideration of sepsis. Establishing the diagnosis of neonatal sepsis using current clinical and [...]

Published
2005

197. Adverse neurodevelopmental outcomes among extremely low birth weight infants with a normal head ultrasound: prevalence and antecedents

Author

Laptook, Abbot R., O'Shea, T. Michael, Shankaran, Seetha, and Bhaskar, Brinda

Subjects
Birth weight, Low -- Observations, Diagnosis, Ultrasonic -- Observations, Cerebral palsy -- Risk factors
Abstract

Objective. Severe abnormalities of the head ultrasound (HUS) are important predictors of cerebral palsy (CP) and mental retardation, and a normal HUS usually ensures the absence of major impairments. With the increasing survival of extremely low birth weight (ELBW) infants (birth weight Methods. Study infants were ELBW infants who were cared for in Neonatal Research Network centers in the years 1995-1999, had a normal early and late HUS, survived to discharge, and returned for follow-up assessments at 18 to 22 months&apos; corrected age. The outcomes of interest were a score Results. Of 1749 infants with a normal early and late HUS (performed at a mean age of 6 and 47 days, respectively), 1473 (84%) returned for follow-up assessment. Infants had a birth weight of 792 [+ or -] 134 g (mean [+ or -] SD) and gestational age of 26 [+ or -] 2 weeks. Rates of CP and MDI Conclusions. Nearly 30% of ELBW infants with a normal HUS had either CP or a low MDI. Risk factors that are associated with this high rate of adverse outcomes include pneumothorax, prolonged exposure to mechanical ventilation, and educational and economic disadvantage. Improvements in pulmonary care to reduce duration of ventilation and avoid air leaks might improve neurodevelopmental outcome for ELBW infants. Pediatrics 2005;115:673-680; brain imaging, extremely preterm infants, intraventricular hemorrhage, neurobehavioral development., ABBREVIATIONS. ELBW, extremely low birth weight; CP, cerebral palsy; CLD, chronic lung disease; HUS, head ultrasound; IVH, intraventricular hemorrhage; SES, socioeconomic status; PDA, patent ductus arteriosus; MDI, Mental Developmental Index; [...]

Published
2005

198. Perception of child vulnerability among mothers of former premature infants

Author

Allen, Elizabeth C., Manuel, Janeen C., Legault, Claudine, Naughton, Michelle J., Pivor, Carol, and O'Shea, T. Michael

Abstract

Objectives. Parents of premature infants often perceive their infants as medically vulnerable. High parental perception of child vulnerability (PPCV) is associated with disproportionately high health care utilization. The objectives of this study were to determine whether higher PPCV is correlated with worse developmental outcome in premature infants at 1-year adjusted age and to identify factors, present at neonatal discharge, that predict high PPCV. Methods. This prospective cohort study assessed mothers of 116 premature infants who were [less than or equal to] 32 weeks&apos; gestation and required supplemental oxygen at 36 weeks postmenstrual age. At neonatal discharge, mothers completed the Spielberger State Anxiety Inventory, Beck Depression Inventory, Impact on Family Scale, Life Orientation Test, General Health Survey, and Medical Outcomes Study social support survey. At 1-year adjusted age, child development was assessed using the Bayley Scales of Infant Development and Vineland Adaptive Behavior Scales, and mothers completed the Vulnerable Child Scale, a 16-item self-report measure of PPCV. Chart review was performed to determine the presence or absence of specific indicators of medical vulnerability at 1-year adjusted age. Results. Mean infant gestational age and birth weight were 26.5 [+ or -] 2.5 weeks and 894 [+ or -] 287 g. A total of 69% of mothers were white, and 78% were high school graduates. Higher PPCV (lower Vulnerable Child Scale score) was correlated with lower scores on the Vineland Adaptive Behavior Composite and Bayley Psychomotor Developmental Index but not on the Bayley Mental Developmental Index. After controlling for the presence of 1 or more indicators of medical vulnerability, higher PPCV was still correlated with lower adaptive development. This correlation was stronger in the group of children with no indicators of medical vulnerability. In univariate analyses, higher PPCV was predicted by nonfirstborn status; longer neonatal hospitalization; higher maternal anxiety and depression; greater impact of the illness on the family; and lower maternal optimism, life satisfaction, and social support. PPCV was not associated with maternal age, education, marital status, income, or ethnicity or with child gender, gestational age, birth weight, or length of mechanical ventilation. A linear regression model containing all variables significant at the univariate level explained 29% of the variance in PPCV. Maternal anxiety was the only variable that was statistically significant in the full model. Conclusions. Higher PPCV is associated with worse developmental outcome in premature infants at 1-year adjusted age. Maternal anxiety at neonatal discharge predicts later high PPCV. Interventions to prevent or decrease PPCV in premature infants should be targeted at parents who are more anxious at hospital discharge. Pediatrics 2004;113:267-273; vulnerable child syndrome, parental perceptions, vulnerability, prematurity., Children who are perceived by their parents as vulnerable have an increased risk of behavior problems, difficult parent-child interactions, (1-3) and disproportionately high health care utilization. (4-6) In their original [...]

Published
2004

199. Association of Growth During Infancy with Neurodevelopment and Obesity in Children Born Very Preterm: The Environmental Influences on Child Health Outcomes Cohort.

Author

O'Shea, T. Michael, Jensen, Elizabeth T., Yi, Joe X., Lester, Barry, Aschner, Judy L., Stroustrup, Annemarie, Zhang, Xueying, McGrath, Monica, Sanderson, Keia, Joseph, Robert M., Singh, Rachana, Thompson, Amanda L., Hofheimer, Julie, Vohr, Betty, McGowan, Elisabeth, Santos, Hudson, and Fry, Rebecca C.

Published
2024
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