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Center for Perinatal Research

Preterm Birth Increases Health Vulnerabilities of Babies With Down Syndrome
 Preterm Birth Increases Health Vulnerabilities of Babies With Down Syndrome 1024 624 JoAnna Pendergrass, DVM
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Babies with Down syndrome who are born preterm have higher prenatal morbidity and mortality rates than those in babies with Down syndrome born at term, suggesting pediatricians can lower their risk threshold for certain screenings or interventions. Compared with age-matched neonates without Down syndrome, babies with Down syndrome are more likely to experience developmental delay,…

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5 Things Neonatologists Should Know About Vitamin K Deficiency
 5 Things Neonatologists Should Know About Vitamin K Deficiency 1024 683 Mary Bates, PhD
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Vitamin K prophylaxis is safe and effective. Why are more parents refusing it, and what can be done? In a new perspective paper in the Journal of Perinatology, researchers from Nationwide Children’s say that vitamin K prophylaxis is an essential component of newborn care and yet, parental refusal of the intervention is on the rise.…

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Featured Researcher — Jonathan Slaughter, MD, MPH
 Featured Researcher — Jonathan Slaughter, MD, MPH 150 150 Katie Brind'Amour, PhD, MS, CHES
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Jonathan Slaughter, MD, MPH, neonatologist and principal investigator in the Center for Perinatal Research at Nationwide Children’s Hospital, works to identify best practices and reduce treatment variation to improve neonatal clinical care and outcomes. His career took off when, after casually observing practice variation across the institutions where he received training, he noticed that preterm…

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Low-Resource Screening Tool Demonstrates Superior Predictive Value for Cerebral Palsy in Infants
 Low-Resource Screening Tool Demonstrates Superior Predictive Value for Cerebral Palsy in Infants 1024 683 JoAnna Pendergrass, DVM
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The use of lower-resource screening tools for cerebral palsy in infants can help increase early detection of the condition and promote access to early interventions.   A recent study reported that the Hammersmith Infant Neurological Examination (HINE), when compared with the Test of Infant Motor Performance (TIMP), had the better predictive value for detecting cerebral…

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Predicting Response to Bronchodilators in Infants with Bronchopulmonary Dysplasia
 Predicting Response to Bronchodilators in Infants with Bronchopulmonary Dysplasia 1024 683 Mary Bates, PhD
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Study emphasizes importance of identifying those patients who will respond to treatment. Certain pulmonary function test parameters in newborns with bronchopulmonary dysplasia are associated with bronchodilator response, according to a new study from researchers at Nationwide Children’s Hospital. The team also found that responders had evidence of greater dysanaptic lung growth than nonresponders. Bronchodilators are…

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Multi-Disciplinary Team Develops Evidence-Based Guidelines for Acute Management of Persistent Pulmonary Hypertension in Newborns
 Multi-Disciplinary Team Develops Evidence-Based Guidelines for Acute Management of Persistent Pulmonary Hypertension in Newborns 200 133 Katie Brind'Amour, PhD, MS, CHES
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What began as an internal effort to simplify practice has transformed into published evidence-based guidelines to standardize care for acute stabilization and management of newborns with pulmonary hypertension.   Persistent pulmonary hypertension of the newborn (PPHN) is a highly varied and changeable condition that presents a challenge for clinical management, even among tertiary care centers…

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What is “Normal” Thyroid Functioning in Preterm Infants?
 What is “Normal” Thyroid Functioning in Preterm Infants? 1024 683 Mary Bates, PhD
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Baby in NICU

Study provides one of the largest samples of thyroid values in preterm infants to establish reference intervals. Preterm infants are born with an immature hypothalamic-pituitary-thyroid axis, putting them at risk for hypothyroidism from a delayed rise in thyroid-stimulating hormone (TSH). Currently in the United States, the thyroid function of all infants is evaluated within the…

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After Lung Transplantation for Cystic Fibrosis, Migration of Stem Cells May Lead to Chimeric Phenotype
 After Lung Transplantation for Cystic Fibrosis, Migration of Stem Cells May Lead to Chimeric Phenotype 1024 575 Jessica Nye, PhD
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Illustration of lungs on blue silhouette of upper chest on black background

Lung transplantation (LTx) for cystic fibrosis (CF) may trigger bidirectional, long-distance migration of tissue specific stem cells (TSC), causing a chimeric phenotype which could have implications for host defense capabilities. CF is caused by mutations in the CF transmembrane conductance regulator (CFTR) gene and is characterized by progressive chronic obstructive lung disease which can lead…

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Repeated Injury to Stem Cells Could be a Significant Contributor to Chronic Lung Disease
 Repeated Injury to Stem Cells Could be a Significant Contributor to Chronic Lung Disease 1024 575 Abbie Miller
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Illustration of lungs on blue silhouette of upper chest on black background

A series of experiments shows that biological aging of tracheobronchial stem cells could drive the development of chronic lung disease. In a recent publication in STEM CELLS Translational Medicine (SCTM), researchers showed that repeated injury to epithelial cells in the airway caused biological aging of the stem cells located there. Tracheobronchial stem cells (TSCs) are…

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Featured Researcher — Rodney Britt, PhD
 Featured Researcher — Rodney Britt, PhD 150 150 Natalie Wilson
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Rodney D. Britt Jr., PhD, is a principal investigator in the Center for Perinatal Research at the Abigail Wexner Research Institute at Nationwide Children’s Hospital and an assistant professor of Pediatrics at The Ohio State University. Dr. Britt earned his bachelor’s degree in Chemistry from North Carolina A&T State University and his doctorate degree in…

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Probiotic Treatment Promotes Neurodevelopment After Experimental Necrotizing Enterocolitis
 Probiotic Treatment Promotes Neurodevelopment After Experimental Necrotizing Enterocolitis 777 640 Lauren Dembeck
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B&W image of Dr. Gail Besner posing for a photo in her lab coat

A single dose of a novel live probiotic therapeutic protects the rodent brain during early development and the effects persist into adolescence. Researchers at Nationwide Children’s Hospital have demonstrated that when given in a biofilm state, probiotic Lactobacillus reuteri prevents the detrimental neurodevelopmental sequalae of experimental necrotizing enterocolitis (NEC).1 The findings, published in Brain, Behavior…

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Specialized Treatment for Severe Bronchopulmonary Dysplasia Increases Survival
 Specialized Treatment for Severe Bronchopulmonary Dysplasia Increases Survival 1024 683 Mary Bates, PhD
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Dr. Edward Shepherd

Most infants with established BPD referred to Nationwide’s BPD Center improve and survive, despite the severity of their illness. In a new study, researchers analyzed the in-hospital outcomes for preterm infants with established bronchopulmonary dysplasia (BPD) referred to Nationwide Children’s Comprehensive Center for BPD. They found that despite the high degree of illness severity in…

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No Evidence Supporting Prophylactic Indomethacin Treatment for Most Preterm Infants
 No Evidence Supporting Prophylactic Indomethacin Treatment for Most Preterm Infants 1024 575 Lauren Dembeck
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Nurse caring for infant in Neonatal Intensive Care Unit (NICU)

Inconsistency among studies prompted researchers to take a closer look at the drug’s effects. Despite limited evidence supporting its use, prophylactic indomethacin treatment is often administered to very preterm infants within the first 24-hours after birth to reduce the risks of intraventricular hemorrhage and longer-term neonatal morbidities, such as bronchopulmonary dysplasia (BPD). Data from a…

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Risk Stratification in Infants With Primary Pulmonary Vein Stenosis
 Risk Stratification in Infants With Primary Pulmonary Vein Stenosis 1024 681 Mary Bates, PhD
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sleeping infant

Categorizing infants with pulmonary vein stenosis into stable and progressive groups could help inform treatment. Primary pulmonary vein stenosis is a rare, often lethal, cardiac disease. It is challenging to treat, as the disease can be progressive in some patients but not others. In a new study, researchers from Nationwide Children’s describe outcomes among preterm infants…

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Cerebral Organoids Provide Insight into Human Brain Development and Neurological Disease
 Cerebral Organoids Provide Insight into Human Brain Development and Neurological Disease 1024 575 JoAnna Pendergrass, DVM
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microscopic image of brain organoid

Correlations between the neuroelectrical maturation and cellular development of cerebral organoids highlight the organoids’ translational and therapeutical potential in early neurodevelopmental disorders. Cerebral organoids are three-dimensional miniature organs that resemble the human brain. Derived from human pluripotent stem cells, cerebral organoids have emerged to advance stem cell research, improve three-dimensional tissue culture techniques and enhance…

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Prematurity and Genomics: Can Complications For a Baby Born Preterm Be Predicted?
 Prematurity and Genomics: Can Complications For a Baby Born Preterm Be Predicted? 1024 575 Eric Butterman
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conceptual art of DNA

Complications from being born preterm are the number one cause of death in the world for children under the age of five, says Leif Nelin, MD, division chief of Neonatology at Nationwide Children’s Hospital and professor of Pediatrics at The Ohio State University . But why do some babies born preterm develop complications while many others seem…

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Advances in Neonatal GERD
 Advances in Neonatal GERD 1024 683 Mary Bates, PhD
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Dr. Jadcherla

New studies from the Jadcherla Lab provide insights into diagnosing, classifying and treating GERD in infants. Differentiating gastroesophageal reflux (GER), which is defined as the passage of gastric contents into the esophagus, from GER disease (GERD), when reflux is associated with troubling symptoms, remains a challenge in infants. Symptom-based diagnosis and treatment of GERD has…

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Searching for a Predictive Biomarker of Pulmonary Hypertension in Babies With Bronchopulmonary Dysplasia
 Searching for a Predictive Biomarker of Pulmonary Hypertension in Babies With Bronchopulmonary Dysplasia 1024 575 Abbie Miller
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Pulmonary hypertension is high blood pressure in the lungs and is a comorbidity of bronchopulmonary dysplasia (BPD), which is the chronic lung disease of premature babies. When pulmonary hypertension is present in the context of BPD, the risk of death is significantly increased. As neonatologists continue to define the phenotype of severe BPD, Jennifer Trittmann, MD, MPH,…

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Uncovering Why Synthetic Tracheal Replacements Fail, and Hints for Success
 Uncovering Why Synthetic Tracheal Replacements Fail, and Hints for Success 1024 575 Kevin Mayhood
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“There is no ideal replacement for the trachea,” says Tendy Chiang, MD, a pediatric otolaryngologist and a principal investigator in the Center for Regenerative Medicine in the Abigail Wexner Research Institute (AWRI) at Nationwide Children’s Hospital. “There are many surgical techniques that can manage tracheal defects and disorders, however, for longer-segment defects, they oftentimes require replacement tissue that…

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What is the Association Between Kidney Injury and Fluid Balance in Premature Newborns?
 What is the Association Between Kidney Injury and Fluid Balance in Premature Newborns? 1024 575 Mary Bates, PhD
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Nurse caring for infant in Neonatal Intensive Care Unit (NICU)

A positive fluid balance is associated with acute kidney injury and worse outcomes in a new study of premature infants. According to new research, there is an association between fluid balance and outcomes in preterm newborns, with a negative fluid balance during the first week of life emerging as a potential therapeutic target. Premature infants…

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Asymptomatic Infants With Congenital Cytomegalovirus May Still Have Detectable, Significant Abnormalities
 Asymptomatic Infants With Congenital Cytomegalovirus May Still Have Detectable, Significant Abnormalities 1024 575 Katie Brind'Amour, PhD, MS, CHES
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Color photo of Black father holding infant on shoulder in front of nursery background with clouds on the wall

More than half of high-risk CMV-positive newborns may have abnormalities not detected by a physical exam alone. A study in 34 infants with a normal physical exam despite a positive diagnosis of congenital cytomegalovirus (CMV) — a viral infection that can lead to neurodevelopmental delays and permanent hearing loss — found that in more than…

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Optimal Use of an FDA-Approved Device for PDA Closure in Infants
 Optimal Use of an FDA-Approved Device for PDA Closure in Infants 150 150 Mary Bates, PhD
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Randomized, controlled clinical trials are needed to answer questions regarding when and with whom to use the device. In January 2019, the US Food and Drug Administration approved a novel device for patent ductus arteriosus (PDA) closure in infants. The Amplatzer Piccolo Occluder is indicated for catheter-based closure of PDA in infants weighing more than…

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CMV Testing: Why You Don’t Need Legislation to Make It a Good Idea
 CMV Testing: Why You Don’t Need Legislation to Make It a Good Idea 1024 575 Samantha Morsink
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CMV is the leading non-genetic cause of sensorineural hearing loss in infancy and childhood. Identification of newborns with congenital CMV infection can improve their outcomes by early intervention programs and/or antiviral treatment. Cytomegalovirus, or CMV, infects almost everyone at some point in time, and it is one of the most common congenital infections worldwide. While…

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Development of Innovative Scoring Systems for Sickness and Tissue Damage From Clostridium difficile Colitis
 Development of Innovative Scoring Systems for Sickness and Tissue Damage From Clostridium difficile Colitis 1024 575 Lauren Dembeck
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In a new publication, the team reported the development of two novel scoring systems to consistently and efficiently assess sickness and tissue injury during antibiotic-associated C. difficile colitis in a murine model. “My laboratory at Nationwide Children’s Research Institute has collaborated for several years with two other laboratories, those of Dr. Steven Goodman and Dr. Michael Bailey.…

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What’s Next for NEC?
 What’s Next for NEC? 898 504 Abbie Miller
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Red. White. Black. These are the colors of necrotizing enterocolitis, or NEC. When surgeons open the distended abdomens of the tiny infants affected by NEC, they see a mottled mixture of red (inflamed), white (ischemic) and black (dead) tissue. Their first task is to assess whether or not there is enough viable tissue to save.…

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Toward a Cell-based Therapy for Cystic Fibrosis Lung Disease
 Toward a Cell-based Therapy for Cystic Fibrosis Lung Disease 150 150 Jeb Phillips
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Because cystic fibrosis (CF) is a genetic disease caused by mutations in the CFTR gene, the pulmonary disease could be reversed if CF airway epithelial cells were replaced with basal cells expressing CFTR without mutations. That is one of the ideas underpinning the Cystic Fibrosis Foundation’s Epithelial Stem Cell Consortium, but there are a number of…

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Acid Reflux Index Severity Alone Should Not Determine GERD Diagnosis
 Acid Reflux Index Severity Alone Should Not Determine GERD Diagnosis 150 150 Kevin Mayhood
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ARI severity plays little role in symptom generation, but symptoms alone are unreliable for diagnosing gastroesophageal reflux disease, researchers say. However, a new study from the Neonatal and Infant Feeding Disorders Program at Nationwide Children’s Hospital shows that stomach acid alone doesn’t appear to have much to do with GERD at all, and responses to esophageal stimulation…

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Prenatal Magnesium Sulfate May Not Reduce Cerebral Palsy Severity as Once Believed
 Prenatal Magnesium Sulfate May Not Reduce Cerebral Palsy Severity as Once Believed 1024 575 Jeb Phillips
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Improved neonatal care and earlier diagnosis and management may instead be reason for a decrease in cerebral palsy severity. A large randomized controlled trial showed in 2008 that when pregnant women at imminent risk of preterm delivery were given magnesium sulfate, their children had reduced rates of moderate or severe cerebral palsy. As a result…

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Researchers Identify Proteins Triggering Imbalance of Cells in Chronic Lung Disease
 Researchers Identify Proteins Triggering Imbalance of Cells in Chronic Lung Disease 1024 575 Kevin Mayhood
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Illustration of lungs on blue silhouette of upper chest on black background

A protein that triggers an imbalance of mucous and ciliated cells in patients with chronic lung disease could be a target for treatments to restore airways. Many chronic lung diseases in children and adults have one thing in common: the airway lining that normally traps and sweeps out bacteria, viruses and diesel particulates stops functioning…

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What Happens When Opioid-Exposed Babies Go Home?
 What Happens When Opioid-Exposed Babies Go Home? 1024 575 Abbie Miller
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Black and white image of an unsmiling White woman holding a young, awake infant in the right third of the frame

Follow-up for babies with NAS or prenatal opioid exposure is essential for understanding risks and outcomes.

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What Can Bench Science Teach Us About Opioid Abuse?
 What Can Bench Science Teach Us About Opioid Abuse? 150 150 Abbie Miller
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In vitro models can help answer big questions about neonatal abstinence syndrome and fetal drug exposure.

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Feeding Difficulties in Opioid-Exposed Infants — Mechanics and Possible Causes
 Feeding Difficulties in Opioid-Exposed Infants — Mechanics and Possible Causes 1024 575 Kevin Mayhood
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A recent study suggests altered vagus nerve activity, creating resistance in the esophagus while swallowing. Infants exposed to opioids prenatally often show signs of gastroesophageal reflux disease. But a study by neonatologists at Nationwide Children’s Hospital found that feeding troubles are more likely due to excessive pressure and a lack of coordinated muscle contractions in…

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A Better Way to Administer Probiotics?
 A Better Way to Administer Probiotics? 150 150 Abbie Miller
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Researchers have designed a delivery system to treat premature infants with necrotizing enterocolitis that may have applications beyond the NICU. Most of the time, we think biofilms are bad news. And when pathogenic microbes form biofilms, they are. The biofilms created by pathogenic microbes create fortresses that make them resistant to attack by the immune…

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Why Obese Women Have More Surgical Infections After Cesarean Delivery
 Why Obese Women Have More Surgical Infections After Cesarean Delivery 1024 575 Jeb Phillips
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Illustration showing the precise pattern of a biofilm - a perfect, 3D matrix

Even though all pregnant woman typically undergo a standardized antiseptic preparation before a cesarean delivery, obese women are twice as likely to develop a surgical site infection after the procedure as women with a normal body mass index. A new, first-of-its-kind study from The Ohio State University Wexner Medical Center and Nationwide Children’s Hospital shows why — and…

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Can We Prevent Future Language Delays in the NICU?
 Can We Prevent Future Language Delays in the NICU? 150 150 Abbie Miller
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Researchers investigate the use of event related potentials to measure the effects of mother’s voice exposure on speech sound differentiation. Preterm infants are at high risk for neurosensory impairments and developmental delays, including hearing loss, which may have lasting consequences. Compared to babies born at term, preterm infants are twice as likely to have a…

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Somali-Born Women Have Lowest Preterm Birth Rate in Ohio
 Somali-Born Women Have Lowest Preterm Birth Rate in Ohio 1024 575 Kevin Mayhood
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Photo of equipment for premature infants

Researchers hope the immigrants can teach them how to reduce the rates of prematurity in the general population. Year after year, studies have found that non-Hispanic white women have the lowest preterm birth rate in Ohio, but new research found a different trend. Somali immigrants had a 5.9 percent preterm birth rate in the state…

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The Challenge of Studying Supplementation: Omega Fatty Acids to Prevent Preterm Birth and Associated Complications
 The Challenge of Studying Supplementation: Omega Fatty Acids to Prevent Preterm Birth and Associated Complications 1024 575 Abbie Miller
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Dietary supplements: it seems that medical professionals either love them or hate them. And while much research shows that the average healthy adult with a good diet probably doesn’t need them, studies of specific supplements in specific patient populations may show efficacy. For example, studies show that omega-3 fatty acid supplements can reduce inflammation and…

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Mapping the Journey to Optimal Health for NICU Graduates
 Mapping the Journey to Optimal Health for NICU Graduates 1024 683 Jeb Phillips
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Babies born preterm need ongoing, specialized care to help them thrive after discharge from the hospital. Innovative programs are being designed to ensure that they get that care. In the early 1980s, only 10 percent of infants born before 28 weeks of gestational age survived to be discharged from the hospital. By 2015, 65 percent…

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Integrating Research Into the “Journeys”
 Integrating Research Into the “Journeys” 1024 683 Jeb Phillips
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Along with their work to build an innovative follow-up program, Nationwide Children’s faculty and staff members are international leaders in NICU follow-up research. A number of foundation and National Institutes of Health-funded follow-up studies are housed entirely or in part at the hospital, and The Research Institute at Nationwide Children’s is one of 17 member…

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What Do Space Rocks Have to Do With Preterm Birth?
 What Do Space Rocks Have to Do With Preterm Birth? 150 150 Abbie Miller
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A brief history of nanobacteria and their implications for human health. I remember when nanobacteria were a really big deal. Press-conference-by-POTUS-about-evidence-of-extraterrestrial-life-level big deal. I hadn’t thought much about them until recently, when they made a surprise appearance in a presentation on idiopathic preterm birth by Irina Buhimschi, MD, director of the Center for Perinatal Research at The…

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New Study Points to a Possible Cause of Many Preterm Births
 New Study Points to a Possible Cause of Many Preterm Births 150 150 Jeb Phillips
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The discovery that small calcium deposits in fetal membranes may lead to a mother’s water breaking prematurely suggests that dietary or other interventions could prevent those preterm births. Most spontaneous preterm births do not have causes that are easy to identify. Physicians frequently have not known why uterine contractions begin weeks earlier than they should,…

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Stress Dose Hydrocortisone Effects on Neurodevelopment for Extremely Low Birthweight Infants
 Stress Dose Hydrocortisone Effects on Neurodevelopment for Extremely Low Birthweight Infants 150 150 Abbie Miller
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First placebo-controlled study on stress dose hydrocortisone and neurodevelopment shows that higher doses of hydrocortisone are not associated with brain injury or neurodevelopmental impairments, but may not be effective in reducing risk for bronchopulmonary dysplasia. Hydrocortisone is one of the 15 most frequently prescribed medications in extremely low birth weight (≤1000 g) infants in the…

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Reducing Practice Variation in Pediatrics
 Reducing Practice Variation in Pediatrics 150 150 Jonathan Slaughter, MD, MPH
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With variations in practice existing even between practitioners at the same institution, research can provide the keys to standardizing care and improving outcomes. Practice variation occurs when care providers diagnose or treat patients differently, even in the setting of similar disease presentation and risk factors. Variations in care have been noted at the geographic level…

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Placental Transfusion Confusion
 Placental Transfusion Confusion 150 150 Katie Brind'Amour, PhD, MS, CHES
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Medical professional organizations cannot reach consensus regarding delayed cord clamping and umbilical cord “milking.” Nearly every relevant professional organization has its own recommendations for placental transfusion techniques known as delayed umbilical cord clamping and milking. But it’s unclear whether additional research will lead to consensus. The American Congress of Obstetricians and Gynecologists and American Academy of Pediatrics say there’s…

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Are We Properly Capturing the Maternal-Child Health Continuum?
 Are We Properly Capturing the Maternal-Child Health Continuum? 150 150 Irina Buhimschi
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An obstetrician doing research at a children’s hospital may seem out of place. But not according to one clinician-scientist, who believes that maternal health and child health are inextricably intertwined. Traditionally, doctors divide into those who practice adult medicine and those who practice pediatrics. With the exception of family physicians, there is little crossover in…

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Thinking Outside the (Tool) Box: How Techniques From Alzheimer’s Research Illuminate the Pathophysiology of Preeclampsia
 Thinking Outside the (Tool) Box: How Techniques From Alzheimer’s Research Illuminate the Pathophysiology of Preeclampsia 150 150 Katie Brind'Amour, PhD, MS, CHES
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Irina Buhimschi, MD, has a habit of getting lost. In July 2007, that poor sense of direction proved to be a fortunate flaw. Having wandered into the wrong presentation at the Protein Society’s national conference, she hovered in the back to get her bearings. Up front, a speaker discussed how misfolded proteins accumulate in the…

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