A New Era in Neonatal Care and Research

By: Aaron Hamvas
May 06, 2015
Last year I joined the Division of Neonatology at Lurie Children’s because I saw so much promise. The division has a national reputation for excellent clinical care, and the hospital’s new facility on the campus of Northwestern University Feinberg School of Medicine has expanded opportunities for research collaboration beyond its walls.
A state-of-the-art neonatal program needs three essential elements. First, it needs strong, nationally recognized subspecialty programs, so that critically ill babies can have immediate access to all pediatric medical and surgical services. This already exists at Lurie Children’s.
Second, it needs robust obstetrical programs. The delivery service at Prentice Women’s Hospital, immediately adjacent to Lurie Children’s, is one of the nation’s largest, with over 12,000 babies delivered each year. Our neonatologists and nurse practitioners are active in both the Prentice and Lurie Children’s Neonatal Intensive Care Units (NICU) and take care of over 2,000 babies annually.  Last year, newborns from 47 other hospitals were transferred to our NICU. We also have direct involvement with 11 partner hospitals throughout the city and suburbs, so our neonatologists are active in hospitals that manage more than 30,000 births annually. As you can see, Lurie Children’s neonatology operation is much bigger than our NICU alone.
The third element in a state-of-the-art neonatology program is research. What defines the very strongest programs nationally is cutting-edge basic and translational research, using clinical care as the basis.  Questions we raise at the bedside can be brought to the lab for answers.
We have several research initiatives that integrate clinical trials with basic science research, several of which are supported by the National Institutes of Health. For example, a major emphasis on identifying fetal and childhood origins of adult disease demonstrates the continuum of biology across the age spectrum. Dr. Karen Mestan is looking at placental and intrauterine factors that may be causing poor outcomes for premature infants and may help to explain why two babies who appear to start the same in life have totally different outcomes. My own long-term research interest in the genetic contributions to lung disease started with newborns but has branched out to include older children and adults.
That’s how medicine and research are going: the boundaries between clinical care and research, between pediatrics and adult medicine, are blurring as a result of a better understanding of disease and accelerated discoveries due to technology.  Also, the concept of personalized medicine has changed the game. We used to speak of common or rare diseases, but in a way, all diseases will become rare, because they will be so specific to an individual’s genetic makeup and the environmental exposures that make their disease and their response to it unique. 
It’s an exciting time to be practicing medicine – basic science findings are finding their way into clinical practice, and soon, these findings will also be translated into specific treatments tailored to an individual. We look forward to being a part of that here at Lurie Children’s.
This article originally appeared in the Spring 2015 issue of Heroes magazine.