Neonatology Updates: Winter 2021
Increased Maternal BMI May Be Associated with Lower Cognitive Function in Children Born Preterm
A study led by Daniel Robinson, MD, MSc, from Lurie Children’s, found that higher maternal BMI was associated with lower cognitive scores at 18 months corrected age in children born prematurely. This significant association remained in an adjusted model accounting for relevant influences on early childhood development. Published in the American Journal of Perinatology, these findings suggest that increased maternal BMI may serve as a marker indicating risk of altered cognitive development in children born preterm.
Point of Care Ultrasound Within Lurie Children’s NICU
The neonatal intensive care unit (NICU) at Lurie Children’s one of the very few in the country to offer point-of-care ultrasound (POCUS) at the bedside, as well as a POCUS curriculum for neonatal trainees. While POCUS has become a regular modality for procedural and diagnostic guidance within pediatric intensive care units and emergency departments, its utilization within NICUs has been limited by insufficient education and lack of access to the technology. The NICU indications for POCUS include predominantly vascular access and umbilical venous catheter (UVC) tip localization, as well as identifying pathology within lung images, such as pneumothorax and pleural effusions. It also is used for targeted echocardiography to assess basic cardiac views, function and pericardial effusion. The NICU POCUS program at Lurie Children’s – headed by Stephanie Marshall, MD, with colleagues Cassandra Montoya, MD, and Shawn Sen, MD – plans to pursue research, as well as expand trainee education, including development of a regional/national course.
Silenced MicroRNA Cluster May Drive Abnormal Lung Development and Bronchopulmonary Dysplasia
Building on her previous research that found an association between an abnormally silenced microRNA cluster (miR-17~92) and severe bronchopulmonary dysplasia (BPD) in premature infants, Mary Robbins, MD, from Lurie Children’s, is seeking to establish a causal relationship. Normally a suppressor of other critical genes, the decrease in this microRNA cluster may drive the development of fibrotic pathways in the lungs. This NIH-funded research could lead to a novel therapeutic target, and potentially the use of the miR-17~92 cluster as a biomarker for earlier BPD diagnosis or risk stratification. Dr. Robbins was recently invested as the Neal, Kathleen and Adam Kulick Endowed Research Scholar in Neonatology.
Early Detection of Cerebral Palsy in NICU Graduates
Lurie Children’s is one of only six centers nationwide in the Cerebral Palsy Foundation’s Early Detection and Intervention Initiative. The multidisciplinary team at the hospital’s Early Childhood Clinic is using a screening protocol to identify infants at high risk for cerebral palsy at 3-6 months and follow closely to make definitive diagnoses in most patients at less than 1 year of age, as well as immediately connect them to needed services. Although some graduates of the neonatal intensive care unit (NICU) are at increased risk for cerebral palsy, in the past they were commonly diagnosed after 18 months. Earlier diagnosis of cerebral palsy is important because newer studies show that earlier therapy is associated with better functional outcomes for these children. Led by neonatologist Raye-Ann O. deRegnier, MD, the team’s next steps are to increase academic and community partnerships to decrease delays in therapy initiation and to develop more effective types of therapy that can be initiated in very young infants.