Maternal and Child Health Commons^™

The Program To Reduce Implicit Bias In Carroll Hospital Center Using The Implicit Association Test, Katherine E. Traynor

Capstone Showcase

Natural brain processes make all individuals susceptible to unconscious bias; however, stressful, fearful, or anger-evoking situations as well as the negative influence of media and social surroundings increase the risk of holding obstructive bias, and there is a greater risk of being negatively impacted by this phenomenon when belonging to a minority population (Rose & Flores, 2020). As a result, high rates of infant mortality (10.2 deaths per 1,000 live births for the Non-Hispanic Black population compared to 4.1 in the White population) and cardiovascular related diseases (190.0 cases per 1,000 in the Non-Hispanic Black population compared to 161.3 in …

Maternal Occupational Exposures And Fetal Growth In A Spanish Birth Cohort, Maribel Casas, Jesús Ibarluzea, Carmen Iñiguez, Loreto Santa-Marina, Michael D Swartz, Kristina W Whitworth

Faculty, Staff and Student Publications

While the epidemiologic literature suggests certain maternal occupational exposures may be associated with reduced measures of size at birth, the occupational literature employing fetal biometry data to assess fetal growth is sparse. The present study examines associations between maternal occupational exposures and ultrasound-measured fetal growth. We included 1,739 singleton pregnancies from the INfancia y Medio Ambiente (INMA) project (2003-2008). At 32 weeks of pregnancy, interviewers ascertained mothers' employment status and assessed job-related physical loads, work schedules, and job strain during pregnancy. Job titles were linked to a job-exposure matrix to estimate exposure to 10 endocrine disrupting chemical (EDC) groups. We …

An Analysis Of Georgia Mothers Who Gave Birth In 2015 And 2016 Without Receiving Prenatal Care, Joncel Stephens, Shanta R. Dube, Merrilee Gober

Journal of the Georgia Public Health Association

Background: The present study characterizes the population of women residing in the state of Georgia who did not receive prenatal care before giving birth to a live infant. The association between mother’s place of residence (rural/non-rural) and preterm delivery was also examined.

Methods: This study examined data obtained from the Georgia Department of Public Health which includes data for 7,062 mothers who did not receive prenatal care before giving birth to a live infant in Georgia in the years 2015 and 2016. Data on the resulting births was also studied. Descriptive analyses of the following variables were used …

Implementing A Robust Process Improvement Program In The Neonatal Intensive Care Unit To Reduce Harm, Lauren Yager

Faculty, Staff and Student Publications

INTRODUCTION: Preventable harm continues to occur with critically ill neonates despite efforts by hospital neonatal intensive care units (NICUs) to improve processes and reduce harm. Attaining significant and sustainable improvements will require training including leadership support, mentoring, and patient family engagement to improve care processes. This paper describes the implementation of a robust process improvement (RPI) program in the NICU to reduce harm.

METHODS: Leaders, staff, and parents were trained in RPI concepts and tools. Multidisciplinary teams including parent members applied the training and received regular mentorship for their improvement initiatives.

RESULTS: Participants (N = 67) completed pretraining and post-training …

Invasive Haemophilus Influenza Type B In An Infant During The Covid-19 Pandemic: The Return Of Diseases We Hoped Never To See Again…

Faculty, Staff and Student Publications

No abstract provided.

Differential Gene Expression In Cord Blood Of Infants Diagnosed With Cerebral Palsy: A Pilot Analysis Of The Beam Cohort, Dwight J Rouse, Sean C Blackwell, Nina K Ayala, Antonio F Saad, Steve N Caritis, Eunice Kennedy Shriver National Institute Of Child Health And Human Development Maternal-Fetal Medicine Units Network

Faculty, Staff and Student Publications

The Beneficial Effects of Antenatal Magnesium clinical trial was conducted between 1997 and 2007, and demonstrated a significant reduction in cerebral palsy (CP) in preterm infants who were exposed to peripartum magnesium sulfate (MgSO4). However, the mechanism by which MgSO4 confers neuroprotection remains incompletely understood. Cord blood samples from this study were interrogated during an era when next-generation sequencing was not widely accessible and few gene expression differences or biomarkers were identified between treatment groups. Our goal was to use bulk RNA deep sequencing to identify differentially expressed genes comparing the following four groups: newborns who ultimately developed CP treated …

Associations Between Eight Earth Observation-Derived Climate Variables And Enteropathogen Infection: An Independent Participant Data Meta-Analysis Of Surveillance Studies With Broad Spectrum Nucleic Acid Diagnostics, Josh M. Colston, Benjamin F. Zaithcik, Hamada S. Badr, Eleanor Burnett, Syed Asad Ali, Ajit Rayamajhi, Syed M. Satter, Daniel Eibach, Ralf Krumkamp, M Imran Nisar, Anita K. M. Zaidi, Zulfiqar Ahmed Bhutta

Department of Paediatrics and Child Health

Diarrheal disease, still a major cause of childhood illness, is caused by numerous, diverse infectious microorganisms, which are differentially sensitive to environmental conditions. Enteropathogen‐specific impacts of climate remain underexplored. Results from 15 studies that diagnosed enteropathogens in 64,788 stool samples from 20,760 children in 19 countries were combined. Infection status for 10 common enteropathogens—adenovirus, astrovirus, norovirus, rotavirus, sapovirus, Campylobacter, ETEC, Shigella, Cryptosporidium and Giardia—was matched by date with hydrometeorological variables from a global Earth observation dataset—precipitation and runoff volume, humidity, soil moisture, solar radiation, air pressure, temperature, and wind speed. Models were fitted for each pathogen, accounting …

Cesarean Skin-To-Skin Contact: Who Gets The Experience In The Operating Room?, Jessica S. Junk-Wilson

Graduate Theses/Dissertations

For the past decade, skin-to-skin contact immediately after birth has been the general recommendation for all births, as there is evidence that it provides many benefits for mothers and infants. Yet, research has shown that immediate skin-to-skin contact is not the standard practice after most Cesarean births. This study assessed access, incidence, and circumstances surrounding Cesarean skin-to-skin contact (CSSC) in the operating room and examined influencing maternal characteristics of age, education, race, and number of births via a survey of 2327 people. Women who experienced a Cesarean section birth in the past 10 years were recruited through Facebook groups for …

Changing Perceptions Of Rural Frontline Workers And Caregivers About Management Of Childhood Diarrhea And Pneumonia Despite Several Inequities: The Nigraan Plus Trial In Pakistan, Fauziah Rabbani, Hyder Ali Khan, Suneel Piryani, Nousheen Pradhan, Natasha Shaukat, Anam Shahil Feroz, Shagufta Perveen

Community Health Sciences

Purpose: Diarrhea and pneumonia greatly contribute to high childhood mortality in Pakistan. Frontline community health workers or the Lady Health Workers (LHWs) provide care at the doorstep of over 60% of Pakistan's rural residents. Difficult terrain, lack of supplies, and inadequate supervision put these LHWs at an added disadvantage in the timely diagnosis and delivery of known treatment options to community caregivers (CCGs). This study aims to assess whether a supportive supervision intervention through Lady Health Supervisors (LHSs) using enhanced mentorship and written feedback cards have the potential to improve case management of childhood diarrhea and pneumonia.
Study setting and …

Disparities Among Black Women In Maternal Health, Josefina Teresa Estrada

Nursing | Senior Theses

The literature shows that Black women face many disparities in terms of health care access and the quality of care. These obstacles could negatively affect the health of the mother and their child. This paper includes a literature review and proposed research study. The objective of this research study is to identify the outcomes of Black women compared to White women and other women of color in terms of maternal health. A literature review is provided in order to identify how race affects the following factors: obstacles that limit access to healthcare, rates of obtaining prenatal care, postpartum outcomes and …

Improving Maternal And Child Health In Pakistan: A Programme Evaluation Using A Difference In Difference Analysis, Muhammad Ashar Malik, Lara Riedige Rohm, Pieter Van Baal, Eddy Van Doorslaer Van Doorslaer

Community Health Sciences

Introduction: Pakistan is a country with high maternal and infant mortality. Several large foreign funded projects were targeted at improving maternal, neonatal and child health. The Norway-Pakistan Partnership Initiative (NPPI) was one of these projects. This study aims to evaluate whether NPPI was successful in improving access and use of skilled maternal healthcare.
Methods: We used data from three rounds (2009-2010, 2011-2012 and 2013-2014) of the Pakistan Social and Living Standards Measurement Survey (PSLM). A difference-in-difference regression framework was used to estimate the effectiveness of NPPI and its different programme components with respect to maternal healthcare seeking behaviour of pregnant …

Defining The Epidemiology Of Safety Risks In Neonatal Intensive Care Unit Patients Requiring Surgery, L Dupree Hatch, Amanda Lorinc, Christoph U Lehmann, Jamie Robinson, Marlee Crankshaw, Maria Sullivan, Timothy A Newman, Tamara Wallace, Matthew B Weinger, Martin L Blakely

Faculty, Staff and Student Publications

OBJECTIVE: The aim of the study was to determine the incidence, type, severity, preventability, and contributing factors of nonroutine events (NREs)-events perceived by care providers or skilled observers as a deviations from optimal care based on the clinical situation-in the perioperative (i.e., preoperative, operative, and postoperative) care of surgical neonates in the neonatal intensive care unit and operating room.

METHODS: A prospective observational study of noncardiac surgical neonates, who received preoperative and postoperative neonatal intensive care unit care, was conducted at an urban academic children's hospital between November 1, 2016, and March 31, 2018. One hundred twenty-nine surgical cases in …

Categorization And Frequency Of Indications For Packed Cell Transfusion In The Preterm Newborn During The Initial Hospital Stay At A Tertiary Care Hospital: A Cross-Sectional Study, Shirin Surani, Heeramani Lohana, Sheraz Ahmed, Rabia Hassan, Sapna Kewalani, Khalil Ahmed

Department of Paediatrics and Child Health

Introduction: Packed cell transfusion is a lifesaving procedure in premature babies as they have more complications as compared to babies who are born at term. Complications related to prematurity increase as gestational age decreases and anemia is one of the complications of prematurity which needs packed cell transfusions. To date, when to transfuse preterm babies and what would be the threshold for hemoglobin and hematocrit is still a point of argument as well as liberal versus restrictive transfusion protocols have been developed but what should be followed still needs more data. In our study, we have observed frequencies of different …

Full Breastfeeding Protection Against Common Enteric Bacteria And Viruses: Results From The Mal-Ed Cohort Study, Benjamin J J. Mccormick, Stephanie A. Richard, Laura E. Murray-Kolb, Gagandeep Kang, Aldo A M. Lima, Estomih Mduma, Margaret N. Kosek, Elizabeth T Rogawski Mcquade, Eric R. Houpt, Zulfiqar Ahmed Bhutta

Woman and Child Health

Background: Breastfeeding is known to reduce risk of enteropathogen infections, but protection from specific enteropathogens is not well characterized.
Objective: To estimate the association between full breastfeeding (days fed breast milk exclusively or with non-nutritive liquids) and enteropathogen detection.
Design: 2,145 newborns were enrolled in eight sites, of whom 1,712 had breastfeeding and key enteropathogen data through 6 months. We focused on eleven enteropathogens: adenovirus 40/41, norovirus, sapovirus, astrovirus, and rotavirus, enterotoxigenic Escherichia coli (ETEC), Campylobacter spp, and typical enteropathogenic E. coli as well as entero-aggregative E. coli, Shigella and Cryptosporidium. Logistic regression was used to estimate the risk of …

Micronutrient Supplements Can Promote Disruptive Protozoan And Fungal Communities In The Developing Infant Gut, Ana Popovic, Celine Bourdon, Pauline W. Wang, David S. Guttman, Sajid Bashir Soofi, Zulfiqar Ahmed Bhutta, Robert H J. Bandsma, John Parkinson, Lisa G. Pell

Centre of Excellence in Women and Child Health

Supplementation with micronutrients, including vitamins, iron and zinc, is a key strategy to alleviate child malnutrition. However, association of gastrointestinal disorders with iron has led to ongoing debate over their administration. To better understand their impact on gut microbiota, we analyse the bacterial, protozoal, fungal and helminth communities of stool samples collected from a subset of 80 children at 12 and 24 months of age, previously enrolled into a large cluster randomized controlled trial of micronutrient supplementation in Pakistan (ClinicalTrials.gov identifier NCT00705445). We show that while bacterial diversity is reduced in supplemented children, vitamins and iron (as well as …

The Efficacy Of A Personalized Mhealth Coaching Program During Pregnancy On Maternal Diet, Supplement Use, And Physical Activity: Protocol For A Parallel-Group Randomized Controlled Trial, Rozina Nuruddin, Khadija Vadsaria, Nuruddin Badruddin Mohammed, Saleem Sayani

Community Health Sciences

Background: Adequate intake of macro- and micronutrients and adoption of an active lifestyle during pregnancy are essential for optimum maternal and fetal health and offspring development. Dietary counseling and advice regarding adequate physical activity are integral components of antenatal care. Personalized coaching through the use of mobile health (mHealth) that supports behavior modification is an innovative approach that needs exploration.
Objective: Our primary aim is to assess the efficacy of an mHealth program in improving diet, supplement use, and physical activity during pregnancy. Secondary objectives include evaluation of the program's effect on maternal and offspring health outcomes and assessment of …

Distance From Healthcare Facilities Is Associated With Increased Morbidity Of Acute Infection In Pediatric Patients In Matiari, Pakistan, Elise Corden, Saman Hasan Siddiqui, Yash Sharma, Sheraz Ahmed, Fayyaz Umrani, Najeeb Rahman, Rafey Ali, Najeeha Talat Iqbal, Syed Asad Ali, Sana Syed

Department of Paediatrics and Child Health

The relationship between environmental factors and child health is not well understood in rural Pakistan. This study characterized the environmental factors related to the morbidity of acute respiratory infections (ARIs), diarrhea, and growth using geographical information systems (GIS) technology. Anthropometric, address and disease prevalence data were collected through the SEEM (Study of Environmental Enteropathy and Malnutrition) study in Matiari, Pakistan. Publicly available map data were used to compile coordinates of healthcare facilities. A Pearson correlation coefficient (r) was used to calculate the correlation between distance from healthcare facilities and participant growth and morbidity. Other continuous variables influencing these …

Unintended Pregnancy And The Associated Factors Among Pregnant Females: Sukh Survey-Karachi, Pakistan, Shama Razzaq, Saleem Jessani, Narjis Rizvi, Sarah Saleem

Community Health Sciences

Objective: Unintended pregnancy has become a substantially growing reproductive health concern in South Asian region. The objective of this survey was to assess the magnitude of unintended pregnancy along with its correlates among currently pregnant women residing in Karachi.
Methods: A community based, multistage, cross-sectional study was carried out among 612 currently pregnant women from squatter settlements of Karachi, inquiring for "unintended pregnancy", outcome of interest. Multivariable logistic analysis was done using SPSS v.19 to determine associated factors.
Results: Of 612 pregnant women interviewed, 168(27.4%) reported their pregnancies as unintended. The multivariable regression identified a high likelihood of unintended pregnancy …

A Comparison Of Methods Of Discontinuing Nasal Cpap In Premature Infants <30 Weeks Gestation: A Feasibility Study

Faculty, Staff and Student Publications

OBJECTIVE: The objective of this study was to determine whether abrupt discontinuation vs gradual wean of nasal CPAP (NCPAP) in infantstherapy.

STUDY DESIGN: We performed a single-center, randomized control trial of premature infants born(n = 66), comparing discontinuation of NCPAP from 6 cmH

RESULTS: Duration of NCPAP or mechanical ventilation was longer in the slow wean arm compared to the fast wean arm (17 vs 12 days, p = 0.03). There were no differences observed in secondary outcomes.

CONCLUSION: In weaning NCPAP, abrupt discontinuation may be associated with a shorter duration of positive pressure respiratory support compared to a gradual …

Residency Support During A Natural Disaster: Hurricane Ida, Tiffany Chang, Elizabeth W. Kelly, Chi Dola

HCA Healthcare Journal of Medicine

Natural disasters can have extraordinary impacts on a community and its infrastructure. Disasters can weaken systems that provide crucial resources, such as shelter, food security, water and health care. Recently, southeast Louisiana sustained devastating damage from Hurricane Ida on the 16th anniversary of Hurricane Katrina. Our medical workforce faced challenges caring for patients in a facility without potable water and powered by a generator. With the support of corporate entities and our academic institution, however, these barriers were quickly overcome and thus highlights the importance of collective resilience in the face of a natural disaster.

The Impact Of The Covid-19 Pandemic On Newborn Hearing Screening Programs In Western States, Nathan A. Blaseg, Hannah M. Williams, Shelby Jepperson, Jessica J. Messersmith

Journal of Early Hearing Detection and Intervention

The primary objective of this study was to determine the impact of the COVID-19 pandemic on newborn hearing screening guideline adherence and the respective rates of screening, diagnosis, and intervention. This was a review of newborn hearing screening data compiled from the Departments of Health of six states for the time periods of March-September 2019 and March-September 2020. Endpoints included the numbers of live births as well as the numbers and timeframes of screening, diagnostic, and intervention events. Two-tailed paired t-tests were performed to determine statistical significance. 181,662 births in six states were assessed. Compared to March-September 2019, March-September 2020 …

Evaluation The Effectiveness Of Abridged Imnci (7-Day) Course V Standard (11-Day) Course In Pakistan, Shabina Ariff, Kamran Sadiq, Uswa Jiwani, Khalil Ahmad, Khadija N Humayun, Shakeel Ahmed, Shaikh Qamaruddin Nizami, Iqtidar Khan, Nabeela Ali, Sajid Bashir Soofi, Zulfiqar Ahmed Bhutta

Department of Paediatrics and Child Health

Background: The conventional IMCI training for healthcare providers is delivered in 11 days, which can be expensive and disruptive to the normal clinical routines of the providers. An equally effective, shorter training course may address these challenges.
Methods: We conducted a quasi-experimental study in two provinces (Sindh and Punjab) of Pakistan. 104 healthcare providers were conveniently selected to receive either the abridged (7-day) or the standard (11-day) training. Knowledge and clinical skills of the participants were assessed before, immediately on conclusion of, and six months after the training.
Results: The improvement in mean knowledge scores of the 7-day and 11-day …

Adverse Childhood Experiences And Urinary Incontinence In Elementary School Aged Children, Amanda Jill Travis Msn, Fnp-C, Margaret C. Harvey Phd, Aprn, Acnp-Bc, Chfn, Michelle Rickard Dnp, Apnp-C

Doctor of Nursing Practice Projects

Purpose/Background: Adverse Childhood Experiences (ACEs) have an impact on health throughout the lifespan (Filletti et al., 1999; Hughes et al., 2017). These experiences range from physical and mental abuse, substance abuse in the home, parental separation or loss, financial instability, acute illness or injury, witnessing violence in the home or community, and incarceration of family members (Hughes et al., 2017). Understanding and screening for ACEs in children with urinary incontinence can help practitioners identify psychological stress as a potentially modifiable risk factor.

Methods: A 5-month chart review was performed identifying English speaking patients ages 6-11 years presenting to the outpatient …

Knowledge, Attitudes, And Beliefs About Safe Sleep Among Preconception Adolescents​, Keita Oumou, Krystal Hunter, Erica Levin, Lori Feldman-Winter

Cooper Rowan Medical Journal

Introduction–To protect against SUID/SIDS, the American Academy of Pediatrics (AAP) released recommendations on creating a safe sleep environment. Studies about teen parents indicate gaps in knowledge regarding infant safe sleep practices, however there are no published studies about adolescents who are preconception. The objective of this stud is to investigate adolescents’ knowledge, attitudes, and beliefs regarding infant safe sleep practices prior to conceiving.

Methods–This was a cross-sectional study of adolescents aged 14-22 years recruited from two outpatient primary care pediatric sites in Southern NJ. Following consent, participants completed a 27-question survey about infant safe sleep practices. For analysis, …

Effectiveness Of Unconditional Cash Transfers Combined With Lipid-Based Nutrient Supplement And/Or Behavior Change Communication To Prevent Stunting Among Children In Pakistan: A Cluster Randomized Controlled Trial, Sajid Bashir Soofi, Shabina Ariff, Gul Nawaz Khan, Atif Habib, Sumra Kureishy, Yasir Ihtesham, Masawar Hussain, Arjumand Rizvi, Muhammad Sajid, Zulfiqar Ahmed Bhutta

Department of Paediatrics and Child Health

Background: In Pakistan, the prevalence of stunting among children under-five years has remained above WHO critical thresholds (≥30%) over the last two decades.
Objective: We hypothesized that an unconditional cash transfer (UCT) combined with lipid-based nutrient supplement (LNS) and/or social and behavior change communication (SBCC) will prevent stunting among children 6-23 months of age.
Design: This was a four-arm, community-based cluster randomized controlled trial conducted in the district of Rahim Yar Khan, Pakistan. A total of 1729 children (UCT n = 434); (UCT+SBCC n = 433); (UCT+LNS n = 430) and (UCT+LNS+SBCC n = 432) were enrolled at 6 months …

Los Efectos Psicosociales Que Produce El Embarazo En Las Vidas De Madres Adolescentes En Quito, Ecuador, Kaylee Howell

Independent Study Project (ISP) Collection

Research Question: What are the psychological and social effects of teen pregnancy facing teen mothers in 2021 and how do they impact their lives? Objective: The general objective is to describe the psychosocial implications produced by teen pregnancy. Background: Teen pregnancy rates of Latin America and the Caribbean are second in the world, second only to the region of Subsaharan-Africa. Within Latin America, Ecuador has the highest rates of adolescent pregnancy, surpassed only by Venezuela. Recently, the taboo surrounding reproductive health has been challenged, with the matter of abortion being brought to the supreme court. In conjunction with the matter …

Draagmoederschap: Surrogacy In The Netherlands, Olivia Murray

Independent Study Project (ISP) Collection

In this paper, I investigated surrogacy in the Netherlands by interviewing four surrogates and one intended parent about their experiences. I found that the participants shared several common experiences and opinions, especially related to why they chose to be surrogates, how surrogates and intended parents negotiate their relationship during and after pregnancy, the tensions of passing on parenthood and merging families, the (non-binding) contracts that surrogates and parents create, Dutch law, and commercial surrogacy. I argue that much of the discourse around surrogacy relitigates many of the arguments made in favor and against sex work, in that it sets surrogacy …

Relation Of Breastfeeding Duration With Blood Pressure And Arterial Stiffness, Lohita Kollipara, Abbi Lane-Cordova, Xuewen Wang

Senior Theses

Background: The purpose of this analysis was to investigate the effects of differing breastfeeding duration on vascular function.

Methods: A study was designed to explore the breastfeeding patterns of 79 participants who delivered a singleton fetus 6 months-3 years ago and were aged 18-45 years old. Participant breastfeeding and dietary habits were self-reported using surveys. Breastfeeding groups were established by following the American Association of Pediatric guidelines on breastfeeding duration: Women who did versus did not breastfeeding for 6 months continuously. Blood pressure was measured using a standard oscillometric cuff, while SphygmoCor® technology was used to measure pulse wave velocity. …

Initial Laparotomy Versus Peritoneal Drainage In Extremely Low Birthweight Infants With Surgical Necrotizing Enterocolitis Or Isolated Intestinal Perforation: A Multicenter Randomized Clinical Trial, Barry Eggleston, Robin K Ohls, William E Truog, Leif D Nelin, Brenda B Poindexter, Claudia Pedroza, Michele C Walsh, Barbara J Stoll, Rachel Geller, Kathleen A Kennedy, Reed A Dimmitt, Waldemar A Carlo, C Michael Cotten, Abbot R Laptook, Krisa P Van Meurs, Kara L Calkins, Gregory M Sokol, Pablo J Sanchez, Myra H Wyckoff, Ravi M Patel, Ivan D Frantz, Seetha Shankaran, Carl T D'Angio, Bradley A Yoder, Edward F Bell, Kristi L Watterberg, Colin A Martin, Carroll M Harmon, Henry Rice, Arlet G Kurkchubasche, Karl Sylvester, James C Y Dunn, Troy A Markel, Diana L Diesen, Amina M Bhatia, Alan Flake, Walter J Chwals, Rebeccah Brown, Kathryn D Bass, Shawn D St Peter, Christina M Shanti, Walter Pegoli, David Skarda, Joel Shilyansky, David G Lemon, Ricardo A Mosquera, Myriam Peralta-Carcelen, Ricki F Goldstein, Betty R Vohr, Isabell B Purdy, Abbey C Hines, Nathalie L Maitre, Roy J Heyne, Sara B Demauro, Elisabeth C Mcgowan, Kimberly Yolton, Howard W Kilbride, Girija Natarajan, Kelley Yost, Sarah Winter, Tarah T Colaizy, Matthew M Laughon, Satyanarayana Lakshminrusimha, Rosemary D Higgins, Eunice Kennedy Shriver National Institute Of Child Health And Human Development Neonatal Research Network

Faculty, Staff and Student Publications

OBJECTIVE: The aim of this study was to determine which initial surgical treatment results in the lowest rate of death or neurodevelopmental impairment (NDI) in premature infants with necrotizing enterocolitis (NEC) or isolated intestinal perforation (IP).

SUMMARY BACKGROUND DATA: The impact of initial laparotomy versus peritoneal drainage for NEC or IP on the rate of death or NDI in extremely low birth weight infants is unknown.

METHODS: We conducted the largest feasible randomized trial in 20 US centers, comparing initial laparotomy versus peritoneal drainage. The primary outcome was a composite of death or NDI at 18 to 22 months corrected …

Initial Laparotomy Versus Peritoneal Drainage In Extremely Low Birthweight Infants With Surgical Necrotizing Enterocolitis Or Isolated Intestinal Perforation: A Multicenter Randomized Clinical Trial, Barry Eggleston, Robin K Ohls, William E Truog, Leif D Nelin, Brenda B Poindexter, Claudia Pedroza, Michele C Walsh, Barbara J Stoll, Rachel Geller, Kathleen A Kennedy, Reed A Dimmitt, Waldemar A Carlo, C Michael Cotten, Abbot R Laptook, Krisa P Van Meurs, Kara L Calkins, Gregory M Sokol, Pablo J Sanchez, Myra H Wyckoff, Ravi M Patel, Ivan D Frantz, Seetha Shankaran, Carl T D'Angio, Bradley A Yoder, Edward F Bell, Kristi L Watterberg, Colin A Martin, Carroll M Harmon, Henry Rice, Arlet G Kurkchubasche, Karl Sylvester, James C Y Dunn, Troy A Markel, Diana L Diesen, Amina M Bhatia, Alan Flake, Walter J Chwals, Rebeccah Brown, Kathryn D Bass, Shawn D St Peter, Christina M Shanti, Walter Pegoli, David Skarda, Joel Shilyansky, David G Lemon, Ricardo A Mosquera, Myriam Peralta-Carcelen, Ricki F Goldstein, Betty R Vohr, Isabell B Purdy, Abbey C Hines, Nathalie L Maitre, Roy J Heyne, Sara B Demauro, Elisabeth C Mcgowan, Kimberly Yolton, Howard W Kilbride, Girija Natarajan, Kelley Yost, Sarah Winter, Tarah T Colaizy, Matthew M Laughon, Satyanarayana Lakshminrusimha, Rosemary D Higgins, Eunice Kennedy Shriver National Institute Of Child Health And Human Development Neonatal Research Network

Faculty, Staff and Student Publications

OBJECTIVE: The aim of this study was to determine which initial surgical treatment results in the lowest rate of death or neurodevelopmental impairment (NDI) in premature infants with necrotizing enterocolitis (NEC) or isolated intestinal perforation (IP).

SUMMARY BACKGROUND DATA: The impact of initial laparotomy versus peritoneal drainage for NEC or IP on the rate of death or NDI in extremely low birth weight infants is unknown.

METHODS: We conducted the largest feasible randomized trial in 20 US centers, comparing initial laparotomy versus peritoneal drainage. The primary outcome was a composite of death or NDI at 18 to 22 months corrected …