Optimizing care for newborns with evidence-based practice; special interest in infectious disease in low birthweight infants, perinatal asphyxia, congenital diaphragmatic hernia, genome-guided approaches to neonatal diseases
I am involved in 4 major areas of research:
1) Neuroprotection. Working with colleagues from Cell Therapies and neuroradiology, we have initiated a pilot trial, funded by the DTRI, in providing autologous cord blood cells in the first 24 postnatal hours to infants with hypoxic ischemic encephalopathy. This follows our involvement with the two pivotal hypothermia studies, in which cooling decreased risk of death or disability, but among the treated groups in both trials, > 40% of infants either died or survived with impairments, strongly suggesting the need for further therapies.
2) Genomics. We led the NICHD Neonatal Research Network development of an Anonymized DNA bank of samples collected from 1,000 extremely low birthweight infants, with phenotype information linked to the samples. This resource will be the basis for multiple candidate gene, and genome wide scans to assess the genetic contributions to risk of morbidities of extremely preterm birth.
3) Newborn Screening and New Technologies: I have collaborated with Drs. David Millington from Duke and Vamsee Pamula, from Advanced Liquid Logic, on prototype new technology devices for use in newborn screening for lysosomal storage disease as well as prototypes for potential use for screening for severe combined immunodeficiency.
4)Microbiome in Micropreemies. Collaborating with Patrick Seed in Pediatric Infectious Diseases, we have initiated studies that will hopefully lead to an understanding of how the evolving microflora that inhabits the intestines of high risk, extremley preterm infants influences metabolism and developing immunologic function, and ultimately, health outcomes. I also conduct epidemiology research on Neonatal practice variation within our center, and within the Neonatal Research Network centers, to identify how variation in practice can influence outcomes.