Neonatology

About the Program

  • Evaluates neonatal morbidity and mortality by conducting research on the short and long-term outcomes of high-risk neonates through early childhood.
  • Research protocols focus on the association between maternal, antenatal/perinatal risk factors, disease biomarkers, perinatal care and subsequent neonatal outcomes.

Objectives

  • Conduct longitudinal studies to:
    • Assess the relationship between antenatal and demographic risk factors and neonatal outcomes
    • Assess the relationship between maternal, placental, neonatal and perinatal risk factors and subsequent infant outcomes
    • Examine the relationship between fetal growth and subsequent neonatal and early childhood neurodevelopmental and growth outcomes
    • Determine the relationship between early biomarkers (maternal, fetal and neonatal) and subsequent infant and childhood outcomes
    • Assess the relationship between perinatal interventions and subsequent neonatal outcomes
    • Monitor trends in survival and the incidence of various neonatal disease entities related to perinatal risk factors, interventions, biochemical and biophysical markers of diseases (e.g, cytokines, chemokines, angiogenic/anti-angiogenic factors, and Doppler velocimetry, etc.) and fetal growth
    • Provide data for hypothesis formulation, study design and sample size estimates for perinatal studies addressing neonatal, infant and early childhood outcomes.
  • Conduct interventional trials for the prevention of adverse neonatal outcomes

Research Questions

  • Perinatal brain injury in the developing fetus and newborn
  • Neurodevelopmental windows of disease pathogenesis during early fetal and neonatal life
  • Prematurity and aberrant fetal growth/development and neonatal outcomes
  • Perinatal inflammation and its implications on neuronal and immune development in the fetus and newborn
  • The development of perinatal interventions to minimize death and impairment in newborns

Important Points & Discoveries

  • Neonatal and adult diseases often originate during early fetal development (e.g., cerebral palsy following fetal inflammatory response syndrome)
  • Collaboration of highly specialized multi-disciplinary teams of investigators are needed to study the normal and aberrant developmental processes that unite with molecular, genetic, epigenetic and environmental factors during pregnancy/early fetal life and result in subsequent disease
  • Understanding of disease mechanisms may lead to targeted interventions that improve subsequent health and survival free of impairment (e.g., therapeutic hypothermia for neonatal encephalopathy)

Selected Publications

  • Yoon BH, Romero R, Park JS, Kim CJ, Kim SH, Choi JH, Han TR. Fetal exposure to an intra-amniotic inflammation and the development of cerebral palsy at the age of three years. Am J Obstet Gynecol 2000 Mar;182:675-81.
  • Shankaran S, Laptook AR, Ehrenkranz RA, Tyson JE, McDonald SA, Donovan EF, Fanaroff AA, Poole WK, Wright LL, Higgins RD, Finer NN, Carlo WA, Duara S, Oh W, Cotten CM, Stevenson DK, Stoll BJ, Lemons JA, Guillet R, Jobe AH; National Institute of Child Health and Human Development Neonatal Research Network. Whole-body hypothermia for neonates with hypoxic-ischemic encephalopathy. N Engl J Med 2005 Oct;353:1574-84.
  • Shankaran S, Langer JC, Kazzi SN, Laptook AR, Walsh M; National Institute of Child Health and Human Development Neonatal Research Network. Cumulative index of exposure to hypocarbia and hyperoxia as risk factors for periventricular leukomalacia in low birth weight infants. Pediatrics 2006 Oct;118:1654-9.
  • Shankaran S, Pappas A, Laptook AR, McDonald SA, Ehrenkranz RA, Tyson JE, Walsh M, Goldberg RN, Higgins RD, Das A; NICHD Neonatal Research Network. Outcomes of safety and effectiveness in a multicenter randomized, controlled trial of whole-body hypothermia for neonatal hypoxic-ischemic encephalopathy. Pediatrics 2008 Oct;122:e791-8.
  • Chaiworapongsa T, Hong JS, Hull WM, Romero R, Whitsett JA. Amniotic fluid concentration of surfactant proteins in intra-amniotic infection. J Matern Fetal Neonatal Med 2008 Sep;21:663-70.
  • Cortez J, Gupta M, Amaram A, Pizzino J, Sawhney M, Sood BG. Noninvasive evaluation of splanchnic tissue oxygenation using near-infrared spectroscopy in preterm neonates. J Matern Fetal Neonatal Med 2011 Apr;24:574-82.
  • Pappas A, Shankaran S, Laptook AR, Langer JC, Bara R, Ehrenkranz RA, Goldberg RN, Das A, Higgins RD, Tyson JE, Walsh MC; Eunice Kennedy Shriver National Institute of Child Health and Human Development Neonatal Research Network. Hypocarbia and adverse outcome in neonatal hypoxic-ischemic encephalopathy. J Pediatr 2011 May;158:752-758.e1.
  • De Jesus LC, Pappas A, Shankaran S, Kendrick D, Das A, Higgins RD, Bell EF, Stoll BJ, Laptook AR, Walsh MC; Eunice Kennedy Shriver National Institute of Child Health and Human Development Neonatal Research Network. Risk factors for post-neonatal intensive care unit discharge mortality among extremely low birthweight infants. J Pediatr 2012 Jul;161:70-4.e1-2.
  • Natarajan G, Pappas A, Shankaran S, Kendrick DE, Das A, Higgins RD, Laptook AR, Bell EF, Stoll BJ, Newman N, Hale EC, Bara R, Walsh MC. Outcomes of extremely low birth weight infants with bronchopulmonary dysplasia: impact of the physiologic definition. Early Hum Dev 2012 Jul;88:509-15.

Distinguished Faculty

 

DIRECTOR
Seetha Shankaran, M.D.

Director, Division of Neonatal-Perinatal Medicine, Department of Pediatrics, Wayne State University (Children’s Hospital of Michigan, Hutzel Women’s Hospital), Director, Regional Neonatal Programs, Detroit Medical Center (Children's, Hutzel Women’s Hospital, Sinai-Grace, and Huron Valley Hospitals)

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