Center for Perinatal Research :: The Research Institute at Nationwide Children's Hospital

 

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Center for Perinatal Research

 

In the Center for Perinatal Research, basic science programs focus on molecular mechanisms of lung development and injury, digestive diseases, infection and inflammation, as well as pulmonary hypertension; with a particular focus on bronchopulmonary dysplasia and necrotizing enterocolitis.

The Center's mission is to prevent premature delivery and to improve the outcomes of critically ill neonates and children through innovative interdisciplinary basic and translational research.

The Ohio Perinatal Research Network (OPRN) is a collaborative among clinicians and scientists from medical and research institutions with the goal of examining risk factors, associated complications and ultimately the prevention of preterm births.

The Neonatal Research Network (NRN) was founded in 1986 by the Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD), part of the National Institutes of Health. The Research Institute at Nationwide Children’s Hospital has joined seventeen other premier research centers across the country that comprise the network. By conducting multi-center clinical studies in neonatal medicine, the NRN is focused on improving care and outcomes for premature infants.

Focus on Prematurity

Prematurity is a significant health challenge facing Ohio and part of The Research Institute’s strategic plan because of the following:

  • Ohio rates are high for infant mortality & preterm births
  • Nationwide Children's can effectively integrate perinatal research and clinical programs
  • Nationwide Children’s has one of the largest neonatal care networks in the United States
  • Significant potential exists for local and national educational, government and public agency partnerships
  • Nationwide Children's is positioned to be an international leader in the fight against prematurity

 

Featured Research

Esophageal function implicated in life threatening experiences in infants

Infants presenting with apparent life threatening events (ALTE) are frequently treated for gastroesophageal reflux (GER). Through utilization of pharyngo-esophageal manometry, respiratory inductance plethysmography, and nasal airflow thermistor methods we were able to observe swallow-respiratory junction interactions in infants presenting with ALTE compared to controls.  Findings were that ALTE infants have more frequent and prolonged spontaneous respiratory events most frequently associated with dysfunctional swallow-respiratory junction interactions, not GER. Therefore, treatment of ALTE infants should target the proximal aero-digestive tract, unless objective evidence has proven GER.

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“Respiratory Events in Infants Presenting with Apparent Life Threatening Events: Is There an Explanation from Esophageal Motility?” Hasenstab KA, Jadcherla SR. The Journal of Pediatrics. (2014).

Read the News Release»

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Brain Imaging Protocol Identifies Delays in Premature Infants

Until recently, predicting the severity of cognitive, motor and behavioral deficits in infants born prematurely was almost impossible. But physicians may now be able to use a highly reliable 3-D MRI imaging technique—developed by a team led by Nehal Parikh, DO, principal investigator in the Center for Perinatal Research—to identify which infants are most at risk.

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“Developing a reliable and reproducible methodology for studying the premature brain was crucial in order for us to get to the next step: assessing neuroprotective therapies,” said Nehal A. Parikh, DO, senior author on the paper. “Now that we have this protocol, we can improve the standard of care and evaluate efforts to promote brain health within 8 to 12 weeks of beginning the interventions. That way, we can quickly see what really works.” Read press release.

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USAID-Funded Grant for Study on Preeclampsia Underway

A team led by Dr. Irina Buhimschi, director of the Center for Perinatal Research at Nationwide Children’s Hospital in Ohio, went through more than 400 different types of paper before they found the ideal selection that shows accurate results. Read full article on FRONTLINES.

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Preeclampsia is one of the most common hypertensive disorders in pregnancy. And one of the leading causes of maternal and perinatal mortality worldwide. The severe complications from preeclampsia are avoidable through prevention and timely treatment. But the disease is only partially understood. An exact cause is unknown. Its diagnosis made difficult because, often, women do not feel sick. Many signs and symptoms of preeclampsia are also typical of a normal pregnancy: headache, nausea, swelling.

The global health community has called for targeted research of preeclampsia diagnostic screening tools that would allow for appropriate and timely care. A team led by Dr.. Irina Buhimschi, director of the Center for Perinatal Research at Nationwide Children’s Hospital, answered the call. And the answer will lead to best outcomes here and around the world.

“We developed a method of diagnosing and predicting preeclampsia that is innovative, low cost, sustainable and scalable,” said Dr. Buhimschi. The paper-based urine test her team developed enables early diagnosis of preeclampsia, which is characterized by protein in the urine (proteinuria). The test reveals misfolded proteins in the urine through Congo Red—a readily available dye used worldwide in textiles, wood pulp and paper.

The team’s innovative test earned them a grant from the Saving Lives at Birth partnership, which includes the US Agency for International Development (USAID), the Government of Norway, the Bill & Melinda Gates Foundation, Grand Challenges Canada, and the UK’s Department for International Development.

The partnership received more than 400 entries in response to their Grand Challenge for Development. Fifty three were shortlisted. Twenty two were awarded grants. Dr. Buhimschi’s team was one of four to receive a transition-to-scale grant (up to $2 million for four years) aimed to grow bold new ideas to save the lives of mothers and newborns in developing countries.

Team collaborators included Dr. Catalin Buhimschi (Department of Obstetrics and Gynecology, The Ohio State University Wexner Medical Center), Dr. Hemant Tagare and Dr. Michael Choma (Yale University School of Medicine), Dr. Robert Pattinson and Dr. Pedro Mulder (University of Pretoria, South Africa), Dr. Thomas Easterling (University of Washington, Seattle), Dr. Hillary Bracken and Dr. Beverly Winikoff (Gynuity Health Projects).

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Dr. Jadcherla's Research Highlighted at Digestive Diseases Week 2013

Dr. Sudarshan Jadcherla, principal investigator at the Center for Perinatal Research at Nationwide Children’s Hospital, was one of 20 presenters—the only neonatologist—at this year’s Digestive Diseases Week (DDW) selected to highlight his research in a video interview featured on YouTube.

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In the video above, Dr. Jadcherla discusses his research and the Neonatal and Infant Feeding Disorders Program he leads at Nationwide Children’s Hospital Feeding Enhancement Program.

Dr. Jadcherla's program presented seven abstracts, two at research forums and five at poster sessions. The video interview features one of the abstracts: Innovative Neonatal Feeding Quality Initiative Optimizes Consumption of Drug-Use in the Neonatal Intensive Unit. Abstract authors: Ish K. Gulati, Manish B. Malkar, Shawn M. Pierson, James Dail, Sudarshan R. Jadcherla.

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Heparin-Binding EGF-like Growth Factor (HB-EGF)

Dr. Gail Besner’s primary research began in 1990 with the identification of the growth factor "heparin-binding EGF-like growth factor" (HB-EGF).  Dr. Besner works to understand HB-EGF’s ability to protect the intestine from injury.

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The long range goal of this research is determine whether or not HB-EGF could be used in therapies to protect and treat intestinal damage in high-risk neonates.

Her studies have shown that HB-EGF’s anti-inflammatory effects and chemical properties play a vital role in the regenerating of intestinal cells after they have been damaged.  Lab research has shown that HB-EGF can protect the intestine from damage caused by hemorrhagic shock, blood supply restriction and the disease necrotizing enterocolitis. Necrotizing enterocolitis results in the destruction of the intestine in newborn babies, especially those born prematurely. Clinical studies are on the horizon to further test HB-EGF as a treatment option.

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Newborn and Infant Feeding Disorders Program

Dr. Sudarshan Jadcherla’s research focuses on neonatal feeding disorders. His clinical research works to define the mechanisms of feeding failure and airway compromise in developing infants and to pave the way for evidence-based diagnosis and therapeutic intervention particularly in neonatal dysphagia, gastroesophageal reflux disease and chronic lung disease of infancy.

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The Neonatal and Infant Feeding Disorders Program at Nationwide Children’s under the direction of Dr. Jadcherla, is the only program in the world taking a multi-organ perspective to understand infant feeding disorders. Read more about feeding disorders.

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Small Baby Guidelines

The Small Baby Guidelines (SBGs), developed by the neonatology team at Nationwide Children’s, provide a uniform, interdisciplinary approach to the family-centered care of extremely premature babies. 

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The guidelines outline care regarding development, nutrition, cardiovascular functioning, infection and other potential health concerns during the first week of these infants’ lives. Guidelines included the following sub-headings.

  • Respiratory
  • Skin
  • Development
  • Cardiovascular
  • PDA
  • Fluids/nutrition
  • Neurological/sedation
  • Infection control and family issues

Evaluation of the SBGs can improve patient outcomes and decrease the length of hospitalization. Infants who were treated using SBGs were discharged an average 13 days earlier than infants who were not treated using a unified approach. The research was published in Acta Paediatrica (2009) and was the first published study that examined this particular patient population while covering all aspects of their care.  Learn more about the Small Baby Guidelines.

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