Beatrice E. LechnerAssistant Professor of Pediatrics
Beatrice Lechner is a neonatologist with a special interest in mechanisms of preterm birth as well as perinatal palliative care. She obtained her MD degree from the University of Frankfurt, Germany in 1997. After completing her residency training at Yale University-Bridgeport Hospital and her fellowship training at Brown University Women & Infants Hospital, she joined the Brown faculty in 2006. In addition to her clinical work, she studies extracellular matrix mechanisms of preterm premature rupture of fetal membranes as well as perinatal palliative care.
Dr. Lechner's basic science research interest is in the role of the extracellular matrix in preterm premature rupture of fetal membranes, a common cause of premature birth. Specifically, her laboratory is elucidating the role of proteoglycans in the maintenance of fetal membrane integrity throughout gestation in order to identify novel targets for the prevention of preterm premature rupture of membranes.
Dr. Lechner's clinical research interest lies in perinatal palliative care, including the development of a perinatal palliative care program in the neonatal intensive care unit (NICU), breastfeeding support in the NICU as well as difficult conversations simulation training for neonatology fellows.
Basic science research
Preterm birth is the leading cause of neonatal mortality and morbidity in the United States. One third of these births are caused by preterm premature rupture of fetal membrane (PPROM). However, we do not fully understand the mechanisms leading to PPROM and successful strategies for prevention and treatment have remained elusive. Our data indicate that the extracellular matrix proteoglycans biglycan and decorin contribute to the maintenance of intact fetal membranes throughout pregnancy via both structural and signaling mechanisms. Our work has focused on identifying the mechanisms by which these proteoglycans contribute to the structural integrity of the fetal membranes using novel techniques to manipulate gestation. Ultimately, this knowledge has the potential to inform the development of new preventive and therapeutic strategies for PPROM.
Of children that die in the United States, over half are infants and of those, over 65% are neonates. Most neonates and infants who die do so in the intensive care unit setting. Thus, a significant number of neonates in the NICU require palliative care services - services that aim to improve the quality of life of infants faced with life-threatening or life-limiting illness. While the numbers of pediatric palliative care programs in the US are increasing in response to the need, dying neonates are receiving less palliative care than pediatric patients and little is known about neonatal palliative care programs or interventions. Furthermore, since neonatologists are the medical providers for most of these neonates, they regularly engage in difficult conversations with parents about therapeutic choices at the limits of viability, redirection of care goals and devastating long-term outcomes. Because of this, it is imperative that neonatologists are skilled in delivering difficult news and knowledgeable about evidence-based communication strategies in conflict situations.Thus, our work has focused on studying various aspects of perinatal palliative care, including developing guidelines for the NICU as well as developing a simulation based communication skills workshop for neonatology fellows.
"The Role of Biglycan in Reproduction", NICHD K08, 2009-2013
"The Structural and Signaling Roles of Biglycan and Decorin in Gestation", NCRR/NIH COBRE in Perinatal Biology, Pilot Project Investigator 2011-2013
"Biglycan and Decorin’s Contributions to Fetal Membrane Mechanical Properties", Oh Zopfi Professorship Seed Grant 2012-2013
“Role of the Extracellular Matrix in Preterm Premature Rupture of Fetal Membranes”, Oh Zopfi Professorship Seed Grant 2015-2016
"Role of the Extracellular Matrix in Preterm Premature Rupture of Fetal Membranes", NCRR/NIH COBRE in Perinatal Biology, Pilot Project Investigator 2015-2016.