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Intraventricular hemorrhage (IVH) or hemorrhage into the germinal matrix tissues of the developing brain, results in significant neurodevelopmental handicap. Our multicenter, randomized, placebo-controlled trial demonstrated that indomethacin significantly lowered the evidence and decreased the severity of IVH in those very low birth weight (VLBW) preterm infants with no evidence for IVH at 6 to 12 postnatal hours, our primary analysis population. A secondary trial conducted at the same time showed no effect of indomethacin for the prevention of existing IVH. Indomethacin has recently been demonstrated to have gender-mediated effects. Although a gender-by-indomethacin effect was not an a priori hypothesis of the application, reanalysis of our data demonstrated that the indomethacin-IVH effect occurred exclusively in male infants. Children randomized to indomethacin had better long-term survival, and male indomethacin subjects exhibited better verbal testing scores during their early grade school years than male placebo children, suggesting this neonatal intervention may produce a long-lasting effect on developmental skills in VLBW preterm infants.
The purpose of the study is to understand the learning abilities of children born prematurely who have been participating in our multicenter trial to reduce the incidence of brain hemorrhage in preterm infants. Previous assessments were done at 3, 4-1/2, 6, 8, and for some children at 12 years of age.
A neurological, developmental, behavioral, and attention assessment will be completed at 12 years and 16 years. The neurological assessment evaluates coordination and reflexes. The developmental assessment evaluates language, overall knowledge, perception, attention, memory skills, reading, and mathematics. A psychometrist will administer the tests, and a developmental pediatrician will do the neurological. Most tests are similar to those done at the previous visit. The developmental tests will take 120-180 minutes and the neurological exam will take about 30 minutes. The mother will complete questionnaires about her child's behavior, which will take about 60 minutes. Speech language testing will take 60 to 90 minutes.
The proposal is a reapplication from the Brown Medical School to participate in the Cooperative Multi-Center Neonatal Research Network (RFA-HD-04-010). Abbot Laptook, M.D., will serve as the Principle Investigator, the Co-Investigator (Alternate) will be William Oh, M.D., and the Follow-up Investigator will be Betty Vohr, M.D. The primary teaching hospital of Brown for this proposal is Women and Infants' Hospital of Rhode Island (WIHRI). The Neonatal Intensive Care Unit (NICU) of WIHRI has a 60+ bed capacity and serves as the sole level III NICU in Southeastern New England. Adjoining WIHRI is Hasbro Children's Hospital, which provides all needed specialized pediatric services for radiologic, surgical, and other subspecialty services. There are a number of considerations that justify Brown as one of the sites for the Network. First, Brown is the sole regional provider of perinatal services in Southeastern New England and thus provides a population that represents a geographic region. The stability of the number of deliveries, number of infants with a birth weight
N/A, University of Iowa, Vohr (PI) 12/01/15-11/30/16
PPG Transfusion of Prematures (TOP) Trial
The goal is to assist in the assessment of extremely low birth weight preterm infants at follow-up using a series of cognitive and behavioral tasks when the children reach 12 and 24 months of (corrected) age.
T77MD09797-06-00, Health Resources and High (PI) 01/13/13-06/30/18
Services Administration Department of Health
and Human Services, Maternal and Child Health Bureau
Brown University Leadership in Education in Behavioral Pediatrics
The purpose of this project is to train future leaders in Developmental-Behavioral Pediatrics by providing a model interdisciplinary program that emphasizes biopsychosocial interventions, collaboration with community partners, and child advocacy experiences.This project will also train medical students, residents, faculty, community physicians, allied health professionals and families in DBP.
R01HD076589, NIH/NICHD Mercer (PI) 10/01/12-06/30/17
Effects of Placental Transfusion on Early Brain Development
The major goals of this research is to determine if delayed umbilical cord clamping (DCC) at birth affects iron stores and influences myelin volume at 4, 10, and 24 months of age, and to determine if DCC, iron stores, and myeline content infancy are associated with improved cognitive, motor, and socio-behavioral outcomes.
U10HD027904, NIH/NICHD Laptook (PI) 04/01/11-03/31/16
Multicenter network of Neonatal Intensive Care Units Neonatal Network Follow-up Coordination
The major goal is to conduct multicenter longitudinal, prospective follow-up studies of very low birth weight infants <1000 grams at 18 months of age.
URC/CCU124745, CDC-EHDI Vohr (PI) 07/01/14-06/30/16
Cooperative Agreement for Early Hearing Detection and Intervention Tracking Research and Intervention
The major goal is to oversee development of cochlear care systems, tracking systems and linking to the medical home.
N/A, Human Resource Service Administration Vohr (PI) 07/01/14-06/30/16
Lost to Follow-up for Hearing Screening
The major goal is to reduce the number of infants who are lost to follow up of newborn hearing screening in the state of Rhode Island
N/A, Rhode Island Department of Health Vohr (PI) 07/01/14-06/30/16
Rhode Island Hearing Assessment Program, Contract from Rhode Island DOH to monitor statewide hearing screening
The major goal is to assure that all infants receive newborn hearing screening and appropriate follow-up in the state of Rhode Island