Newborn Bilirubin Screening for Biliary Atresia

In a preliminary study published as a letter to the editor in the prestigious New England Journal of Medicine, Dr. Gracia-Prats as a member of the research group at Texas Children’s Hospital showed that screening of the direct or conjugated bilirubin concentration in newborns can identify infants with biliary atresia early, before symptoms develop. A total of 11,636 infants born in four Houston hospitals over a 15-month period were included in this study. The net sensitivity of screening was 100.0%, the net specificity 99.9%, and the net positive predictive value 18.2%.

Sex-specific differences in neonatal hyperoxic lung injury

Male sex is considered an independent predictor for the development of bronchopulmonary dysplasia (BPD) after adjusting for other confounders. In this study published in the American Journal of Physiology-Lung Cellular and Molecular Physiology, Drs. Lingappan and Moorthy report the sex-specific molecular mechanisms in a murine model of BPD. They showed that neonatal male mice showed grater arrest in alveolarization and impairment in angiogenesis, which was accompanied with increased inflammation compared to female mice with elucidation of the mediators leading to these sex-specific differences, in their study.

Delayed Introduction of Parenteral Phosphorus Is Associated with Hypercalcemia in Extremely Preterm Infants

Dr. Amy Hair and group showed that early introduction of phosphorus in parenteral nutrition solutions was associated with reduced incidence of whole blood ionized calcium abnormalities in the first week of life in a study published in the Journal of Nutrition. This study included 150 premature babies and showed that early introduction of phosphorus was associated with a decreased mean peak iCa and decreased the incidence of severe hypercalcemia in the first week of life.

Elevated Diastolic Closing Margin Is Associated with Intraventricular Hemorrhage in Premature Infants

In a study published in the Journal of Pediatrics, Drs. Christopher Rhee, Jeffrey Kaiser and colleagues asked the question whether the diastolic closing margin, defined as diastolic blood pressure minus critical closing pressure, was associated with the development of early severe intraventricular hemorrhage (IVH). This study included data from 185 premature infants and concluded that elevated diastolic closing margin was associated with severe IVH and that measurement of DCM may be more useful than blood pressure in defining cerebral perfusion in premature infants.

Gene Expression Profiling Identifies Cell Proliferation and Inflammation as the Predominant Pathways Regulated by Aryl Hydrocarbon Receptor in Primary Human Fetal Lung Cells Exposed to Hyperoxia

The role of Aryl hydrocarbon receptor (AhR) signaling was elucidated in an original research study published in Toxicological Sciences by Dr.Binoy Shivanna and their group.  AhR protects newborn mice and primary fetal human pulmonary microvascular endothelial cells (HPMECs) against hyperoxic injury. This study reported the gene expression profile in AhR-sufficient and -deficient HPMEC exposed to normoxic and hyperoxic conditions. They found that cell cycle was the predominant pathway affected by the combined effect of AhR knockdown and hyperoxia. Functional analysis of cell cycle showed that AhR-deficient cells had decreased proliferation compared with AhR-sufficient cells.

Hypoglycaemia and hyperglycaemia are associated with unfavourable outcome in infants with hypoxic ischaemic encephalopathy: a post hoc analysis of the CoolCap Study

Drs. Jeffrey Kaiser and Sudeepta Basu investigated the association of neonatal hypoglycemia and hyperglycemia with outcomes in infants with hypoxic ischemic encephalopathy (HIE) in this study. Unfavorable outcome was more common among subjects with hypoglycemia, hyperglycemia and any glucose derangement within the first 12 h compared with normoglycemic infants. These associations remained significant after adjusting for birth weight, Apgar score, pH, Sarnat stage and hypothermia therapy. This study was a post-hoc analysis of the CoolCap Study and included 214 infants at ≥36 weeks' gestation with moderate-to-severe HIE and was published in the Archives of Disease in Childhood - Fetal and Neonatal Edition.