NICHD Neonatal Research Network

点击翻译按钮获取中文摘要

PROJECT SUMMARY/ABSTRACT Advances in the care of preterm and term newborns continues to demonstrate progress. However, adverse childhood outcomes following morbidities of prematurity (BPD, IVH, NEC and others) and conditions affecting late preterm and term infants (HIE, PPHN, sepsis) remain excessively high. The overarching goal of the Brown Neonatal Research Network (NRN) Center is to identify critical gaps that contribute to undesirable newborn outcomes and expand the evidence base to guide treatment and management with exceptionally high-quality clinical research. Our specific goals are to bring fresh innovation to the NRN in domains of novel biomarkers, genomics, neurobehavior and imaging and apply these to the design of timely clinical trials. New trials need to be rigorous and reproducible since the ultimate measure of impact is whether the results drive change in clinical practice. To accomplish our goals, the Brown NRN Center has been invigorated with important leadership transitions among our physician scientists and research coordinator. We anticipate that our new investigators will provide an infusion of novel ideas and areas of expertise which will build upon our solid foundation. The latter has been created by our current investigators who will remain active in the NRN and help maintain our longstanding clinical and research practices. That includes meaningful contributions to the NRN since 1991 in which Brown investigators have led multi-center trials, made substantial contributions to trial development, and conducted trials well. Our clinical research productivity is also reflected in our ability to perform high quality clinical trials outside the NRN framework and reflects a deep commitment to our academic mission. The Brown NRN Center is based at a single center, Women & Infants Hospital of Rhode Island (WIH) which functions as the hub of a well-organized perinatal region encompassing all of Rhode Island and southeastern Massachusetts. WIH performs 80% of the deliveries in Rhode Island and through its Maternal Fetal Medicine outreach, and maternal/neonatal transports, impacts close to 15,000 deliveries a year. The Brown NRN Center has close links with our Maternal Fetal Medicine Unit Network (MFMU) colleagues and have demonstrated the ability to perform secondary studies of a MFMU clinical trial across the two networks. Our state-of-the-art Neonatal Intensive Care Unit has fully embraced a family-oriented approach to newborn intensive care where research and clinical management are linked reflecting our strong culture of research. Critical to the mission of the NRN and any regional center is a well-developed and effective follow-up program since primary study outcomes are often assessed between 2-7 years of age. The Brown NRN Center uses innovative programs such as Transition Home Plus to maintain relationships with families after discharge to home while reducing hospitalization rates and costs. The Brown NRN Center has a comprehensive array of clinical and research abilities to examine the mother-infant dyad and provide critical collaboration for the conduct of rigorous, cutting edge, multi-center trials that are the goals of the NRN.