• The “Therapeutic Hypothermia for Infants with Mild Encephalopathy” (TIME) study is open for enrollment as of November 2. This trial is a multi-center Phase I/II study to determine if therapeutic hypothermia (TH) is safe and provides benefit for newborns with mild HIE. It will be performed at 5 hospitals in California including Lucile Packard Children’s Hospital Stanford. Therapeutic hypothermia is the standard of care and has been proven to improve survival and outcome for babies with moderate to severe HIE; however, there is no evidence that TH benefits babies with mild HIE. Recent prospective data indicate that about 25% of neonates with mild HIE are at risk of neurodevelopmental impairments at 2 years of age, with cognitive scores at 5 years of age that are similar to those who had moderate HIE. Despite the current lack of systematic evidence there is therapeutic drift and many infants with mild HIE in California are already being treated with TH. The TIME study will randomize 68 neonates to either treatment with TH or normothermia with neurodevelopmental follow-up at 12-14 months of age. Sonia Bonifacio, MD, is the PI, and Krisa Van Meurs, MD, in the Co-PI. Other investigators include Henry Lee, MD, MS Epi, Susan Hintz, MD, MS Epi, and Courtney Wusthoff, MD.
• Second year neonatal-perinatal medicine fellow Jonathan Reiss, MD, presented at the 96th Perinatal & Developmental Medicine Symposium, November 10-12. His research was titled "The Newborn Screen Metabolic Composition of Infants Born to Mothers with Preeclampsia and Diabetes is Distinct and is Associated with the Size of the Newborn."
• Several faculty members and trainees presented at the 2020 Stanford Maternal and Child Health Research Institute Symposium. Due to COVID-19 restrictions, this year’s symposium was a virtual event held on November 6. The following presented posters:
  • Stephanie Leonard, PhD: “An Expanded obstetric comorbidity scoring system for predicting severe maternal morbidity”
  • Emily Pang (medical student): “Evaluating variations in neonatal intensive care: Longitudinal population-based trends in clinical management and care of newborns in California”
  • Laura Peterson, MD: “Deep immune profiling reveals imbalances in pro- and anti-inflammatory functioning in preterm infants”
  • Meera Sankar, MD: "Barriers to optimal breast milk provision in the Neonatal Intensive Care Unit"
  • David Stevenson, MD, moderated a session entitled "Early Career Investigators and Trainees." To watch, click on the YouTube video below.

• Alexis Davis, MD, MS Epi, presented a Pediatrics Grand Rounds on October 2 as part of the Quality Improvement Series: Learning From Our System Failures.
• Lisa Bain, MD, was a co-author on a paper that won an award for Best Interdisciplinary Collaboration from Stanford Medicine Center for Improvement. The paper appeared in March 2020 in Pediatric Quality & Safety and is titled "Reduction of CLABSI through Focus on Mesosystem: Standardization, Data and Accountability."
• Co-investigators Anoop Rao, MD, and Vinod Bhutani, MD, were awarded an NIH Phase II SBIR grant ($1.5 million) for their work on designing a novel nasogastric tube. Their clinical study will commence in 2021.

Stephanie Miller, MD, was promoted to Clinical Associate Professor on September 1, 2020.

• Valerie Chock, MD, MS Epi, was awarded the prestigious Harman Faculty Scholar Award from Stanford's Maternal & Child Health Research Institute (MCHRI). The award will provide Dr. Chock with $100,000/year in funding for 3 years (2020-2023) to study targeted cerebral oxygen saturations in preterm infants. This work will build on her Early NIRS study research. (See Notable Publication below.) Dr. Chock is the second member of our Division to be named an MCHRI Faculty Scholar, with Susan Hintz, MD, MS Epi, having received the Harman Award in 2009.
• During her fellowship at the Stanford Byers Center for Design, Janene Fuerch, MD, co-founded a health care technology company in 2017. Known as Emme, the company offers an integrated system of a smart case paired with app that automatically records when women take their birth control pill and helps them track their daily habits and overall health. Recently, Emme raised a venture capital seed round of $2.5 million, and the products are now commercially available. A press release by PR Newswire details the company's launch and success.
  

Early NIRS Study helps identify preemies at risk for adverse outcomes: A study of over 100 very preterm infants found that near infrared spectroscopy (NIRS) was able to detect periods of lower cerebral oxygenation and altered cerebral autoregulation, identifying infants at risk of death or neuroradiologic injury. The Early NIRS​ Study enrolled infants with a birth weight of less than 1250 grams during their first 96 hours of life at 6 tertiary neonatal intensive care centers. Infants with adverse events had a lower average cerebral oxygenation ​level and were more likely to have significant correlations between cerebral oxygenation and mean arterial blood pressure. A cutoff cerebral oxygenation ​level of 50% was predictive for adverse outcomes. Investigators conclude that maintaining cerebral oxygenation at levels above 50% and avoiding hemodynamic alterations may ​improve surviv​al and reduce the incidence of intraventricular hemorrhage among very preterm infants. Full findings are published in the Journal of Pediatrics. Valerie Chock, MD, MS Epi, is the lead author, and Krisa Van Meurs, MD, is the senior author.

Premie BiliRecs improves adherence to phototherapy guidelines: A clinical decision support tool integrated into the electronic health record (EHR) at Lucile Packard Children’s Hospital Stanford boosted adherence to phototherapy initiation guidelines for preterm infants, 27 weeks to 34 weeks postmenstrual age. Premie BiliRecs is a free, web-based tool developed by Jonathan Palma, MD, MS, and former Stanford neonatal-perinatal medicine fellow, Yassar Arain, MD. The tool uses cutoffs derived from expert consensus recommendations (Maisels et al., 2012), and automates the process of determining total bilirubin thresholds for phototherapy initiation and exchange transfusion based on postmenstrual age. Adherence to phototherapy guidelines prior to the integration of Premie BiliRecs was 39.4%. Following the tool’s implementation, adherence jumped to 69.8%; less preterm infants were exposed to phototherapy without an increase in adverse events. Full findings are published in the Journal of Perinatology. Dr. Palma is the senior author, Dr. Arain is the lead author, and Vinod Bhutani, MD, is a co-author.

• The American Academy of Pediatrics (AAP) announced William Benitz, MD, as the 2020 recipient of the of the  Avroy Fanaroff Neonatal Education Award. Dr. Benitz says he is profoundly honored and humbled to be included in the company of prior recipients, which include three from our Division — Ron Ariagno, MD, David Stevenson, MD, and Jeffrey Gould, MD, MPH. Because this year's AAP National Conference & Exhibition has moved online, the date and place of Dr. Benitz's award presentation has yet to be determined and will likely be sometime in 2021. 
• Arun Gupta, MD, was appointed by the AAP Board of Directors to assist in editing and co-authoring the revised AAP interim guidance on the "Management of Infants Born to Mothers with Suspected or Confirmed COVID-19". The revised guidance was approved by the AAP Board and published on July 22nd. 
• The annual Pediatric Hospital Medicine conference was held virtually this year, July 20-24. Jadene Wong, MD, was invited to give a presentation on newborn tox screens. 
• Dr. Gupta co-chaired the Planning Committee for a one day newborn conference called: "Hot Topics in Newborn Medicine for the Pediatric Hospitalist." This virtual conference was sponsored by the AAP Section on Hospital Medicine and held on July 27 in conjunction with the Pediatric Hospital Medicine conference. There were over 600 people from around the country registered for the event. Faculty speakers included several members of our division's neonatal hospitalist group – Dr. Gupta, Nichole Wang, MD, Elizabeth Blecharczyk, MD, Neha Joshi, MD, and Chandani DeZure, MD. Topics covered by our division’s faculty included cytomegalovirus screening, cord blood gas management, early onset sepsis, neonatal abstinence syndrome, and COVID and newborns.
  
• Jochen Profit, MD, MPH, served on the National Academies of Sciences, Engineering, and Medicine (NASEM) Committee on Assessing Health Outcomes by Birth Settings. The report’s findings and recommendations were published here.
• Dr. Profit also presented notable lectures and addresses via webinar:
  • He was co-lecturer of Oxford University Department of Paediatrics Grand Rounds on July 1. The presentation was entitled "Birth of the International Neonatal SARS-CoV-2 Collaboration." 
  • He spoke to the CPQCC community about addressing racism and advancing health equity in the NICU space. Watch the video below. 

Highlights

• Alexis Davis, MD, MS Epi, medical director of our NICU at Lucile Packard Children’s Hospital Stanford (LPCHS), was selected to receive the inaugural LPCHS Medical Staff Impact Award. This award recognizes a Packard Children’s Hospital physician who achieves high standards in the practice of medicine and is viewed as a role model, collaborator, and leader by his or her peers.
• Stanford's Department of Medicine honored Jonathan Palma, MD, MS, with a 2019 Teaching Award for biomedical informatics research. Dr. Palma is the co-director of the Clinical Informatics Fellowship program. 
• Stanford’s Department of Pediatrics honored 4 neonatology faculty members with 2020 Faculty Awards:
  • Anca Pasca, MD: Early Career Clinical Excellence Award
  • Adam Frymoyer, MD: Laura Bachrach Mentor Award
  • Suzan Carmichael, PhD: Postdoc Mentor Award
  • Louis Halamek, MD: Medical Education Scholarship Award

• Malathi Balasundaram, MD, was promoted to Clinical Associate Professor June 1.
• Ciaran Phibbs, PhD, was awarded an R01 for $1.9 million (direct costs) to examine how obstetric volume affects the outcomes of both mothers and infants. The goal is to determine if there should be minimum volume standards for delivery, and if these should be different for urban and rural areas. The grant began on June 15 and will last four years. 
• Jingjing Li, PhD, Gary Shaw, DrPH, and David K. Stevenson, MD, have formed an interdisciplinary team and were awarded the Chan Zuckerberg Initiative grant of $520,000 for a project entitled “Single-Cell Placental Epigenomes and Social Disparity of Preterm Birth.” The goal will be to determine how socioeconomic status (SES) may reprogram epigenomes, and identify SES-associated epigenomic alterations in the placenta. Dr. Li was trained in March of Dimes Prematurity Research Center – Stanford and recently moved to an independent position at UCSF. This grant will establish a strong connection between UCSF and Stanford to integrate genomic, epidemiological, and clinical approaches for prematurity research.
• Neonatal-perinatal medicine fellow Pearl Houghteling, MD (Class of 2022), received a Clinical Trainee Support award (2020-2022) from Stanford's Maternal and Child Health Research Institute. Dr. Houghteling will assess the impact of supplemental iron and anemia on the microbiome of premature neonates, and her mentor is David Relman, MD.
  
• Gary Darmstadt, MD, was featured on a video with former U.S. Olympic gold medalist Shawn Johnson East to discuss the benefits of skin-to-skin care. Watch here.
  

Highlights

Lisa Bain, MD, was promoted to Clinical Associate Professor on May 1.

Highlights

• William Rhine, MD, (PI) and Anoop Rao, MD, MS, (Co-Investigator) were awarded an NIH Small Business Innovation Research Phase 1 grant to continue work on a non-invasive blood pressure device. Designed to monitor the blood pressure of critically ill neonates, the device will be comfortable, low-cost and easy to use. To date, the team has enrolled over 50 neonates. Preliminary results indicate the device meets FDA-defined accuracy parameters. This device has also been granted the Breakthrough Device Designation by the FDA, thereby advancing this work one step closer to clinical use and offering potential advantages in reimbursement policies. This NIH-SBIR grant is in conjunction with a Stanford spin-off named PyrAmes Inc. We are looking to expand this study to include neonates, pediatric, and adult patients at interested centers across the country in Fall 2020.
  
• Henry Lee, MD, MS Epi, is the PI of a new R01 funded project entitled “Improving outcomes of periviable births via an enhanced prediction tool.” The goal will be to develop, implement, and evaluate prognostic tools for neonates born at or near the limits of viability in the setting of the California Perinatal Quality Care Collaborative.
• Gary Darmstadt, MD, was elected to The Lancet new Commission on Gender Equality and Health, and to the WHO Strategic Advisory Group of Experts (STAGE) on Maternal, Newborn, and Child and Adolescent Health and Nutrition, reporting to the WHO Director General.
  
• Meera Sankar, MD, Shazia Bhombal, MD, and William Benitz, MD, published a paper in Congenital Heart Disease regarding the management of patent ductus arteriosus in 2019, and the journal reported it was among the top 10 percent of most downloaded papers. 

Highlights

• Philip Sunshine, MD, is the recipient of the 2020 Albion Walter Hewlett Award, the highest honor for an academic physician at Stanford. Given by the Department of Medicine, this annual award is named after Doctor Albion Walter Hewlett who served as the executive head of the Department of Medicine from 1916-1925 and was known for his compassion and outstanding contributions to patient care and medical science.
• Christine Johnson, MD (co-lead), Linda Truong, MD (co-lead), and Dharshi Sivakumar, MD, lead the Resuscitation Committee and produced educational videos to provide staff with an easily accessible neonatal resuscitation reference source. A study comparing the effectiveness of these videos with yearly simulation-based skills days was awarded poster presentations at CAN Cool Topics 2020 and PAS 2020.
  
• William Benitz, MD, gave the 22nd Annual Arnold J. Rudolph Lecture at Texas Children’s Hospital/Baylor School of Medicine in Houston, TX, where he spoke about management of the patent ductus arteriosus in preterm infants. Dr. Benitz also spent a day there as the Arnold J. Rudolph Visiting Professor. 
• Robert Castro, MD, was named a co-awardee of the 2020 David Wirtschafter Award for his outstanding work on Neonatal Abstinence Syndrome managment. The award is co-sponsored by the California Perinatal Quality Care Collaborative and the California Association of Neonatologists and recognizes outstanding neonatal quality improvement leadership. 
• The 26th Annual CAN/AAP District IX SoNPM Conference, Cool Topics in Neonatology, and the California Perinatal Quality Care Collaborative (CPQCC) Pre-Conference were held March 6-8, 2020 at the Coronado Island Marriott Resort. 
  • Based on her outstanding scholarly activities during fellowship at Stanford, Vidya Pai, MD, MS Epi, was awarded the 2020 Bhatt-Ramanathan Scholarship from the California Association Neonatologists/AAP District IX SoNPM. Dr. Pai received a certificate and $2000 at the conference in March, and presented to fellows attending the conference’s “Life After Fellowship” workshop.
  • Meera Sankar, MD, gave a podium presentation on behalf of the California Association of Neonatologists research committee. Dr. Sankar shared the preliminary results of a multi-site prospective research study of transcutaneous bilirubin (TCB) in extremely preterm infants less than 30-weeks gestation from California NICUs. The objective of this study is to develop guidelines for when to consider total serum bilirubin levels based on TCB levels and to monitor levels during and after phototherapy in extremely preterm infants admitted to the NICU.

Highlights

• Henry Lee, MD, MS Epi, is an editor and co-author of Questions from NeoReviews, which includes more than 1,000 questions to help clinicians enhance their neo knowledge and/or prepare for board certification. Order here.
• Shazia Bhombal, MD, and Sonia Bonafacio, MD were faculty speakers at 2020 NeoPREP: An Intensive Review and Update of Neonatal-Perinatal Medicine in Long Beach, CA, February 7-11.  
• Speaking on behalf of our POCUS (Point-of-Care Ultrasound) team, our neonatal-perinatal fellow Caroline Yeon-Kyeong Noh, MD (class of 2021) gave oral presentations at the Cool Topics in Neonatology annual conference in Coronado, CA and at the Lung Ultrasound in Neonates and Children conference in Paris, France. 

Highlights

• William Benitz, MD, was appointed as the Philip Sunshine, MD, Professor in Neonatology, Emeritus, effective January 31, 2020. He was recalled to active service for the period of February 1, 2020 through January 31, 2022.
  
• Nicole Yamada, MD, MS, was elected as a member of the Society for Pediatric Research. Dr. Yamada will be recognized along with other new members at the Pediatric Academic Societies 2020 Meeting in Philadelphia in May.  
• The Family Centered Care (FCC) team at El Camino Hospital received the Teamwork in Action award at the hospital’s 53rd Annual Employee Service Awards. Since its inception in 2016, the FCC team at El Camino Hospital is dedicated to improving the experience of parents and families of the babies admitted to the NICU. Recent quality improvement (QI) projects include: creation of a family advisory board, creation of an innovative discharge teaching tool, establishment of a parent buddy program, formation of a multidisciplinary team to promote early hand expression of breastmilk, an initiative on kangaroo care and skin to skin contact, and a parent comfort team.  Leadership oversees these QI projects and is comprised of neonatologists Malathi Balasundaram, MD, Stephanie Miller, MD, and Dharshi Sivakumar, MD, as well as Arlene Fleming, NICU Staff Nurse, Jody Charles, NICU Clinical Nurse Manager, and Melinda Porter, NICU Clinical Nurse Specialist.