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Morell AS, Monsell SE, Cornet MC, Wisnowski JL, McKinstry RC, Mathur AM, Li Y, Glass HC, Gonzalez FF, Mayock DE, Benninger KL, Van Meurs KP, Lampland AL, Wu TW, Riley D, Mietzsch U, Chalak L, Flibotte J, Weitkamp JH, Ahmad KA, Yanowitz TD, Baserga M, Merhar S, Rao R, Sokol GM, Comstock BA, Heagerty PJ, Juul SE, Wu YW. Genetic and Congenital Anomalies in Infants With Hypoxic-Ischemic Encephalopathy. Pediatr Neurol 2024; 154:44-50. [PMID: 38518503 DOI: 10.1016/j.pediatrneurol.2024.02.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/07/2023] [Revised: 02/01/2024] [Accepted: 02/14/2024] [Indexed: 03/24/2024]
Abstract
BACKGROUND Infants with hypoxic ischemic encephalopathy (HIE) may have underlying conditions predisposing them to hypoxic-ischemic injury during labor and delivery. It is unclear how genetic and congenital anomalies impact outcomes of HIE. METHODS Infants with HIE enrolled in a phase III trial underwent genetic testing when clinically indicated. Infants with known genetic or congenital anomalies were excluded. The primary outcome, i.e., death or neurodevelopmental impairment (NDI), was determined at age two years by a standardized neurological examination, Bayley Scales of Infant Development, Third Edition (BSID-III), and the Gross Motor Function Classification Scales. Secondary outcomes included cerebral palsy and BSID-III motor, cognitive, and language scores at age two years. RESULTS Of 500 infants with HIE, 24 (5%, 95% confidence interval 3% to 7%) were diagnosed with a genetic (n = 15) or congenital (n = 14) anomaly. Infants with and without genetic or congenital anomalies had similar rates of severe encephalopathy and findings on brain magnetic resonance imaging. However, infants with genetic or congenital anomalies were more likely to have death or NDI (75% vs 50%, P = 0.02). Among survivors, those with a genetic or congenital anomaly were more likely to be diagnosed with cerebral palsy (32% vs 13%, P = 0.02), and had lower BSID-III scores in all three domains than HIE survivors without such anomalies. CONCLUSIONS Among infants with HIE, 5% were diagnosed with a genetic or congenital anomaly. Despite similar clinical markers of HIE severity, infants with HIE and a genetic or congenital anomaly had worse neurodevelopmental outcomes than infants with HIE alone.
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Affiliation(s)
- Adriana S Morell
- Department of Neurology, University of California San Francisco, San Francisco, California.
| | - Sarah E Monsell
- Department of Biostatistics, University of Washington, Seattle, Washington
| | - Marie-Coralie Cornet
- Department of Pediatrics, University of California San Francisco, San Francisco, California
| | - Jessica L Wisnowski
- Department of Pediatrics, Children's Hospital Los Angeles, Los Angeles, California; Department of Radiology, Children's Hospital Los Angeles, Los Angeles, California
| | - Robert C McKinstry
- Department of Radiology, Washington University School of Medicine, St. Louis, Missouri
| | - Amit M Mathur
- Department of Pediatrics, Saint Louis University School of Medicine, St. Louis, Missouri
| | - Yi Li
- Department of Radiology and Biomedical Imaging, University of California San Francisco, San Francisco, California
| | - Hannah C Glass
- Department of Neurology, University of California San Francisco, San Francisco, California; Department of Pediatrics, University of California San Francisco, San Francisco, California; Department of Epidemiology and Biostatistics, University of California, San Francisco, San Francisco, California
| | - Fernando F Gonzalez
- Department of Pediatrics, University of California San Francisco, San Francisco, California
| | - Dennis E Mayock
- Department of Pediatrics, University of Washington School of Medicine, Seattle, Washington
| | | | - Krisa P Van Meurs
- Department of Pediatrics, Stanford University School of Medicine, Stanford, California
| | - Andrea L Lampland
- Department of Neonatology, Children's Minnesota, St. Paul, Minnesota
| | - Tai-Wei Wu
- Department of Pediatrics, Children's Hospital Los Angeles, Los Angeles, California; Department of Pediatrics, University of Southern California Keck School of Medicine, Los Angeles, California
| | - David Riley
- Department of Pediatrics, Cook Children's Medical Center, Ft. Worth, Texas; Department of Pediatrics, Texas Christian University, Ft. Worth, Texas; Department of Pediatrics, University of North Texas Health Science Center, Ft. Worth, Texas
| | - Ulrike Mietzsch
- Department of Pediatrics, University of Washington School of Medicine, Seattle, Washington; Department of Pediatrics, Indiana University School of Medicine, Indianapolis, Indiana
| | - Lina Chalak
- Department of Pediatrics, The University of Texas Southwestern Medical Center, Dallas, Texas
| | - John Flibotte
- Department of Pediatrics, The Children's Hospital of Philadelphia, Philadelphia, Pennsylvania; Department of Pediatrics, University of Pennsylvania School of Medicine, Philadelphia, Pennsylvania
| | | | - Kaashif A Ahmad
- Pediatrix Medical Group of San Antonio, San Antonio, Texas; Department of Pediatrics, Children's Hospital of San Antonio, San Antonio, Texas; Department of Pediatrics, Methodist Children's Hospital, San Antonio, Texas
| | - Toby D Yanowitz
- Department of Pediatrics, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania; Department of Pediatrics, Children's Hospital of Pittsburgh of UPMC, Pittsburgh, Pennsylvania; Department of Pediatrics, Magee Women's Hospital of UPMC, Pittsburgh, Pennsylvania
| | - Mariana Baserga
- Department of Pediatrics, University of Utah, Salt Lake City, Utah
| | - Stephanie Merhar
- Department of Pediatrics, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio; Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, Ohio
| | - Rakesh Rao
- Department of Pediatrics, Washington University School of Medicine, St. Louis, Missouri
| | - Gregory M Sokol
- Department of Pediatrics, Indiana University School of Medicine, Indianapolis, Indiana
| | - Bryan A Comstock
- Department of Biostatistics, University of Washington, Seattle, Washington
| | - Patrick J Heagerty
- Department of Biostatistics, University of Washington, Seattle, Washington
| | - Sandra E Juul
- Department of Pediatrics, University of Washington School of Medicine, Seattle, Washington
| | - Yvonne W Wu
- Department of Neurology, University of California San Francisco, San Francisco, California; Department of Pediatrics, University of California San Francisco, San Francisco, California
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Randell RL, Balevic SJ, Greenberg RG, Cohen-Wolkowiez M, Thompson EJ, Venkatachalam S, Smith MJ, Bendel C, Bliss JM, Chaaban H, Chhabra R, Dammann CEL, Downey LC, Hornik C, Hussain N, Laughon MM, Lavery A, Moya F, Saxonhouse M, Sokol GM, Trembath A, Weitkamp JH, Hornik CP. Opportunistic dried blood spot sampling validates and optimizes a pediatric population pharmacokinetic model of metronidazole. Antimicrob Agents Chemother 2024; 68:e0153323. [PMID: 38477706 PMCID: PMC10994817 DOI: 10.1128/aac.01533-23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2023] [Accepted: 02/16/2024] [Indexed: 03/14/2024] Open
Abstract
Pharmacokinetic models rarely undergo external validation in vulnerable populations such as critically ill infants, thereby limiting the accuracy, efficacy, and safety of model-informed dosing in real-world settings. Here, we describe an opportunistic approach using dried blood spots (DBS) to evaluate a population pharmacokinetic model of metronidazole in critically ill preterm infants of gestational age (GA) ≤31 weeks from the Metronidazole Pharmacokinetics in Premature Infants (PTN_METRO, NCT01222585) study. First, we used linear correlation to compare 42 paired DBS and plasma metronidazole concentrations from 21 preterm infants [mean (SD): post natal age 28.0 (21.7) days, GA 26.3 (2.4) weeks]. Using the resulting predictive equation, we estimated plasma metronidazole concentrations (ePlasma) from 399 DBS collected from 122 preterm and term infants [mean (SD): post natal age 16.7 (15.8) days, GA 31.4 (5.1) weeks] from the Antibiotic Safety in Infants with Complicated Intra-Abdominal Infections (SCAMP, NCT01994993) trial. When evaluating the PTN_METRO model using ePlasma from the SCAMP trial, we found that the model generally predicted ePlasma well in preterm infants with GA ≤31 weeks. When including ePlasma from term and preterm infants with GA >31 weeks, the model was optimized using a sigmoidal Emax maturation function of postmenstrual age on clearance and estimated the exponent of weight on volume of distribution. The optimized model supports existing dosing guidelines and adds new data to support a 6-hour dosing interval for infants with postmenstrual age >40 weeks. Using an opportunistic DBS to externally validate and optimize a metronidazole population pharmacokinetic model was feasible and useful in this vulnerable population.
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Affiliation(s)
- Rachel L. Randell
- Department of Pediatrics, Duke University, Durham, North Carolina, USA
- Duke Clinical Research Institute, Durham, North Carolina, USA
| | - Stephen J. Balevic
- Department of Pediatrics, Duke University, Durham, North Carolina, USA
- Duke Clinical Research Institute, Durham, North Carolina, USA
| | - Rachel G. Greenberg
- Department of Pediatrics, Duke University, Durham, North Carolina, USA
- Duke Clinical Research Institute, Durham, North Carolina, USA
| | - Michael Cohen-Wolkowiez
- Department of Pediatrics, Duke University, Durham, North Carolina, USA
- Duke Clinical Research Institute, Durham, North Carolina, USA
| | - Elizabeth J. Thompson
- Department of Pediatrics, Duke University, Durham, North Carolina, USA
- Duke Clinical Research Institute, Durham, North Carolina, USA
| | | | - Michael J. Smith
- Department of Pediatrics, Duke University, Durham, North Carolina, USA
| | - Catherine Bendel
- Department of Pediatrics, University of Minnesota Medical School, Minneapolis, Minnesota, USA
| | - Joseph M. Bliss
- Department of Pediatrics, University of Rochester Medical Center, Rochester, New York, USA
| | - Hala Chaaban
- Division of Neonatology, Department of Pediatrics, Oklahoma University Health Sciences Center, Oklahoma City, Oklahoma, USA
| | - Rakesh Chhabra
- Division of Neonatology, Department of Pediatrics, Hackensack University Medical Center, Hackensack, New Jersey, USA
| | | | - L. Corbin Downey
- Department of Pediatrics, Atrium Health Wake Forest Baptist Medical Center, Winston-Salem, North Carolina, USA
| | - Chi Hornik
- Department of Pediatrics, Duke University, Durham, North Carolina, USA
- Duke Clinical Research Institute, Durham, North Carolina, USA
| | - Naveed Hussain
- Division of Neonatology, Department of Pediatrics, Connecticut Children’s, Hartford, Connecticut, USA
| | - Matthew M. Laughon
- Department of Pediatrics, Division of Neonatal-Perinatal Medicine, The University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| | | | - Fernando Moya
- Division of Wilmington Pediatric Specialties, Department of Pediatrics, UNC School of Medicine, Chapel Hill, North Carolina, USA
| | - Matthew Saxonhouse
- Division of Neonatology, Department of Pediatrics, Levine Children’s Hospital, Wake Forest School of Medicine, Charlotte campus, Atrium Healthcare, Charlotte, North Carolina, USA
| | - Gregory M. Sokol
- Department of Pediatrics, Indiana University School of Medicine, Indianapolis, Indiana, USA
| | - Andrea Trembath
- Division of Neonatal-Perinatal Medicine, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| | - Joern-Hendrik Weitkamp
- Mildred Stahlman Division of Neonatology, Monroe Carell Jr. Children’s Hospital at Vanderbilt, Vanderbilt University Medical Center, Nashville, Tennessee, USA
| | - Christoph P. Hornik
- Department of Pediatrics, Duke University, Durham, North Carolina, USA
- Duke Clinical Research Institute, Durham, North Carolina, USA
| | - Best Pharmaceuticals for Children Act – Pediatric Trials Network Steering Committee
- Department of Pediatrics, Duke University, Durham, North Carolina, USA
- Duke Clinical Research Institute, Durham, North Carolina, USA
- Department of Pediatrics, University of Minnesota Medical School, Minneapolis, Minnesota, USA
- Department of Pediatrics, University of Rochester Medical Center, Rochester, New York, USA
- Division of Neonatology, Department of Pediatrics, Oklahoma University Health Sciences Center, Oklahoma City, Oklahoma, USA
- Division of Neonatology, Department of Pediatrics, Hackensack University Medical Center, Hackensack, New Jersey, USA
- Department of Pediatrics, Tufts Medical Center, Tufts University, Boston, Massachusetts, USA
- Department of Pediatrics, Atrium Health Wake Forest Baptist Medical Center, Winston-Salem, North Carolina, USA
- Division of Neonatology, Department of Pediatrics, Connecticut Children’s, Hartford, Connecticut, USA
- Department of Pediatrics, Division of Neonatal-Perinatal Medicine, The University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
- Loma Linda University, Loma Linda, California, USA
- Division of Wilmington Pediatric Specialties, Department of Pediatrics, UNC School of Medicine, Chapel Hill, North Carolina, USA
- Division of Neonatology, Department of Pediatrics, Levine Children’s Hospital, Wake Forest School of Medicine, Charlotte campus, Atrium Healthcare, Charlotte, North Carolina, USA
- Department of Pediatrics, Indiana University School of Medicine, Indianapolis, Indiana, USA
- Division of Neonatal-Perinatal Medicine, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
- Mildred Stahlman Division of Neonatology, Monroe Carell Jr. Children’s Hospital at Vanderbilt, Vanderbilt University Medical Center, Nashville, Tennessee, USA
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Numis AL, Glass HC, Comstock BA, Gonzalez F, Maitre NL, Massey SL, Mayock DE, Mietzsch U, Natarajan N, Sokol GM, Bonifacio S, Van Meurs K, Thomas C, Ahmad K, Heagerty P, Juul SE, Wu YW, Wusthoff CJ. Relationship of Neonatal Seizure Burden Before Treatment and Response to Initial Antiseizure Medication. J Pediatr 2024; 268:113957. [PMID: 38360261 DOI: 10.1016/j.jpeds.2024.113957] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/18/2023] [Revised: 02/07/2024] [Accepted: 02/08/2024] [Indexed: 02/17/2024]
Abstract
OBJECTIVE To assess among a cohort of neonates with hypoxic-ischemic encephalopathy (HIE) the association of pretreatment maximal hourly seizure burden and total seizure duration with successful response to initial antiseizure medication (ASM). STUDY DESIGN This was a retrospective review of data collected from infants enrolled in the HEAL Trial (NCT02811263) between January 25, 2017, and October 9, 2019. We evaluated a cohort of neonates born at ≥36 weeks of gestation with moderate-to-severe HIE who underwent continuous electroencephalogram monitoring and had acute symptomatic seizures. Poisson regression analyzed associations between (1) pretreatment maximal hourly seizure burden, (2) pretreatment total seizure duration, (3) time from first seizure to initial ASM, and (4) successful response to initial ASM. RESULTS Among 39 neonates meeting inclusion criteria, greater pretreatment maximal hourly seizure burden was associated with lower chance of successful response to initial ASM (adjusted relative risk for each 5-minute increase in seizure burden 0.83, 95% CI 0.69-0.99). There was no association between pretreatment total seizure duration and chance of successful response. Shorter time-to-treatment was paradoxically associated with lower chance of successful response to treatment, although this difference was small in magnitude (relative risk 1.007, 95% CI 1.003-1.010). CONCLUSIONS Maximal seizure burden may be more important than other, more commonly used measures in predicting response to acute seizure treatments.
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Affiliation(s)
- Adam L Numis
- Department of Neurology and Weill Institute for Neuroscience, University of California San Francisco, San Francisco, CA; Department of Pediatrics UCSF Benioff Children's Hospital, University of California San Francisco, San Francisco, CA.
| | - Hannah C Glass
- Department of Neurology and Weill Institute for Neuroscience, University of California San Francisco, San Francisco, CA; Department of Pediatrics UCSF Benioff Children's Hospital, University of California San Francisco, San Francisco, CA; Department of Epidemiology & Biostatistics, University of California San Francisco, San Francisco, CA
| | - Bryan A Comstock
- Department of Biostatistics, University of Washington, Seattle, WA
| | - Fernando Gonzalez
- Department of Pediatrics UCSF Benioff Children's Hospital, University of California San Francisco, San Francisco, CA
| | - Nathalie L Maitre
- Department of Pediatrics, Emory University School of Medicine and Children's Healthcare of Atlanta, Atlanta, GA
| | - Shavonne L Massey
- Departments of Neurology and Pediatrics, Children's Hospital of Philadelphia and Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA
| | - Dennis E Mayock
- Division of Neonatology, Department of Pediatrics, University of Washington School of Medicine, Seattle, WA
| | - Ulrike Mietzsch
- Division of Neonatology, Department of Pediatrics, University of Washington School of Medicine, Seattle, WA; Department of Pediatrics, Indiana University School of Medicine, Indianapolis, IN
| | - Niranjana Natarajan
- Division of Pediatric Neurology, Department of Neurology, University of Washington School of Medicine, Seattle, WA
| | - Gregory M Sokol
- Department of Pediatrics, Indiana University School of Medicine, Indianapolis, IN
| | - Sonia Bonifacio
- Division of Neonatal and Developmental Medicine, Department of Pediatrics, Stanford University School of Medicine, Stanford, CA
| | - Krisa Van Meurs
- Division of Neonatal and Developmental Medicine, Department of Pediatrics, Stanford University School of Medicine, Stanford, CA
| | - Cameron Thomas
- Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, OH; Division of Neurology, Cincinnati Children's Hospital Medical Center, Cincinnati, OH
| | - Kaashif Ahmad
- Pediatrix Medical Group of San Antonio, Children's Hospital of San Antonio, San Antonio, TX
| | - Patrick Heagerty
- Department of Biostatistics, University of Washington, Seattle, WA
| | - Sandra E Juul
- Division of Neonatology, Department of Pediatrics, University of Washington School of Medicine, Seattle, WA
| | - Yvonne W Wu
- Department of Neurology and Weill Institute for Neuroscience, University of California San Francisco, San Francisco, CA; Department of Pediatrics UCSF Benioff Children's Hospital, University of California San Francisco, San Francisco, CA
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4
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Glass HC, Numis AL, Comstock BA, Gonzalez FF, Mietzsch U, Bonifacio SL, Massey S, Thomas C, Natarajan N, Mayock DE, Sokol GM, Van Meurs KP, Ahmad KA, Maitre N, Heagerty PJ, Juul SE, Wu YW, Wusthoff CJ. Association of EEG Background and Neurodevelopmental Outcome in Neonates With Hypoxic-Ischemic Encephalopathy Receiving Hypothermia. Neurology 2023; 101:e2223-e2233. [PMID: 37816642 PMCID: PMC10727206 DOI: 10.1212/wnl.0000000000207744] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2023] [Accepted: 06/20/2023] [Indexed: 10/12/2023] Open
Abstract
BACKGROUND AND OBJECTIVES Predicting neurodevelopmental outcome for neonates with hypoxic-ischemic encephalopathy (HIE) is important for clinical decision-making, care planning, and parent communication. We examined the relationship between EEG background and neurodevelopmental outcome among children enrolled in a trial of erythropoietin or placebo for neonates with HIE treated with therapeutic hypothermia. METHODS Participants had EEG recorded throughout hypothermia. EEG background was classified as normal, discontinuous, or severely abnormal (defined as burst suppression, low voltage suppressed, or status epilepticus) at 5 1-hour epochs: onset of recording, 24, 36, 48, and 72 hours after birth. The predominant background pattern during the entire continuous video EEG monitoring recording was calculated using the arithmetic mean of the 5 EEG background ratings (normal = 0; discontinuous = 1; severely abnormal = 2) as follows: "predominantly normal" (mean = 0), "normal/discontinuous" (0 < mean<1), "predominantly discontinuous" (mean = 1), "discontinuous/severely abnormal" (1 < mean<2), or "predominantly severely abnormal" (mean = 2). Primary outcome was death or neurodevelopmental impairment (NDI) defined as cerebral palsy, Gross Motor Function Classification Score ≥1, or cognitive score <90 on Bayley Scales of Infant Toddler Development, third edition at age 2 years. Neurodevelopment was also categorized into a 5-level ordinal measure: no, mild, moderate, severe NDI, or death for secondary analysis. We used generalized linear regression models with robust standard errors to assess the relative risk of death or NDI by EEG background in both unadjusted and adjusted analyses controlling for the effects of treatment group, sex, HIE severity, and study recruitment site. RESULTS Among 142 neonates, the predominant background EEG pattern was predominantly normal in 35 (25%), normal/discontinuous in 68 (48%), predominantly discontinuous in 11 (7.7%), discontinuous/severely abnormal in 16 (11%), and predominantly severely abnormal in 12 (8.5%). Increasing severity of background across monitoring epochs was associated with increasingly worse clinical outcomes. Children with severe EEG background abnormality at any time point (n = 36, 25%) were significantly more likely to die or have severe NDI at 2 years (adjusted relative risk: 7.95, 95% CI 3.49-18.12). DISCUSSION EEG background is strongly associated with NDI at age 2 years. These results can be used to assist health care providers to plan follow-up care and counsel families for decision-making related to goals of care.
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Affiliation(s)
- Hannah C Glass
- Departments of Neurology and Weill Institute for Neuroscience (H.C.G., A.L.N., Y.W.W.); Pediatrics (H.C.G., A.L.N., Y.W.W.), UCSF Benioff Children's Hospital; Epidemiology & Biostatistics (H.C.G.), University of California San Francisco, CA; Department Biostatistics (B.A.C., P.J.H.), University of Washington, Seattle; Department of Pediatrics (U.M., S.E.J.), Division of Neonatology, University of Washington School of Medicine, Seattle Children's Hospital; Department of Pediatrics (K.P.V.M., S.L.B.), Division of Neonatal and Developmental Medicine, Stanford University, Palo Alto, CA; Departments of Neurology and Pediatrics, Children's Hospital of Philadelphia and Perelman School of Medicine (S.L.M.), University of Pennsylvania, Philadelphia; Department of Pediatrics (C.T.), University of Cincinnati and Division of Neurology, Cincinnati Children's Hospital Medical Center, OH; Department of Neurology (N.N.), University of Washington School of Medicine, Seattle; Department of Pediatrics (G.S.), Indiana University School of Medicine, Indianapolis, IN; Pediatrix Neonatology of San Antonio (K.A.A.), TX; Department of Pediatrics, and Emory + Children's Pediatric Institute (N.M.), Emory University, Atlanta, GA; Department of Neurology (C.J.W.), Stanford University, Palo Alto, CA.
| | - Adam L Numis
- Departments of Neurology and Weill Institute for Neuroscience (H.C.G., A.L.N., Y.W.W.); Pediatrics (H.C.G., A.L.N., Y.W.W.), UCSF Benioff Children's Hospital; Epidemiology & Biostatistics (H.C.G.), University of California San Francisco, CA; Department Biostatistics (B.A.C., P.J.H.), University of Washington, Seattle; Department of Pediatrics (U.M., S.E.J.), Division of Neonatology, University of Washington School of Medicine, Seattle Children's Hospital; Department of Pediatrics (K.P.V.M., S.L.B.), Division of Neonatal and Developmental Medicine, Stanford University, Palo Alto, CA; Departments of Neurology and Pediatrics, Children's Hospital of Philadelphia and Perelman School of Medicine (S.L.M.), University of Pennsylvania, Philadelphia; Department of Pediatrics (C.T.), University of Cincinnati and Division of Neurology, Cincinnati Children's Hospital Medical Center, OH; Department of Neurology (N.N.), University of Washington School of Medicine, Seattle; Department of Pediatrics (G.S.), Indiana University School of Medicine, Indianapolis, IN; Pediatrix Neonatology of San Antonio (K.A.A.), TX; Department of Pediatrics, and Emory + Children's Pediatric Institute (N.M.), Emory University, Atlanta, GA; Department of Neurology (C.J.W.), Stanford University, Palo Alto, CA
| | - Bryan A Comstock
- Departments of Neurology and Weill Institute for Neuroscience (H.C.G., A.L.N., Y.W.W.); Pediatrics (H.C.G., A.L.N., Y.W.W.), UCSF Benioff Children's Hospital; Epidemiology & Biostatistics (H.C.G.), University of California San Francisco, CA; Department Biostatistics (B.A.C., P.J.H.), University of Washington, Seattle; Department of Pediatrics (U.M., S.E.J.), Division of Neonatology, University of Washington School of Medicine, Seattle Children's Hospital; Department of Pediatrics (K.P.V.M., S.L.B.), Division of Neonatal and Developmental Medicine, Stanford University, Palo Alto, CA; Departments of Neurology and Pediatrics, Children's Hospital of Philadelphia and Perelman School of Medicine (S.L.M.), University of Pennsylvania, Philadelphia; Department of Pediatrics (C.T.), University of Cincinnati and Division of Neurology, Cincinnati Children's Hospital Medical Center, OH; Department of Neurology (N.N.), University of Washington School of Medicine, Seattle; Department of Pediatrics (G.S.), Indiana University School of Medicine, Indianapolis, IN; Pediatrix Neonatology of San Antonio (K.A.A.), TX; Department of Pediatrics, and Emory + Children's Pediatric Institute (N.M.), Emory University, Atlanta, GA; Department of Neurology (C.J.W.), Stanford University, Palo Alto, CA
| | - Fernando F Gonzalez
- Departments of Neurology and Weill Institute for Neuroscience (H.C.G., A.L.N., Y.W.W.); Pediatrics (H.C.G., A.L.N., Y.W.W.), UCSF Benioff Children's Hospital; Epidemiology & Biostatistics (H.C.G.), University of California San Francisco, CA; Department Biostatistics (B.A.C., P.J.H.), University of Washington, Seattle; Department of Pediatrics (U.M., S.E.J.), Division of Neonatology, University of Washington School of Medicine, Seattle Children's Hospital; Department of Pediatrics (K.P.V.M., S.L.B.), Division of Neonatal and Developmental Medicine, Stanford University, Palo Alto, CA; Departments of Neurology and Pediatrics, Children's Hospital of Philadelphia and Perelman School of Medicine (S.L.M.), University of Pennsylvania, Philadelphia; Department of Pediatrics (C.T.), University of Cincinnati and Division of Neurology, Cincinnati Children's Hospital Medical Center, OH; Department of Neurology (N.N.), University of Washington School of Medicine, Seattle; Department of Pediatrics (G.S.), Indiana University School of Medicine, Indianapolis, IN; Pediatrix Neonatology of San Antonio (K.A.A.), TX; Department of Pediatrics, and Emory + Children's Pediatric Institute (N.M.), Emory University, Atlanta, GA; Department of Neurology (C.J.W.), Stanford University, Palo Alto, CA
| | - Ulrike Mietzsch
- Departments of Neurology and Weill Institute for Neuroscience (H.C.G., A.L.N., Y.W.W.); Pediatrics (H.C.G., A.L.N., Y.W.W.), UCSF Benioff Children's Hospital; Epidemiology & Biostatistics (H.C.G.), University of California San Francisco, CA; Department Biostatistics (B.A.C., P.J.H.), University of Washington, Seattle; Department of Pediatrics (U.M., S.E.J.), Division of Neonatology, University of Washington School of Medicine, Seattle Children's Hospital; Department of Pediatrics (K.P.V.M., S.L.B.), Division of Neonatal and Developmental Medicine, Stanford University, Palo Alto, CA; Departments of Neurology and Pediatrics, Children's Hospital of Philadelphia and Perelman School of Medicine (S.L.M.), University of Pennsylvania, Philadelphia; Department of Pediatrics (C.T.), University of Cincinnati and Division of Neurology, Cincinnati Children's Hospital Medical Center, OH; Department of Neurology (N.N.), University of Washington School of Medicine, Seattle; Department of Pediatrics (G.S.), Indiana University School of Medicine, Indianapolis, IN; Pediatrix Neonatology of San Antonio (K.A.A.), TX; Department of Pediatrics, and Emory + Children's Pediatric Institute (N.M.), Emory University, Atlanta, GA; Department of Neurology (C.J.W.), Stanford University, Palo Alto, CA
| | - Sonia Lomeli Bonifacio
- Departments of Neurology and Weill Institute for Neuroscience (H.C.G., A.L.N., Y.W.W.); Pediatrics (H.C.G., A.L.N., Y.W.W.), UCSF Benioff Children's Hospital; Epidemiology & Biostatistics (H.C.G.), University of California San Francisco, CA; Department Biostatistics (B.A.C., P.J.H.), University of Washington, Seattle; Department of Pediatrics (U.M., S.E.J.), Division of Neonatology, University of Washington School of Medicine, Seattle Children's Hospital; Department of Pediatrics (K.P.V.M., S.L.B.), Division of Neonatal and Developmental Medicine, Stanford University, Palo Alto, CA; Departments of Neurology and Pediatrics, Children's Hospital of Philadelphia and Perelman School of Medicine (S.L.M.), University of Pennsylvania, Philadelphia; Department of Pediatrics (C.T.), University of Cincinnati and Division of Neurology, Cincinnati Children's Hospital Medical Center, OH; Department of Neurology (N.N.), University of Washington School of Medicine, Seattle; Department of Pediatrics (G.S.), Indiana University School of Medicine, Indianapolis, IN; Pediatrix Neonatology of San Antonio (K.A.A.), TX; Department of Pediatrics, and Emory + Children's Pediatric Institute (N.M.), Emory University, Atlanta, GA; Department of Neurology (C.J.W.), Stanford University, Palo Alto, CA
| | - Shavonne Massey
- Departments of Neurology and Weill Institute for Neuroscience (H.C.G., A.L.N., Y.W.W.); Pediatrics (H.C.G., A.L.N., Y.W.W.), UCSF Benioff Children's Hospital; Epidemiology & Biostatistics (H.C.G.), University of California San Francisco, CA; Department Biostatistics (B.A.C., P.J.H.), University of Washington, Seattle; Department of Pediatrics (U.M., S.E.J.), Division of Neonatology, University of Washington School of Medicine, Seattle Children's Hospital; Department of Pediatrics (K.P.V.M., S.L.B.), Division of Neonatal and Developmental Medicine, Stanford University, Palo Alto, CA; Departments of Neurology and Pediatrics, Children's Hospital of Philadelphia and Perelman School of Medicine (S.L.M.), University of Pennsylvania, Philadelphia; Department of Pediatrics (C.T.), University of Cincinnati and Division of Neurology, Cincinnati Children's Hospital Medical Center, OH; Department of Neurology (N.N.), University of Washington School of Medicine, Seattle; Department of Pediatrics (G.S.), Indiana University School of Medicine, Indianapolis, IN; Pediatrix Neonatology of San Antonio (K.A.A.), TX; Department of Pediatrics, and Emory + Children's Pediatric Institute (N.M.), Emory University, Atlanta, GA; Department of Neurology (C.J.W.), Stanford University, Palo Alto, CA
| | - Cameron Thomas
- Departments of Neurology and Weill Institute for Neuroscience (H.C.G., A.L.N., Y.W.W.); Pediatrics (H.C.G., A.L.N., Y.W.W.), UCSF Benioff Children's Hospital; Epidemiology & Biostatistics (H.C.G.), University of California San Francisco, CA; Department Biostatistics (B.A.C., P.J.H.), University of Washington, Seattle; Department of Pediatrics (U.M., S.E.J.), Division of Neonatology, University of Washington School of Medicine, Seattle Children's Hospital; Department of Pediatrics (K.P.V.M., S.L.B.), Division of Neonatal and Developmental Medicine, Stanford University, Palo Alto, CA; Departments of Neurology and Pediatrics, Children's Hospital of Philadelphia and Perelman School of Medicine (S.L.M.), University of Pennsylvania, Philadelphia; Department of Pediatrics (C.T.), University of Cincinnati and Division of Neurology, Cincinnati Children's Hospital Medical Center, OH; Department of Neurology (N.N.), University of Washington School of Medicine, Seattle; Department of Pediatrics (G.S.), Indiana University School of Medicine, Indianapolis, IN; Pediatrix Neonatology of San Antonio (K.A.A.), TX; Department of Pediatrics, and Emory + Children's Pediatric Institute (N.M.), Emory University, Atlanta, GA; Department of Neurology (C.J.W.), Stanford University, Palo Alto, CA
| | - Niranjana Natarajan
- Departments of Neurology and Weill Institute for Neuroscience (H.C.G., A.L.N., Y.W.W.); Pediatrics (H.C.G., A.L.N., Y.W.W.), UCSF Benioff Children's Hospital; Epidemiology & Biostatistics (H.C.G.), University of California San Francisco, CA; Department Biostatistics (B.A.C., P.J.H.), University of Washington, Seattle; Department of Pediatrics (U.M., S.E.J.), Division of Neonatology, University of Washington School of Medicine, Seattle Children's Hospital; Department of Pediatrics (K.P.V.M., S.L.B.), Division of Neonatal and Developmental Medicine, Stanford University, Palo Alto, CA; Departments of Neurology and Pediatrics, Children's Hospital of Philadelphia and Perelman School of Medicine (S.L.M.), University of Pennsylvania, Philadelphia; Department of Pediatrics (C.T.), University of Cincinnati and Division of Neurology, Cincinnati Children's Hospital Medical Center, OH; Department of Neurology (N.N.), University of Washington School of Medicine, Seattle; Department of Pediatrics (G.S.), Indiana University School of Medicine, Indianapolis, IN; Pediatrix Neonatology of San Antonio (K.A.A.), TX; Department of Pediatrics, and Emory + Children's Pediatric Institute (N.M.), Emory University, Atlanta, GA; Department of Neurology (C.J.W.), Stanford University, Palo Alto, CA
| | - Dennis E Mayock
- Departments of Neurology and Weill Institute for Neuroscience (H.C.G., A.L.N., Y.W.W.); Pediatrics (H.C.G., A.L.N., Y.W.W.), UCSF Benioff Children's Hospital; Epidemiology & Biostatistics (H.C.G.), University of California San Francisco, CA; Department Biostatistics (B.A.C., P.J.H.), University of Washington, Seattle; Department of Pediatrics (U.M., S.E.J.), Division of Neonatology, University of Washington School of Medicine, Seattle Children's Hospital; Department of Pediatrics (K.P.V.M., S.L.B.), Division of Neonatal and Developmental Medicine, Stanford University, Palo Alto, CA; Departments of Neurology and Pediatrics, Children's Hospital of Philadelphia and Perelman School of Medicine (S.L.M.), University of Pennsylvania, Philadelphia; Department of Pediatrics (C.T.), University of Cincinnati and Division of Neurology, Cincinnati Children's Hospital Medical Center, OH; Department of Neurology (N.N.), University of Washington School of Medicine, Seattle; Department of Pediatrics (G.S.), Indiana University School of Medicine, Indianapolis, IN; Pediatrix Neonatology of San Antonio (K.A.A.), TX; Department of Pediatrics, and Emory + Children's Pediatric Institute (N.M.), Emory University, Atlanta, GA; Department of Neurology (C.J.W.), Stanford University, Palo Alto, CA
| | - Gregory M Sokol
- Departments of Neurology and Weill Institute for Neuroscience (H.C.G., A.L.N., Y.W.W.); Pediatrics (H.C.G., A.L.N., Y.W.W.), UCSF Benioff Children's Hospital; Epidemiology & Biostatistics (H.C.G.), University of California San Francisco, CA; Department Biostatistics (B.A.C., P.J.H.), University of Washington, Seattle; Department of Pediatrics (U.M., S.E.J.), Division of Neonatology, University of Washington School of Medicine, Seattle Children's Hospital; Department of Pediatrics (K.P.V.M., S.L.B.), Division of Neonatal and Developmental Medicine, Stanford University, Palo Alto, CA; Departments of Neurology and Pediatrics, Children's Hospital of Philadelphia and Perelman School of Medicine (S.L.M.), University of Pennsylvania, Philadelphia; Department of Pediatrics (C.T.), University of Cincinnati and Division of Neurology, Cincinnati Children's Hospital Medical Center, OH; Department of Neurology (N.N.), University of Washington School of Medicine, Seattle; Department of Pediatrics (G.S.), Indiana University School of Medicine, Indianapolis, IN; Pediatrix Neonatology of San Antonio (K.A.A.), TX; Department of Pediatrics, and Emory + Children's Pediatric Institute (N.M.), Emory University, Atlanta, GA; Department of Neurology (C.J.W.), Stanford University, Palo Alto, CA
| | - Krisa P Van Meurs
- Departments of Neurology and Weill Institute for Neuroscience (H.C.G., A.L.N., Y.W.W.); Pediatrics (H.C.G., A.L.N., Y.W.W.), UCSF Benioff Children's Hospital; Epidemiology & Biostatistics (H.C.G.), University of California San Francisco, CA; Department Biostatistics (B.A.C., P.J.H.), University of Washington, Seattle; Department of Pediatrics (U.M., S.E.J.), Division of Neonatology, University of Washington School of Medicine, Seattle Children's Hospital; Department of Pediatrics (K.P.V.M., S.L.B.), Division of Neonatal and Developmental Medicine, Stanford University, Palo Alto, CA; Departments of Neurology and Pediatrics, Children's Hospital of Philadelphia and Perelman School of Medicine (S.L.M.), University of Pennsylvania, Philadelphia; Department of Pediatrics (C.T.), University of Cincinnati and Division of Neurology, Cincinnati Children's Hospital Medical Center, OH; Department of Neurology (N.N.), University of Washington School of Medicine, Seattle; Department of Pediatrics (G.S.), Indiana University School of Medicine, Indianapolis, IN; Pediatrix Neonatology of San Antonio (K.A.A.), TX; Department of Pediatrics, and Emory + Children's Pediatric Institute (N.M.), Emory University, Atlanta, GA; Department of Neurology (C.J.W.), Stanford University, Palo Alto, CA
| | - Kaashif A Ahmad
- Departments of Neurology and Weill Institute for Neuroscience (H.C.G., A.L.N., Y.W.W.); Pediatrics (H.C.G., A.L.N., Y.W.W.), UCSF Benioff Children's Hospital; Epidemiology & Biostatistics (H.C.G.), University of California San Francisco, CA; Department Biostatistics (B.A.C., P.J.H.), University of Washington, Seattle; Department of Pediatrics (U.M., S.E.J.), Division of Neonatology, University of Washington School of Medicine, Seattle Children's Hospital; Department of Pediatrics (K.P.V.M., S.L.B.), Division of Neonatal and Developmental Medicine, Stanford University, Palo Alto, CA; Departments of Neurology and Pediatrics, Children's Hospital of Philadelphia and Perelman School of Medicine (S.L.M.), University of Pennsylvania, Philadelphia; Department of Pediatrics (C.T.), University of Cincinnati and Division of Neurology, Cincinnati Children's Hospital Medical Center, OH; Department of Neurology (N.N.), University of Washington School of Medicine, Seattle; Department of Pediatrics (G.S.), Indiana University School of Medicine, Indianapolis, IN; Pediatrix Neonatology of San Antonio (K.A.A.), TX; Department of Pediatrics, and Emory + Children's Pediatric Institute (N.M.), Emory University, Atlanta, GA; Department of Neurology (C.J.W.), Stanford University, Palo Alto, CA
| | - Nathalie Maitre
- Departments of Neurology and Weill Institute for Neuroscience (H.C.G., A.L.N., Y.W.W.); Pediatrics (H.C.G., A.L.N., Y.W.W.), UCSF Benioff Children's Hospital; Epidemiology & Biostatistics (H.C.G.), University of California San Francisco, CA; Department Biostatistics (B.A.C., P.J.H.), University of Washington, Seattle; Department of Pediatrics (U.M., S.E.J.), Division of Neonatology, University of Washington School of Medicine, Seattle Children's Hospital; Department of Pediatrics (K.P.V.M., S.L.B.), Division of Neonatal and Developmental Medicine, Stanford University, Palo Alto, CA; Departments of Neurology and Pediatrics, Children's Hospital of Philadelphia and Perelman School of Medicine (S.L.M.), University of Pennsylvania, Philadelphia; Department of Pediatrics (C.T.), University of Cincinnati and Division of Neurology, Cincinnati Children's Hospital Medical Center, OH; Department of Neurology (N.N.), University of Washington School of Medicine, Seattle; Department of Pediatrics (G.S.), Indiana University School of Medicine, Indianapolis, IN; Pediatrix Neonatology of San Antonio (K.A.A.), TX; Department of Pediatrics, and Emory + Children's Pediatric Institute (N.M.), Emory University, Atlanta, GA; Department of Neurology (C.J.W.), Stanford University, Palo Alto, CA
| | - Patrick J Heagerty
- Departments of Neurology and Weill Institute for Neuroscience (H.C.G., A.L.N., Y.W.W.); Pediatrics (H.C.G., A.L.N., Y.W.W.), UCSF Benioff Children's Hospital; Epidemiology & Biostatistics (H.C.G.), University of California San Francisco, CA; Department Biostatistics (B.A.C., P.J.H.), University of Washington, Seattle; Department of Pediatrics (U.M., S.E.J.), Division of Neonatology, University of Washington School of Medicine, Seattle Children's Hospital; Department of Pediatrics (K.P.V.M., S.L.B.), Division of Neonatal and Developmental Medicine, Stanford University, Palo Alto, CA; Departments of Neurology and Pediatrics, Children's Hospital of Philadelphia and Perelman School of Medicine (S.L.M.), University of Pennsylvania, Philadelphia; Department of Pediatrics (C.T.), University of Cincinnati and Division of Neurology, Cincinnati Children's Hospital Medical Center, OH; Department of Neurology (N.N.), University of Washington School of Medicine, Seattle; Department of Pediatrics (G.S.), Indiana University School of Medicine, Indianapolis, IN; Pediatrix Neonatology of San Antonio (K.A.A.), TX; Department of Pediatrics, and Emory + Children's Pediatric Institute (N.M.), Emory University, Atlanta, GA; Department of Neurology (C.J.W.), Stanford University, Palo Alto, CA
| | - Sandra E Juul
- Departments of Neurology and Weill Institute for Neuroscience (H.C.G., A.L.N., Y.W.W.); Pediatrics (H.C.G., A.L.N., Y.W.W.), UCSF Benioff Children's Hospital; Epidemiology & Biostatistics (H.C.G.), University of California San Francisco, CA; Department Biostatistics (B.A.C., P.J.H.), University of Washington, Seattle; Department of Pediatrics (U.M., S.E.J.), Division of Neonatology, University of Washington School of Medicine, Seattle Children's Hospital; Department of Pediatrics (K.P.V.M., S.L.B.), Division of Neonatal and Developmental Medicine, Stanford University, Palo Alto, CA; Departments of Neurology and Pediatrics, Children's Hospital of Philadelphia and Perelman School of Medicine (S.L.M.), University of Pennsylvania, Philadelphia; Department of Pediatrics (C.T.), University of Cincinnati and Division of Neurology, Cincinnati Children's Hospital Medical Center, OH; Department of Neurology (N.N.), University of Washington School of Medicine, Seattle; Department of Pediatrics (G.S.), Indiana University School of Medicine, Indianapolis, IN; Pediatrix Neonatology of San Antonio (K.A.A.), TX; Department of Pediatrics, and Emory + Children's Pediatric Institute (N.M.), Emory University, Atlanta, GA; Department of Neurology (C.J.W.), Stanford University, Palo Alto, CA
| | - Yvonne W Wu
- Departments of Neurology and Weill Institute for Neuroscience (H.C.G., A.L.N., Y.W.W.); Pediatrics (H.C.G., A.L.N., Y.W.W.), UCSF Benioff Children's Hospital; Epidemiology & Biostatistics (H.C.G.), University of California San Francisco, CA; Department Biostatistics (B.A.C., P.J.H.), University of Washington, Seattle; Department of Pediatrics (U.M., S.E.J.), Division of Neonatology, University of Washington School of Medicine, Seattle Children's Hospital; Department of Pediatrics (K.P.V.M., S.L.B.), Division of Neonatal and Developmental Medicine, Stanford University, Palo Alto, CA; Departments of Neurology and Pediatrics, Children's Hospital of Philadelphia and Perelman School of Medicine (S.L.M.), University of Pennsylvania, Philadelphia; Department of Pediatrics (C.T.), University of Cincinnati and Division of Neurology, Cincinnati Children's Hospital Medical Center, OH; Department of Neurology (N.N.), University of Washington School of Medicine, Seattle; Department of Pediatrics (G.S.), Indiana University School of Medicine, Indianapolis, IN; Pediatrix Neonatology of San Antonio (K.A.A.), TX; Department of Pediatrics, and Emory + Children's Pediatric Institute (N.M.), Emory University, Atlanta, GA; Department of Neurology (C.J.W.), Stanford University, Palo Alto, CA
| | - Courtney J Wusthoff
- Departments of Neurology and Weill Institute for Neuroscience (H.C.G., A.L.N., Y.W.W.); Pediatrics (H.C.G., A.L.N., Y.W.W.), UCSF Benioff Children's Hospital; Epidemiology & Biostatistics (H.C.G.), University of California San Francisco, CA; Department Biostatistics (B.A.C., P.J.H.), University of Washington, Seattle; Department of Pediatrics (U.M., S.E.J.), Division of Neonatology, University of Washington School of Medicine, Seattle Children's Hospital; Department of Pediatrics (K.P.V.M., S.L.B.), Division of Neonatal and Developmental Medicine, Stanford University, Palo Alto, CA; Departments of Neurology and Pediatrics, Children's Hospital of Philadelphia and Perelman School of Medicine (S.L.M.), University of Pennsylvania, Philadelphia; Department of Pediatrics (C.T.), University of Cincinnati and Division of Neurology, Cincinnati Children's Hospital Medical Center, OH; Department of Neurology (N.N.), University of Washington School of Medicine, Seattle; Department of Pediatrics (G.S.), Indiana University School of Medicine, Indianapolis, IN; Pediatrix Neonatology of San Antonio (K.A.A.), TX; Department of Pediatrics, and Emory + Children's Pediatric Institute (N.M.), Emory University, Atlanta, GA; Department of Neurology (C.J.W.), Stanford University, Palo Alto, CA
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5
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Chock VY, Kirpalani H, Bell EF, Tan S, Hintz SR, Ball MB, Smith E, Das A, Loggins YC, Sood BG, Chalak LF, Wyckoff MH, Kicklighter SD, Kennedy KA, Patel RM, Carlo WA, Johnson KJ, Watterberg KL, Sánchez PJ, Laptook AR, Seabrook RB, Cotten CM, Mancini T, Sokol GM, Ohls RK, Hibbs AM, Poindexter BB, Reynolds AM, DeMauro SB, Chawla S, Baserga M, Walsh MC, Higgins RD, Van Meurs KP. Tissue Oxygenation Changes After Transfusion and Outcomes in Preterm Infants: A Secondary Near-Infrared Spectroscopy Study of the Transfusion of Prematures Randomized Clinical Trial (TOP NIRS). JAMA Netw Open 2023; 6:e2334889. [PMID: 37733345 PMCID: PMC10514737 DOI: 10.1001/jamanetworkopen.2023.34889] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/30/2023] [Accepted: 07/18/2023] [Indexed: 09/22/2023] Open
Abstract
Importance Preterm infants with varying degrees of anemia have different tissue oxygen saturation responses to red blood cell (RBC) transfusion, and low cerebral saturation may be associated with adverse outcomes. Objective To determine whether RBC transfusion in preterm infants is associated with increases in cerebral and mesenteric tissue saturation (Csat and Msat, respectively) or decreases in cerebral and mesenteric fractional tissue oxygen extraction (cFTOE and mFTOE, respectively) and whether associations vary based on degree of anemia, and to investigate the association of Csat with death or neurodevelopmental impairment (NDI) at 22 to 26 months corrected age. Design, Setting, and Participants This was a prospective observational secondary study conducted among a subset of infants between August 2015 and April 2017 in the Transfusion of Prematures (TOP) multicenter randomized clinical trial at 16 neonatal intensive care units of the Eunice Kennedy Shriver National Institute of Child Health and Human Development Neonatal Research Network. Preterm neonates with gestational age 22 to 28 weeks and birth weight 1000 g or less were randomized to higher or lower hemoglobin thresholds for transfusion. Data were analyzed between October 2020 and May 2022. Interventions Near-infrared spectroscopy monitoring of Csat and Msat. Main Outcomes and Measures Primary outcomes were changes in Csat, Msat, cFTOE, and mFTOE after transfusion between hemoglobin threshold groups, adjusting for age at transfusion, gestational age, birth weight stratum, and center. Secondary outcome at 22 to 26 months was death or NDI defined as cognitive delay (Bayley Scales of Infant and Toddler Development-III score <85), cerebral palsy with Gross Motor Function Classification System level II or greater, or severe vision or hearing impairment. Results A total of 179 infants (45 [44.6%] male) with mean (SD) gestational age 25.9 (1.5) weeks were enrolled, and valid data were captured from 101 infants during 237 transfusion events. Transfusion was associated with a significant increase in mean Csat of 4.8% (95% CI, 2.7%-6.9%) in the lower-hemoglobin threshold group compared to 2.7% (95% CI, 1.2%-4.2%) in the higher-hemoglobin threshold group, while mean Msat increased 6.7% (95% CI, 2.4%-11.0%) vs 5.6% (95% CI, 2.7%-8.5%). Mean cFTOE and mFTOE decreased in both groups to a similar extent. There was no significant change in peripheral oxygen saturation (SpO2) in either group (0.2% vs -0.2%). NDI or death occurred in 36 infants (37%). Number of transfusions with mean pretransfusion Csat less than 50% was associated with NDI or death (odds ratio, 2.41; 95% CI, 1.08-5.41; P = .03). Conclusions and Relevance In this secondary study of the TOP randomized clinical trial, Csat and Msat were increased after transfusion despite no change in SpO2. Lower pretransfusion Csat may be associated with adverse outcomes, supporting further investigation of targeted tissue saturation monitoring in preterm infants with anemia. Trial Registration ClinicalTrials.gov Identifier: NCT01702805.
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Affiliation(s)
- Valerie Y. Chock
- Division of Neonatal and Developmental Medicine, Department of Pediatrics, Stanford University School of Medicine and Lucile Packard Children’s Hospital, Palo Alto, California
| | - Haresh Kirpalani
- Department of Pediatrics, University of Pennsylvania, Philadelphia
| | | | - Sylvia Tan
- Social, Statistical and Environmental Sciences Unit, RTI International, Research Triangle Park, North Carolina
| | - Susan R. Hintz
- Division of Neonatal and Developmental Medicine, Department of Pediatrics, Stanford University School of Medicine and Lucile Packard Children’s Hospital, Palo Alto, California
| | - M. Bethany Ball
- Division of Neonatal and Developmental Medicine, Department of Pediatrics, Stanford University School of Medicine and Lucile Packard Children’s Hospital, Palo Alto, California
| | - Emily Smith
- Social, Statistical and Environmental Sciences Unit, RTI International, Research Triangle Park, North Carolina
| | - Abhik Das
- Social, Statistical and Environmental Sciences Unit, RTI International, Rockville, Maryland
| | - Yvonne C. Loggins
- Department of Pediatrics, Children’s Healthcare of Atlanta, Emory University School of Medicine, Atlanta, Georgia
| | - Beena G. Sood
- Department of Pediatrics, Wayne State University, Detroit, Michigan
| | - Lina F. Chalak
- Department of Pediatrics, University of Texas Southwestern Medical Center, Dallas
| | - Myra H. Wyckoff
- Department of Pediatrics, University of Texas Southwestern Medical Center, Dallas
| | - Stephen D. Kicklighter
- Division of Neonatology, Department of Pediatrics, WakeMed Health and Hospitals, Raleigh, North Carolina
| | - Kathleen A. Kennedy
- Department of Pediatrics, McGovern Medical School at The University of Texas Health Science Center at Houston, Houston
| | - Ravi M. Patel
- Department of Pediatrics, Children’s Healthcare of Atlanta, Emory University School of Medicine, Atlanta, Georgia
| | - Waldemar A. Carlo
- Division of Neonatology, University of Alabama at Birmingham, Birmingham
| | | | | | - Pablo J. Sánchez
- Department of Pediatrics, Nationwide Children’s Hospital, The Ohio State University College of Medicine, Columbus
| | - Abbot R. Laptook
- Department of Pediatrics, Women & Infants Hospital, Brown University, Providence, Rhode Island
| | - Ruth B. Seabrook
- Department of Pediatrics, Nationwide Children’s Hospital, The Ohio State University College of Medicine, Columbus
| | | | - Toni Mancini
- Department of Pediatrics, University of Pennsylvania, Philadelphia
| | - Gregory M. Sokol
- Department of Pediatrics, Indiana University School of Medicine, Indianapolis
| | - Robin K. Ohls
- University of New Mexico Health Sciences Center, Albuquerque
- Division of Neonatology, Department of Pediatrics, University of Utah School of Medicine, Salt Lake City
| | - Anna Maria Hibbs
- Department of Pediatrics, Rainbow Babies & Children’s Hospital, Case Western Reserve University, Cleveland, Ohio
| | - Brenda B. Poindexter
- Department of Pediatrics, Cincinnati Children’s Hospital Medical Center, University of Cincinnati College of Medicine, Cincinnati, Ohio
| | - Anne Marie Reynolds
- Department of Pediatrics, University of Buffalo Women’s and Children’s Hospital of Buffalo, Buffalo, New York
| | - Sara B. DeMauro
- Children’s Hospital of Philadelphia, Philadelphia, Pennsylvania
| | - Sanjay Chawla
- Department of Pediatrics, Wayne State University, Detroit, Michigan
| | - Mariana Baserga
- Division of Neonatology, Department of Pediatrics, University of Utah School of Medicine, Salt Lake City
| | - Michele C. Walsh
- Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, Bethesda, Maryland
| | - Rosemary D. Higgins
- Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, Bethesda, Maryland
- Research and Sponsored Programs, Florida Gulf Coast University, Fort Myers
| | - Krisa P. Van Meurs
- Division of Neonatal and Developmental Medicine, Department of Pediatrics, Stanford University School of Medicine and Lucile Packard Children’s Hospital, Palo Alto, California
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6
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Glass HC, Wusthoff CJ, Comstock BA, Numis AL, Gonzalez FF, Maitre N, Massey SL, Mayock DE, Mietzsch U, Natarajan N, Sokol GM, Bonifacio SL, Van Meurs KP, Thomas C, Ahmad KA, Heagerty PJ, Juul SE, Wu YW. Risk of seizures in neonates with hypoxic-ischemic encephalopathy receiving hypothermia plus erythropoietin or placebo. Pediatr Res 2023; 94:252-259. [PMID: 36470964 PMCID: PMC10239788 DOI: 10.1038/s41390-022-02398-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/20/2022] [Revised: 10/27/2022] [Accepted: 11/03/2022] [Indexed: 12/12/2022]
Abstract
BACKGROUND An ancillary study of the High-Dose Erythropoietin for Asphyxia and Encephalopathy (HEAL) trial for neonates with hypoxic-ischemic encephalopathy (HIE) and treated with therapeutic hypothermia examined the hypothesis that neonates randomized to receive erythropoietin (Epo) would have a lower seizure risk and burden compared with neonates who received placebo. METHODS Electroencephalograms (EEGs) from 7/17 HEAL trial centers were reviewed. Seizure presence was compared across treatment groups using a logistic regression model adjusting for treatment, HIE severity, center, and seizure burden prior to the first dose. Among neonates with seizures, differences across treatment groups in median maximal hourly seizure burden were assessed using adjusted quantile regression models. RESULTS Forty-six of 150 (31%) neonates had EEG seizures (31% in Epo vs 30% in placebo, p = 0.96). Maximal hourly seizure burden after the study drug was not significantly different between groups (median 11.4 for Epo, IQR: 5.6, 18.1 vs median 9.7, IQR: 4.9, 21.0 min/h for placebo). CONCLUSION In neonates with HIE treated with hypothermia who were randomized to Epo or placebo, we found no meaningful between-group difference in seizure risk or burden. These findings are consistent with overall trial results, which do not support Epo use for neonates with HIE undergoing therapeutic hypothermia. IMPACT In the HEAL trial of erythropoietin (Epo) vs placebo for neonates with encephalopathy presumed due to hypoxic-ischemic encephalopathy (HIE) who were also treated with therapeutic hypothermia, electrographic seizures were detected in 31%, which is lower than most prior studies. Epo did not reduce the proportion of neonates with acute provoked seizures (31% in Epo vs 30% in placebo) or maximal hourly seizure burden after the study drug (median 11.4, IQR 5.6, 18.1 for Epo vs median 9.7, IQR 4.9, 21.0 min/h for placebo). There was no anti- or pro-convulsant effect of Epo when combined with therapeutic hypothermia for HIE.
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Affiliation(s)
- Hannah C Glass
- Department of Pediatrics, UCSF Benioff Children's Hospital, University of California San Francisco, San Francisco, CA, USA.
- Department of Epidemiology & Biostatistics, University of California San Francisco, San Francisco, CA, USA.
| | - Courtney J Wusthoff
- Department of Neurology, Stanford University, Palo Alto, CA, USA
- Department of Pediatrics, Division of Neonatal and Developmental Medicine, Stanford University, Palo Alto, CA, USA
| | - Bryan A Comstock
- Department Biostatistics, University of Washington, Seattle, WA, USA
| | - Adam L Numis
- Department of Pediatrics, UCSF Benioff Children's Hospital, University of California San Francisco, San Francisco, CA, USA
- Department of Neurology and Weill Institute for Neuroscience, University of California San Francisco, San Francisco, CA, USA
| | - Fernando F Gonzalez
- Department of Pediatrics, UCSF Benioff Children's Hospital, University of California San Francisco, San Francisco, CA, USA
| | - Nathalie Maitre
- Department of Pediatrics, and Emory + Children's Pediatric Institute, Emory University, Atlanta, GA, USA
| | - Shavonne L Massey
- Departments of Neurology and Pediatrics, Children's Hospital of Philadelphia and Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Dennis E Mayock
- Department of Pediatrics, Division of Neonatology, University of Washington School of Medicine, Seattle Children's Hospital, Seattle, WA, USA
| | - Ulrike Mietzsch
- Department of Pediatrics, Division of Neonatology, University of Washington School of Medicine, Seattle Children's Hospital, Seattle, WA, USA
| | - Niranjana Natarajan
- Department of Neurology, University of Washington School of Medicine, Seattle, WA, USA
| | - Gregory M Sokol
- Department of Pediatrics, Indiana University School of Medicine, Indianapolis, IN, USA
| | - Sonia L Bonifacio
- Division of Neonatal and Developmental Medicine, Stanford University School of Medicine and Lucile Packard Children's Hospital Stanford, Palo Alto, CA, USA
| | - Krisa P Van Meurs
- Division of Neonatal and Developmental Medicine, Stanford University School of Medicine and Lucile Packard Children's Hospital Stanford, Palo Alto, CA, USA
| | - Cameron Thomas
- Department of Pediatrics, University of Cincinnati, Cincinnati, OH, USA
- Division of Neurology, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA
| | | | | | - Sandra E Juul
- Department of Pediatrics, Division of Neonatology, University of Washington School of Medicine, Seattle Children's Hospital, Seattle, WA, USA
| | - Yvonne W Wu
- Department of Pediatrics, UCSF Benioff Children's Hospital, University of California San Francisco, San Francisco, CA, USA
- Department of Neurology and Weill Institute for Neuroscience, University of California San Francisco, San Francisco, CA, USA
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7
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Chock VY, Smith E, Tan S, Ball MB, Das A, Hintz SR, Kirpalani H, Bell EF, Chalak LF, Carlo WA, Cotten CM, Widness JA, Kennedy KA, Ohls RK, Seabrook RB, Patel RM, Laptook AR, Mancini T, Sokol GM, Walsh MC, Yoder BA, Poindexter BB, Chawla S, D’Angio CT, Higgins RD, Van Meurs KP. Early brain and abdominal oxygenation in extremely low birth weight infants. Pediatr Res 2022; 92:1034-1041. [PMID: 35513716 PMCID: PMC9588487 DOI: 10.1038/s41390-022-02082-z] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/24/2021] [Revised: 02/24/2022] [Accepted: 04/10/2022] [Indexed: 11/30/2022]
Abstract
BACKGROUND Extremely low birth weight (ELBW) infants are at risk for end-organ hypoxia and ischemia. Regional tissue oxygenation of the brain and gut as monitored with near-infrared spectroscopy (NIRS) may change with postnatal age, but normal ranges are not well defined. METHODS A prospective study of ELBW preterm infants utilized NIRS monitoring to assess changes in cerebral and mesenteric saturation (Csat and Msat) over the first week after birth. This secondary study of a multicenter trial comparing hemoglobin transfusion thresholds assessed cerebral and mesenteric fractional tissue oxygen extraction (cFTOE and mFTOE) and relationships with perinatal variables. RESULTS In 124 infants, both Csat and Msat declined over the first week, with a corresponding increase in oxygen extraction. With lower gestational age, lower birth weight, and 5-min Apgar score ≤5, there was a greater increase in oxygen extraction in the brain compared to the gut. Infants managed with a lower hemoglobin transfusion threshold receiving ≥2 transfusions in the first week had the lowest Csat and highest cFTOE (p < 0.001). CONCLUSION Brain oxygen extraction preferentially increased in more immature and anemic preterm infants. NIRS monitoring may enhance understanding of cerebral and mesenteric oxygenation patterns and inform future protective strategies in the preterm ELBW population. IMPACT Simultaneous monitoring of cerebral and mesenteric tissue saturation demonstrates the balance of oxygenation between preterm brain and gut and may inform protective strategies. Over the first week, oxygen saturation of the brain and gut declines as oxygen extraction increases. A low hemoglobin transfusion threshold is associated with lower cerebral saturation and higher cerebral oxygen extraction compared to a high hemoglobin transfusion threshold, although this did not translate into clinically relevant differences in the TOP trial primary outcome. Greater oxygen extraction by the brain compared to the gut occurs with lower gestational age, lower birth weight, and 5-min Apgar score ≤5.
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Affiliation(s)
- Valerie Y. Chock
- Department of Pediatrics, Division of Neonatal and Developmental Medicine, Stanford University School of Medicine and Lucile Packard Children’s Hospital, Palo Alto, CA,Corresponding author: Valerie Y. Chock, MD, MS Epi, Division of Neonatal and Developmental Medicine, Stanford University School of Medicine, 453 Quarry Road, Palo Alto, CA. 94304 USA, (650) 723-5711,
| | - Emily Smith
- Social, Statistical and Environmental Sciences Unit, RTI International, Research Triangle Park, NC
| | - Sylvia Tan
- Social, Statistical and Environmental Sciences Unit, RTI International, Research Triangle Park, NC
| | - M. Bethany Ball
- Department of Pediatrics, Division of Neonatal and Developmental Medicine, Stanford University School of Medicine and Lucile Packard Children’s Hospital, Palo Alto, CA
| | - Abhik Das
- Social, Statistical and Environmental Sciences Unit, RTI International, Rockville, MD
| | - Susan R. Hintz
- Department of Pediatrics, Division of Neonatal and Developmental Medicine, Stanford University School of Medicine and Lucile Packard Children’s Hospital, Palo Alto, CA
| | - Haresh Kirpalani
- Department of Pediatrics, University of Pennsylvania, Philadelphia, PA
| | - Edward F. Bell
- Department of Pediatrics, University of Iowa, Iowa City, IA
| | - Lina F. Chalak
- Department of Pediatrics, University of Texas Southwestern Medical Center, Dallas, TX
| | - Waldemar A. Carlo
- Division of Neonatology, University of Alabama at Birmingham, Birmingham, AL
| | | | | | - Kathleen A. Kennedy
- Department of Pediatrics, McGovern Medical School at The University of Texas Health Science Center at Houston, Houston, TX
| | - Robin K. Ohls
- University of New Mexico Health Sciences Center, Albuquerque, NM,Department of Pediatrics, Division of Neonatology, University of Utah School of Medicine, Salt Lake City, UT
| | - Ruth B. Seabrook
- Department of Pediatrics, Nationwide Children’s Hospital, The Ohio State University College of Medicine, Columbus, OH
| | - Ravi M. Patel
- Emory University School of Medicine, Department of Pediatrics, Children’s Healthcare of Atlanta, Atlanta, GA
| | - Abbot R. Laptook
- Department of Pediatrics, Women & Infants Hospital, Brown University, Providence, RI
| | - Toni Mancini
- Department of Pediatrics, University of Pennsylvania, Philadelphia, PA
| | - Gregory M. Sokol
- Department of Pediatrics, Indiana University School of Medicine, Indianapolis, IN
| | - Michele C. Walsh
- Department of Pediatrics, Rainbow Babies & Children’s Hospital, Case Western Reserve University, Cleveland, OH
| | - Bradley A. Yoder
- Department of Pediatrics, Division of Neonatology, University of Utah School of Medicine, Salt Lake City, UT
| | - Brenda B. Poindexter
- Emory University School of Medicine, Department of Pediatrics, Children’s Healthcare of Atlanta, Atlanta, GA
| | - Sanjay Chawla
- Department of Pediatrics, Wayne State University, Detroit, MI
| | - Carl T. D’Angio
- University of Rochester School of Medicine and Dentistry, Rochester, NY
| | - Rosemary D. Higgins
- Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, Bethesda, MD,College of Health and Human Services, George Mason University, Fairfax, VA
| | - Krisa P. Van Meurs
- Department of Pediatrics, Division of Neonatal and Developmental Medicine, Stanford University School of Medicine and Lucile Packard Children’s Hospital, Palo Alto, CA
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8
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Vishnubhotla RV, Zhao Y, Wen Q, Dietrich J, Sokol GM, Sadhasivam S, Radhakrishnan R. Brain structural connectome in neonates with prenatal opioid exposure. Front Neurosci 2022; 16:952322. [PMID: 36188457 PMCID: PMC9523134 DOI: 10.3389/fnins.2022.952322] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2022] [Accepted: 09/01/2022] [Indexed: 11/13/2022] Open
Abstract
IntroductionInfants with prenatal opioid exposure (POE) are shown to be at risk for poor long-term neurobehavioral and cognitive outcomes. Early detection of brain developmental alterations on neuroimaging could help in understanding the effect of opioids on the developing brain. Recent studies have shown altered brain functional network connectivity through the application of graph theoretical modeling, in infants with POE. In this study, we assess global brain structural connectivity through diffusion tensor imaging (DTI) metrics and apply graph theoretical modeling to brain structural connectivity in infants with POE.MethodsIn this prospective observational study in infants with POE and control infants, brain MRI including DTI was performed before completion of 3 months corrected postmenstrual age. Tractography was performed on the whole brain using a deterministic fiber tracking algorithm. Pairwise connectivity and network measure were calculated based on fiber count and fractional anisotropy (FA) values. Graph theoretical metrics were also derived.ResultsThere were 11 POE and 18 unexposed infants included in the analysis. Pairwise connectivity based on fiber count showed alterations in 32 connections. Pairwise connectivity based on FA values showed alterations in 24 connections. Connections between the right superior frontal gyrus and right paracentral lobule and between the right superior occipital gyrus and right fusiform gyrus were significantly different after adjusting for multiple comparisons between POE infants and unexposed controls. Additionally, alterations in graph theoretical network metrics were identified with fiber count and FA value derived tracts.ConclusionComparisons show significant differences in fiber count in two structural connections. The long-term clinical outcomes related to these findings may be assessed in longitudinal follow-up studies.
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Affiliation(s)
- Ramana V. Vishnubhotla
- Department of Radiology and Imaging Sciences, Indiana University School of Medicine, Indianapolis, IN, United States
| | - Yi Zhao
- Department of Biostatistics and Health Data Science, Indiana University School of Medicine, Indianapolis, IN, United States
| | - Qiuting Wen
- Department of Radiology and Imaging Sciences, Indiana University School of Medicine, Indianapolis, IN, United States
| | - Jonathan Dietrich
- Indiana University School of Medicine, Indianapolis, IN, United States
| | - Gregory M. Sokol
- Department of Pediatrics, Indiana University School of Medicine, Indianapolis, IN, United States
| | - Senthilkumar Sadhasivam
- Department of Anesthesiology and Perioperative Medicine, University of Pittsburgh Medical Center, University of Pittsburgh School of Medicine, Pittsburgh, PA, United States
| | - Rupa Radhakrishnan
- Department of Radiology and Imaging Sciences, Indiana University School of Medicine, Indianapolis, IN, United States
- *Correspondence: Rupa Radhakrishnan,
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9
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Wu YW, Comstock BA, Gonzalez FF, Mayock DE, Goodman AM, Maitre NL, Chang T, Van Meurs KP, Lampland AL, Bendel-Stenzel E, Mathur AM, Wu TW, Riley D, Mietzsch U, Chalak L, Flibotte J, Weitkamp JH, Ahmad KA, Yanowitz TD, Baserga M, Poindexter BB, Rogers EE, Lowe JR, Kuban KCK, O'Shea TM, Wisnowski JL, McKinstry RC, Bluml S, Bonifacio S, Benninger KL, Rao R, Smyser CD, Sokol GM, Merhar S, Schreiber MD, Glass HC, Heagerty PJ, Juul SE. Trial of Erythropoietin for Hypoxic-Ischemic Encephalopathy in Newborns. N Engl J Med 2022; 387:148-159. [PMID: 35830641 PMCID: PMC10542745 DOI: 10.1056/nejmoa2119660] [Citation(s) in RCA: 68] [Impact Index Per Article: 34.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
BACKGROUND Neonatal hypoxic-ischemic encephalopathy is an important cause of death as well as long-term disability in survivors. Erythropoietin has been hypothesized to have neuroprotective effects in infants with hypoxic-ischemic encephalopathy, but its effects on neurodevelopmental outcomes when given in conjunction with therapeutic hypothermia are unknown. METHODS In a multicenter, double-blind, randomized, placebo-controlled trial, we assigned 501 infants born at 36 weeks or more of gestation with moderate or severe hypoxic-ischemic encephalopathy to receive erythropoietin or placebo, in conjunction with standard therapeutic hypothermia. Erythropoietin (1000 U per kilogram of body weight) or saline placebo was administered intravenously within 26 hours after birth, as well as at 2, 3, 4, and 7 days of age. The primary outcome was death or neurodevelopmental impairment at 22 to 36 months of age. Neurodevelopmental impairment was defined as cerebral palsy, a Gross Motor Function Classification System level of at least 1 (on a scale of 0 [normal] to 5 [most impaired]), or a cognitive score of less than 90 (which corresponds to 0.67 SD below the mean, with higher scores indicating better performance) on the Bayley Scales of Infant and Toddler Development, third edition. RESULTS Of 500 infants in the modified intention-to-treat analysis, 257 received erythropoietin and 243 received placebo. The incidence of death or neurodevelopmental impairment was 52.5% in the erythropoietin group and 49.5% in the placebo group (relative risk, 1.03; 95% confidence interval [CI], 0.86 to 1.24; P = 0.74). The mean number of serious adverse events per child was higher in the erythropoietin group than in the placebo group (0.86 vs. 0.67; relative risk, 1.26; 95% CI, 1.01 to 1.57). CONCLUSIONS The administration of erythropoietin to newborns undergoing therapeutic hypothermia for hypoxic-ischemic encephalopathy did not result in a lower risk of death or neurodevelopmental impairment than placebo and was associated with a higher rate of serious adverse events. (Funded by the National Institute of Neurological Disorders and Stroke; ClinicalTrials.gov number, NCT02811263.).
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Affiliation(s)
- Yvonne W Wu
- From the Departments of Neurology (Y.W.W., A.M.G., H.C.G.), Pediatrics (Y.W.W., F.F.G., E.E.R., H.C.G.), and Epidemiology (H.C.G.), University of California, San Francisco, San Francisco, the Department of Pediatrics, Stanford University School of Medicine, Stanford (K.P.V.M., S. Bonifacio), and the Departments of Pediatrics (T.-W.W., J.L.W.) and Radiology (J.L.W., S. Bluml), Children's Hospital Los Angeles, and the Departments of Pediatrics (T.-W.W., J.L.W.) and Radiology (J.L.W., S. Bluml), University of Southern California Keck School of Medicine, Los Angeles - all in California; the Department of Biostatistics, University of Washington (B.A.C., P.J.H.), and the Department of Pediatrics, University of Washington School of Medicine (D.E.M., U.M., S.E.J.) - both in Seattle; the Department of Pediatrics, Children's Healthcare of Atlanta (N.L.M.), and the Department of Pediatrics, Emory University (N.L.M., B.B.P.) - both in Atlanta; the Division of Neurology, Children's National Hospital, and the Department of Neurology, George Washington School of Medicine and Health Sciences - both in Washington, D.C. (T.C.); the Department of Neonatology, Children's Minnesota, St. Paul (A.L.L.), and the Department of Pediatric and Adolescent Medicine, Mayo Clinic, Rochester (E.B.-S.) - both in Minnesota; the Department of Pediatrics, Saint Louis University School of Medicine (A.M.M.), and the Departments of Radiology (R.C.M., C.D.S.), Pediatrics (R.R., C.D.S.), and Neurology (C.D.S.), Washington University in St. Louis School of Medicine - both in St. Louis; the Department of Pediatrics, Cook Children's Medical Center, the Department of Pediatrics, Texas Christian University, and the Department of Pediatrics, University of North Texas Health Science Center, Ft. Worth (D.R.), the Department of Pediatrics, University of Texas Southwestern Medical Center, Dallas (L.C.), and Pediatrix Medical Group of San Antonio, Children's Hospital of San Antonio, and Methodist Children's Hospital, San Antonio (K.A.A.) - all in Texas; the Department of Pediatrics, Indiana University School of Medicine, Indianapolis (U.M., G.M.S.); the Department of Pediatrics, Children's Hospital of Philadelphia, and the Department of Pediatrics, University of Pennsylvania Perelman School of Medicine, Philadelphia (J.F.), and the Department of Pediatrics, University of Pittsburgh School of Medicine, the Department of Pediatrics, UPMC Children's Hospital of Pittsburgh, and the Department of Pediatrics, UPMC Magee-Womens Hospital, Pittsburgh (T.D.Y.) - all in Pennsylvania; the Department of Pediatrics, Vanderbilt University Medical Center, Nashville (J.-H.W.); the Department of Pediatrics, University of Utah, Salt Lake City (M.B.); the Department of Pediatrics, University of New Mexico School of Medicine, Albuquerque (J.R.L.); the Department of Pediatrics, Boston University Medical Center, Boston (K.C.K.K.); the Department of Pediatrics, University of North Carolina at Chapel Hill School of Medicine, Chapel Hill (T.M.O.); the Department of Pediatrics, Nationwide Children's Hospital, Columbus (K.L.B.), and the Department of Pediatrics, Cincinnati Children's Hospital Medical Center, and the Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati (S.M.) - all in Ohio; and the Department of Pediatrics, University of Chicago, Chicago (M.D.S.)
| | - Bryan A Comstock
- From the Departments of Neurology (Y.W.W., A.M.G., H.C.G.), Pediatrics (Y.W.W., F.F.G., E.E.R., H.C.G.), and Epidemiology (H.C.G.), University of California, San Francisco, San Francisco, the Department of Pediatrics, Stanford University School of Medicine, Stanford (K.P.V.M., S. Bonifacio), and the Departments of Pediatrics (T.-W.W., J.L.W.) and Radiology (J.L.W., S. Bluml), Children's Hospital Los Angeles, and the Departments of Pediatrics (T.-W.W., J.L.W.) and Radiology (J.L.W., S. Bluml), University of Southern California Keck School of Medicine, Los Angeles - all in California; the Department of Biostatistics, University of Washington (B.A.C., P.J.H.), and the Department of Pediatrics, University of Washington School of Medicine (D.E.M., U.M., S.E.J.) - both in Seattle; the Department of Pediatrics, Children's Healthcare of Atlanta (N.L.M.), and the Department of Pediatrics, Emory University (N.L.M., B.B.P.) - both in Atlanta; the Division of Neurology, Children's National Hospital, and the Department of Neurology, George Washington School of Medicine and Health Sciences - both in Washington, D.C. (T.C.); the Department of Neonatology, Children's Minnesota, St. Paul (A.L.L.), and the Department of Pediatric and Adolescent Medicine, Mayo Clinic, Rochester (E.B.-S.) - both in Minnesota; the Department of Pediatrics, Saint Louis University School of Medicine (A.M.M.), and the Departments of Radiology (R.C.M., C.D.S.), Pediatrics (R.R., C.D.S.), and Neurology (C.D.S.), Washington University in St. Louis School of Medicine - both in St. Louis; the Department of Pediatrics, Cook Children's Medical Center, the Department of Pediatrics, Texas Christian University, and the Department of Pediatrics, University of North Texas Health Science Center, Ft. Worth (D.R.), the Department of Pediatrics, University of Texas Southwestern Medical Center, Dallas (L.C.), and Pediatrix Medical Group of San Antonio, Children's Hospital of San Antonio, and Methodist Children's Hospital, San Antonio (K.A.A.) - all in Texas; the Department of Pediatrics, Indiana University School of Medicine, Indianapolis (U.M., G.M.S.); the Department of Pediatrics, Children's Hospital of Philadelphia, and the Department of Pediatrics, University of Pennsylvania Perelman School of Medicine, Philadelphia (J.F.), and the Department of Pediatrics, University of Pittsburgh School of Medicine, the Department of Pediatrics, UPMC Children's Hospital of Pittsburgh, and the Department of Pediatrics, UPMC Magee-Womens Hospital, Pittsburgh (T.D.Y.) - all in Pennsylvania; the Department of Pediatrics, Vanderbilt University Medical Center, Nashville (J.-H.W.); the Department of Pediatrics, University of Utah, Salt Lake City (M.B.); the Department of Pediatrics, University of New Mexico School of Medicine, Albuquerque (J.R.L.); the Department of Pediatrics, Boston University Medical Center, Boston (K.C.K.K.); the Department of Pediatrics, University of North Carolina at Chapel Hill School of Medicine, Chapel Hill (T.M.O.); the Department of Pediatrics, Nationwide Children's Hospital, Columbus (K.L.B.), and the Department of Pediatrics, Cincinnati Children's Hospital Medical Center, and the Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati (S.M.) - all in Ohio; and the Department of Pediatrics, University of Chicago, Chicago (M.D.S.)
| | - Fernando F Gonzalez
- From the Departments of Neurology (Y.W.W., A.M.G., H.C.G.), Pediatrics (Y.W.W., F.F.G., E.E.R., H.C.G.), and Epidemiology (H.C.G.), University of California, San Francisco, San Francisco, the Department of Pediatrics, Stanford University School of Medicine, Stanford (K.P.V.M., S. Bonifacio), and the Departments of Pediatrics (T.-W.W., J.L.W.) and Radiology (J.L.W., S. Bluml), Children's Hospital Los Angeles, and the Departments of Pediatrics (T.-W.W., J.L.W.) and Radiology (J.L.W., S. Bluml), University of Southern California Keck School of Medicine, Los Angeles - all in California; the Department of Biostatistics, University of Washington (B.A.C., P.J.H.), and the Department of Pediatrics, University of Washington School of Medicine (D.E.M., U.M., S.E.J.) - both in Seattle; the Department of Pediatrics, Children's Healthcare of Atlanta (N.L.M.), and the Department of Pediatrics, Emory University (N.L.M., B.B.P.) - both in Atlanta; the Division of Neurology, Children's National Hospital, and the Department of Neurology, George Washington School of Medicine and Health Sciences - both in Washington, D.C. (T.C.); the Department of Neonatology, Children's Minnesota, St. Paul (A.L.L.), and the Department of Pediatric and Adolescent Medicine, Mayo Clinic, Rochester (E.B.-S.) - both in Minnesota; the Department of Pediatrics, Saint Louis University School of Medicine (A.M.M.), and the Departments of Radiology (R.C.M., C.D.S.), Pediatrics (R.R., C.D.S.), and Neurology (C.D.S.), Washington University in St. Louis School of Medicine - both in St. Louis; the Department of Pediatrics, Cook Children's Medical Center, the Department of Pediatrics, Texas Christian University, and the Department of Pediatrics, University of North Texas Health Science Center, Ft. Worth (D.R.), the Department of Pediatrics, University of Texas Southwestern Medical Center, Dallas (L.C.), and Pediatrix Medical Group of San Antonio, Children's Hospital of San Antonio, and Methodist Children's Hospital, San Antonio (K.A.A.) - all in Texas; the Department of Pediatrics, Indiana University School of Medicine, Indianapolis (U.M., G.M.S.); the Department of Pediatrics, Children's Hospital of Philadelphia, and the Department of Pediatrics, University of Pennsylvania Perelman School of Medicine, Philadelphia (J.F.), and the Department of Pediatrics, University of Pittsburgh School of Medicine, the Department of Pediatrics, UPMC Children's Hospital of Pittsburgh, and the Department of Pediatrics, UPMC Magee-Womens Hospital, Pittsburgh (T.D.Y.) - all in Pennsylvania; the Department of Pediatrics, Vanderbilt University Medical Center, Nashville (J.-H.W.); the Department of Pediatrics, University of Utah, Salt Lake City (M.B.); the Department of Pediatrics, University of New Mexico School of Medicine, Albuquerque (J.R.L.); the Department of Pediatrics, Boston University Medical Center, Boston (K.C.K.K.); the Department of Pediatrics, University of North Carolina at Chapel Hill School of Medicine, Chapel Hill (T.M.O.); the Department of Pediatrics, Nationwide Children's Hospital, Columbus (K.L.B.), and the Department of Pediatrics, Cincinnati Children's Hospital Medical Center, and the Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati (S.M.) - all in Ohio; and the Department of Pediatrics, University of Chicago, Chicago (M.D.S.)
| | - Dennis E Mayock
- From the Departments of Neurology (Y.W.W., A.M.G., H.C.G.), Pediatrics (Y.W.W., F.F.G., E.E.R., H.C.G.), and Epidemiology (H.C.G.), University of California, San Francisco, San Francisco, the Department of Pediatrics, Stanford University School of Medicine, Stanford (K.P.V.M., S. Bonifacio), and the Departments of Pediatrics (T.-W.W., J.L.W.) and Radiology (J.L.W., S. Bluml), Children's Hospital Los Angeles, and the Departments of Pediatrics (T.-W.W., J.L.W.) and Radiology (J.L.W., S. Bluml), University of Southern California Keck School of Medicine, Los Angeles - all in California; the Department of Biostatistics, University of Washington (B.A.C., P.J.H.), and the Department of Pediatrics, University of Washington School of Medicine (D.E.M., U.M., S.E.J.) - both in Seattle; the Department of Pediatrics, Children's Healthcare of Atlanta (N.L.M.), and the Department of Pediatrics, Emory University (N.L.M., B.B.P.) - both in Atlanta; the Division of Neurology, Children's National Hospital, and the Department of Neurology, George Washington School of Medicine and Health Sciences - both in Washington, D.C. (T.C.); the Department of Neonatology, Children's Minnesota, St. Paul (A.L.L.), and the Department of Pediatric and Adolescent Medicine, Mayo Clinic, Rochester (E.B.-S.) - both in Minnesota; the Department of Pediatrics, Saint Louis University School of Medicine (A.M.M.), and the Departments of Radiology (R.C.M., C.D.S.), Pediatrics (R.R., C.D.S.), and Neurology (C.D.S.), Washington University in St. Louis School of Medicine - both in St. Louis; the Department of Pediatrics, Cook Children's Medical Center, the Department of Pediatrics, Texas Christian University, and the Department of Pediatrics, University of North Texas Health Science Center, Ft. Worth (D.R.), the Department of Pediatrics, University of Texas Southwestern Medical Center, Dallas (L.C.), and Pediatrix Medical Group of San Antonio, Children's Hospital of San Antonio, and Methodist Children's Hospital, San Antonio (K.A.A.) - all in Texas; the Department of Pediatrics, Indiana University School of Medicine, Indianapolis (U.M., G.M.S.); the Department of Pediatrics, Children's Hospital of Philadelphia, and the Department of Pediatrics, University of Pennsylvania Perelman School of Medicine, Philadelphia (J.F.), and the Department of Pediatrics, University of Pittsburgh School of Medicine, the Department of Pediatrics, UPMC Children's Hospital of Pittsburgh, and the Department of Pediatrics, UPMC Magee-Womens Hospital, Pittsburgh (T.D.Y.) - all in Pennsylvania; the Department of Pediatrics, Vanderbilt University Medical Center, Nashville (J.-H.W.); the Department of Pediatrics, University of Utah, Salt Lake City (M.B.); the Department of Pediatrics, University of New Mexico School of Medicine, Albuquerque (J.R.L.); the Department of Pediatrics, Boston University Medical Center, Boston (K.C.K.K.); the Department of Pediatrics, University of North Carolina at Chapel Hill School of Medicine, Chapel Hill (T.M.O.); the Department of Pediatrics, Nationwide Children's Hospital, Columbus (K.L.B.), and the Department of Pediatrics, Cincinnati Children's Hospital Medical Center, and the Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati (S.M.) - all in Ohio; and the Department of Pediatrics, University of Chicago, Chicago (M.D.S.)
| | - Amy M Goodman
- From the Departments of Neurology (Y.W.W., A.M.G., H.C.G.), Pediatrics (Y.W.W., F.F.G., E.E.R., H.C.G.), and Epidemiology (H.C.G.), University of California, San Francisco, San Francisco, the Department of Pediatrics, Stanford University School of Medicine, Stanford (K.P.V.M., S. Bonifacio), and the Departments of Pediatrics (T.-W.W., J.L.W.) and Radiology (J.L.W., S. Bluml), Children's Hospital Los Angeles, and the Departments of Pediatrics (T.-W.W., J.L.W.) and Radiology (J.L.W., S. Bluml), University of Southern California Keck School of Medicine, Los Angeles - all in California; the Department of Biostatistics, University of Washington (B.A.C., P.J.H.), and the Department of Pediatrics, University of Washington School of Medicine (D.E.M., U.M., S.E.J.) - both in Seattle; the Department of Pediatrics, Children's Healthcare of Atlanta (N.L.M.), and the Department of Pediatrics, Emory University (N.L.M., B.B.P.) - both in Atlanta; the Division of Neurology, Children's National Hospital, and the Department of Neurology, George Washington School of Medicine and Health Sciences - both in Washington, D.C. (T.C.); the Department of Neonatology, Children's Minnesota, St. Paul (A.L.L.), and the Department of Pediatric and Adolescent Medicine, Mayo Clinic, Rochester (E.B.-S.) - both in Minnesota; the Department of Pediatrics, Saint Louis University School of Medicine (A.M.M.), and the Departments of Radiology (R.C.M., C.D.S.), Pediatrics (R.R., C.D.S.), and Neurology (C.D.S.), Washington University in St. Louis School of Medicine - both in St. Louis; the Department of Pediatrics, Cook Children's Medical Center, the Department of Pediatrics, Texas Christian University, and the Department of Pediatrics, University of North Texas Health Science Center, Ft. Worth (D.R.), the Department of Pediatrics, University of Texas Southwestern Medical Center, Dallas (L.C.), and Pediatrix Medical Group of San Antonio, Children's Hospital of San Antonio, and Methodist Children's Hospital, San Antonio (K.A.A.) - all in Texas; the Department of Pediatrics, Indiana University School of Medicine, Indianapolis (U.M., G.M.S.); the Department of Pediatrics, Children's Hospital of Philadelphia, and the Department of Pediatrics, University of Pennsylvania Perelman School of Medicine, Philadelphia (J.F.), and the Department of Pediatrics, University of Pittsburgh School of Medicine, the Department of Pediatrics, UPMC Children's Hospital of Pittsburgh, and the Department of Pediatrics, UPMC Magee-Womens Hospital, Pittsburgh (T.D.Y.) - all in Pennsylvania; the Department of Pediatrics, Vanderbilt University Medical Center, Nashville (J.-H.W.); the Department of Pediatrics, University of Utah, Salt Lake City (M.B.); the Department of Pediatrics, University of New Mexico School of Medicine, Albuquerque (J.R.L.); the Department of Pediatrics, Boston University Medical Center, Boston (K.C.K.K.); the Department of Pediatrics, University of North Carolina at Chapel Hill School of Medicine, Chapel Hill (T.M.O.); the Department of Pediatrics, Nationwide Children's Hospital, Columbus (K.L.B.), and the Department of Pediatrics, Cincinnati Children's Hospital Medical Center, and the Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati (S.M.) - all in Ohio; and the Department of Pediatrics, University of Chicago, Chicago (M.D.S.)
| | - Nathalie L Maitre
- From the Departments of Neurology (Y.W.W., A.M.G., H.C.G.), Pediatrics (Y.W.W., F.F.G., E.E.R., H.C.G.), and Epidemiology (H.C.G.), University of California, San Francisco, San Francisco, the Department of Pediatrics, Stanford University School of Medicine, Stanford (K.P.V.M., S. Bonifacio), and the Departments of Pediatrics (T.-W.W., J.L.W.) and Radiology (J.L.W., S. Bluml), Children's Hospital Los Angeles, and the Departments of Pediatrics (T.-W.W., J.L.W.) and Radiology (J.L.W., S. Bluml), University of Southern California Keck School of Medicine, Los Angeles - all in California; the Department of Biostatistics, University of Washington (B.A.C., P.J.H.), and the Department of Pediatrics, University of Washington School of Medicine (D.E.M., U.M., S.E.J.) - both in Seattle; the Department of Pediatrics, Children's Healthcare of Atlanta (N.L.M.), and the Department of Pediatrics, Emory University (N.L.M., B.B.P.) - both in Atlanta; the Division of Neurology, Children's National Hospital, and the Department of Neurology, George Washington School of Medicine and Health Sciences - both in Washington, D.C. (T.C.); the Department of Neonatology, Children's Minnesota, St. Paul (A.L.L.), and the Department of Pediatric and Adolescent Medicine, Mayo Clinic, Rochester (E.B.-S.) - both in Minnesota; the Department of Pediatrics, Saint Louis University School of Medicine (A.M.M.), and the Departments of Radiology (R.C.M., C.D.S.), Pediatrics (R.R., C.D.S.), and Neurology (C.D.S.), Washington University in St. Louis School of Medicine - both in St. Louis; the Department of Pediatrics, Cook Children's Medical Center, the Department of Pediatrics, Texas Christian University, and the Department of Pediatrics, University of North Texas Health Science Center, Ft. Worth (D.R.), the Department of Pediatrics, University of Texas Southwestern Medical Center, Dallas (L.C.), and Pediatrix Medical Group of San Antonio, Children's Hospital of San Antonio, and Methodist Children's Hospital, San Antonio (K.A.A.) - all in Texas; the Department of Pediatrics, Indiana University School of Medicine, Indianapolis (U.M., G.M.S.); the Department of Pediatrics, Children's Hospital of Philadelphia, and the Department of Pediatrics, University of Pennsylvania Perelman School of Medicine, Philadelphia (J.F.), and the Department of Pediatrics, University of Pittsburgh School of Medicine, the Department of Pediatrics, UPMC Children's Hospital of Pittsburgh, and the Department of Pediatrics, UPMC Magee-Womens Hospital, Pittsburgh (T.D.Y.) - all in Pennsylvania; the Department of Pediatrics, Vanderbilt University Medical Center, Nashville (J.-H.W.); the Department of Pediatrics, University of Utah, Salt Lake City (M.B.); the Department of Pediatrics, University of New Mexico School of Medicine, Albuquerque (J.R.L.); the Department of Pediatrics, Boston University Medical Center, Boston (K.C.K.K.); the Department of Pediatrics, University of North Carolina at Chapel Hill School of Medicine, Chapel Hill (T.M.O.); the Department of Pediatrics, Nationwide Children's Hospital, Columbus (K.L.B.), and the Department of Pediatrics, Cincinnati Children's Hospital Medical Center, and the Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati (S.M.) - all in Ohio; and the Department of Pediatrics, University of Chicago, Chicago (M.D.S.)
| | - Taeun Chang
- From the Departments of Neurology (Y.W.W., A.M.G., H.C.G.), Pediatrics (Y.W.W., F.F.G., E.E.R., H.C.G.), and Epidemiology (H.C.G.), University of California, San Francisco, San Francisco, the Department of Pediatrics, Stanford University School of Medicine, Stanford (K.P.V.M., S. Bonifacio), and the Departments of Pediatrics (T.-W.W., J.L.W.) and Radiology (J.L.W., S. Bluml), Children's Hospital Los Angeles, and the Departments of Pediatrics (T.-W.W., J.L.W.) and Radiology (J.L.W., S. Bluml), University of Southern California Keck School of Medicine, Los Angeles - all in California; the Department of Biostatistics, University of Washington (B.A.C., P.J.H.), and the Department of Pediatrics, University of Washington School of Medicine (D.E.M., U.M., S.E.J.) - both in Seattle; the Department of Pediatrics, Children's Healthcare of Atlanta (N.L.M.), and the Department of Pediatrics, Emory University (N.L.M., B.B.P.) - both in Atlanta; the Division of Neurology, Children's National Hospital, and the Department of Neurology, George Washington School of Medicine and Health Sciences - both in Washington, D.C. (T.C.); the Department of Neonatology, Children's Minnesota, St. Paul (A.L.L.), and the Department of Pediatric and Adolescent Medicine, Mayo Clinic, Rochester (E.B.-S.) - both in Minnesota; the Department of Pediatrics, Saint Louis University School of Medicine (A.M.M.), and the Departments of Radiology (R.C.M., C.D.S.), Pediatrics (R.R., C.D.S.), and Neurology (C.D.S.), Washington University in St. Louis School of Medicine - both in St. Louis; the Department of Pediatrics, Cook Children's Medical Center, the Department of Pediatrics, Texas Christian University, and the Department of Pediatrics, University of North Texas Health Science Center, Ft. Worth (D.R.), the Department of Pediatrics, University of Texas Southwestern Medical Center, Dallas (L.C.), and Pediatrix Medical Group of San Antonio, Children's Hospital of San Antonio, and Methodist Children's Hospital, San Antonio (K.A.A.) - all in Texas; the Department of Pediatrics, Indiana University School of Medicine, Indianapolis (U.M., G.M.S.); the Department of Pediatrics, Children's Hospital of Philadelphia, and the Department of Pediatrics, University of Pennsylvania Perelman School of Medicine, Philadelphia (J.F.), and the Department of Pediatrics, University of Pittsburgh School of Medicine, the Department of Pediatrics, UPMC Children's Hospital of Pittsburgh, and the Department of Pediatrics, UPMC Magee-Womens Hospital, Pittsburgh (T.D.Y.) - all in Pennsylvania; the Department of Pediatrics, Vanderbilt University Medical Center, Nashville (J.-H.W.); the Department of Pediatrics, University of Utah, Salt Lake City (M.B.); the Department of Pediatrics, University of New Mexico School of Medicine, Albuquerque (J.R.L.); the Department of Pediatrics, Boston University Medical Center, Boston (K.C.K.K.); the Department of Pediatrics, University of North Carolina at Chapel Hill School of Medicine, Chapel Hill (T.M.O.); the Department of Pediatrics, Nationwide Children's Hospital, Columbus (K.L.B.), and the Department of Pediatrics, Cincinnati Children's Hospital Medical Center, and the Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati (S.M.) - all in Ohio; and the Department of Pediatrics, University of Chicago, Chicago (M.D.S.)
| | - Krisa P Van Meurs
- From the Departments of Neurology (Y.W.W., A.M.G., H.C.G.), Pediatrics (Y.W.W., F.F.G., E.E.R., H.C.G.), and Epidemiology (H.C.G.), University of California, San Francisco, San Francisco, the Department of Pediatrics, Stanford University School of Medicine, Stanford (K.P.V.M., S. Bonifacio), and the Departments of Pediatrics (T.-W.W., J.L.W.) and Radiology (J.L.W., S. Bluml), Children's Hospital Los Angeles, and the Departments of Pediatrics (T.-W.W., J.L.W.) and Radiology (J.L.W., S. Bluml), University of Southern California Keck School of Medicine, Los Angeles - all in California; the Department of Biostatistics, University of Washington (B.A.C., P.J.H.), and the Department of Pediatrics, University of Washington School of Medicine (D.E.M., U.M., S.E.J.) - both in Seattle; the Department of Pediatrics, Children's Healthcare of Atlanta (N.L.M.), and the Department of Pediatrics, Emory University (N.L.M., B.B.P.) - both in Atlanta; the Division of Neurology, Children's National Hospital, and the Department of Neurology, George Washington School of Medicine and Health Sciences - both in Washington, D.C. (T.C.); the Department of Neonatology, Children's Minnesota, St. Paul (A.L.L.), and the Department of Pediatric and Adolescent Medicine, Mayo Clinic, Rochester (E.B.-S.) - both in Minnesota; the Department of Pediatrics, Saint Louis University School of Medicine (A.M.M.), and the Departments of Radiology (R.C.M., C.D.S.), Pediatrics (R.R., C.D.S.), and Neurology (C.D.S.), Washington University in St. Louis School of Medicine - both in St. Louis; the Department of Pediatrics, Cook Children's Medical Center, the Department of Pediatrics, Texas Christian University, and the Department of Pediatrics, University of North Texas Health Science Center, Ft. Worth (D.R.), the Department of Pediatrics, University of Texas Southwestern Medical Center, Dallas (L.C.), and Pediatrix Medical Group of San Antonio, Children's Hospital of San Antonio, and Methodist Children's Hospital, San Antonio (K.A.A.) - all in Texas; the Department of Pediatrics, Indiana University School of Medicine, Indianapolis (U.M., G.M.S.); the Department of Pediatrics, Children's Hospital of Philadelphia, and the Department of Pediatrics, University of Pennsylvania Perelman School of Medicine, Philadelphia (J.F.), and the Department of Pediatrics, University of Pittsburgh School of Medicine, the Department of Pediatrics, UPMC Children's Hospital of Pittsburgh, and the Department of Pediatrics, UPMC Magee-Womens Hospital, Pittsburgh (T.D.Y.) - all in Pennsylvania; the Department of Pediatrics, Vanderbilt University Medical Center, Nashville (J.-H.W.); the Department of Pediatrics, University of Utah, Salt Lake City (M.B.); the Department of Pediatrics, University of New Mexico School of Medicine, Albuquerque (J.R.L.); the Department of Pediatrics, Boston University Medical Center, Boston (K.C.K.K.); the Department of Pediatrics, University of North Carolina at Chapel Hill School of Medicine, Chapel Hill (T.M.O.); the Department of Pediatrics, Nationwide Children's Hospital, Columbus (K.L.B.), and the Department of Pediatrics, Cincinnati Children's Hospital Medical Center, and the Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati (S.M.) - all in Ohio; and the Department of Pediatrics, University of Chicago, Chicago (M.D.S.)
| | - Andrea L Lampland
- From the Departments of Neurology (Y.W.W., A.M.G., H.C.G.), Pediatrics (Y.W.W., F.F.G., E.E.R., H.C.G.), and Epidemiology (H.C.G.), University of California, San Francisco, San Francisco, the Department of Pediatrics, Stanford University School of Medicine, Stanford (K.P.V.M., S. Bonifacio), and the Departments of Pediatrics (T.-W.W., J.L.W.) and Radiology (J.L.W., S. Bluml), Children's Hospital Los Angeles, and the Departments of Pediatrics (T.-W.W., J.L.W.) and Radiology (J.L.W., S. Bluml), University of Southern California Keck School of Medicine, Los Angeles - all in California; the Department of Biostatistics, University of Washington (B.A.C., P.J.H.), and the Department of Pediatrics, University of Washington School of Medicine (D.E.M., U.M., S.E.J.) - both in Seattle; the Department of Pediatrics, Children's Healthcare of Atlanta (N.L.M.), and the Department of Pediatrics, Emory University (N.L.M., B.B.P.) - both in Atlanta; the Division of Neurology, Children's National Hospital, and the Department of Neurology, George Washington School of Medicine and Health Sciences - both in Washington, D.C. (T.C.); the Department of Neonatology, Children's Minnesota, St. Paul (A.L.L.), and the Department of Pediatric and Adolescent Medicine, Mayo Clinic, Rochester (E.B.-S.) - both in Minnesota; the Department of Pediatrics, Saint Louis University School of Medicine (A.M.M.), and the Departments of Radiology (R.C.M., C.D.S.), Pediatrics (R.R., C.D.S.), and Neurology (C.D.S.), Washington University in St. Louis School of Medicine - both in St. Louis; the Department of Pediatrics, Cook Children's Medical Center, the Department of Pediatrics, Texas Christian University, and the Department of Pediatrics, University of North Texas Health Science Center, Ft. Worth (D.R.), the Department of Pediatrics, University of Texas Southwestern Medical Center, Dallas (L.C.), and Pediatrix Medical Group of San Antonio, Children's Hospital of San Antonio, and Methodist Children's Hospital, San Antonio (K.A.A.) - all in Texas; the Department of Pediatrics, Indiana University School of Medicine, Indianapolis (U.M., G.M.S.); the Department of Pediatrics, Children's Hospital of Philadelphia, and the Department of Pediatrics, University of Pennsylvania Perelman School of Medicine, Philadelphia (J.F.), and the Department of Pediatrics, University of Pittsburgh School of Medicine, the Department of Pediatrics, UPMC Children's Hospital of Pittsburgh, and the Department of Pediatrics, UPMC Magee-Womens Hospital, Pittsburgh (T.D.Y.) - all in Pennsylvania; the Department of Pediatrics, Vanderbilt University Medical Center, Nashville (J.-H.W.); the Department of Pediatrics, University of Utah, Salt Lake City (M.B.); the Department of Pediatrics, University of New Mexico School of Medicine, Albuquerque (J.R.L.); the Department of Pediatrics, Boston University Medical Center, Boston (K.C.K.K.); the Department of Pediatrics, University of North Carolina at Chapel Hill School of Medicine, Chapel Hill (T.M.O.); the Department of Pediatrics, Nationwide Children's Hospital, Columbus (K.L.B.), and the Department of Pediatrics, Cincinnati Children's Hospital Medical Center, and the Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati (S.M.) - all in Ohio; and the Department of Pediatrics, University of Chicago, Chicago (M.D.S.)
| | - Ellen Bendel-Stenzel
- From the Departments of Neurology (Y.W.W., A.M.G., H.C.G.), Pediatrics (Y.W.W., F.F.G., E.E.R., H.C.G.), and Epidemiology (H.C.G.), University of California, San Francisco, San Francisco, the Department of Pediatrics, Stanford University School of Medicine, Stanford (K.P.V.M., S. Bonifacio), and the Departments of Pediatrics (T.-W.W., J.L.W.) and Radiology (J.L.W., S. Bluml), Children's Hospital Los Angeles, and the Departments of Pediatrics (T.-W.W., J.L.W.) and Radiology (J.L.W., S. Bluml), University of Southern California Keck School of Medicine, Los Angeles - all in California; the Department of Biostatistics, University of Washington (B.A.C., P.J.H.), and the Department of Pediatrics, University of Washington School of Medicine (D.E.M., U.M., S.E.J.) - both in Seattle; the Department of Pediatrics, Children's Healthcare of Atlanta (N.L.M.), and the Department of Pediatrics, Emory University (N.L.M., B.B.P.) - both in Atlanta; the Division of Neurology, Children's National Hospital, and the Department of Neurology, George Washington School of Medicine and Health Sciences - both in Washington, D.C. (T.C.); the Department of Neonatology, Children's Minnesota, St. Paul (A.L.L.), and the Department of Pediatric and Adolescent Medicine, Mayo Clinic, Rochester (E.B.-S.) - both in Minnesota; the Department of Pediatrics, Saint Louis University School of Medicine (A.M.M.), and the Departments of Radiology (R.C.M., C.D.S.), Pediatrics (R.R., C.D.S.), and Neurology (C.D.S.), Washington University in St. Louis School of Medicine - both in St. Louis; the Department of Pediatrics, Cook Children's Medical Center, the Department of Pediatrics, Texas Christian University, and the Department of Pediatrics, University of North Texas Health Science Center, Ft. Worth (D.R.), the Department of Pediatrics, University of Texas Southwestern Medical Center, Dallas (L.C.), and Pediatrix Medical Group of San Antonio, Children's Hospital of San Antonio, and Methodist Children's Hospital, San Antonio (K.A.A.) - all in Texas; the Department of Pediatrics, Indiana University School of Medicine, Indianapolis (U.M., G.M.S.); the Department of Pediatrics, Children's Hospital of Philadelphia, and the Department of Pediatrics, University of Pennsylvania Perelman School of Medicine, Philadelphia (J.F.), and the Department of Pediatrics, University of Pittsburgh School of Medicine, the Department of Pediatrics, UPMC Children's Hospital of Pittsburgh, and the Department of Pediatrics, UPMC Magee-Womens Hospital, Pittsburgh (T.D.Y.) - all in Pennsylvania; the Department of Pediatrics, Vanderbilt University Medical Center, Nashville (J.-H.W.); the Department of Pediatrics, University of Utah, Salt Lake City (M.B.); the Department of Pediatrics, University of New Mexico School of Medicine, Albuquerque (J.R.L.); the Department of Pediatrics, Boston University Medical Center, Boston (K.C.K.K.); the Department of Pediatrics, University of North Carolina at Chapel Hill School of Medicine, Chapel Hill (T.M.O.); the Department of Pediatrics, Nationwide Children's Hospital, Columbus (K.L.B.), and the Department of Pediatrics, Cincinnati Children's Hospital Medical Center, and the Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati (S.M.) - all in Ohio; and the Department of Pediatrics, University of Chicago, Chicago (M.D.S.)
| | - Amit M Mathur
- From the Departments of Neurology (Y.W.W., A.M.G., H.C.G.), Pediatrics (Y.W.W., F.F.G., E.E.R., H.C.G.), and Epidemiology (H.C.G.), University of California, San Francisco, San Francisco, the Department of Pediatrics, Stanford University School of Medicine, Stanford (K.P.V.M., S. Bonifacio), and the Departments of Pediatrics (T.-W.W., J.L.W.) and Radiology (J.L.W., S. Bluml), Children's Hospital Los Angeles, and the Departments of Pediatrics (T.-W.W., J.L.W.) and Radiology (J.L.W., S. Bluml), University of Southern California Keck School of Medicine, Los Angeles - all in California; the Department of Biostatistics, University of Washington (B.A.C., P.J.H.), and the Department of Pediatrics, University of Washington School of Medicine (D.E.M., U.M., S.E.J.) - both in Seattle; the Department of Pediatrics, Children's Healthcare of Atlanta (N.L.M.), and the Department of Pediatrics, Emory University (N.L.M., B.B.P.) - both in Atlanta; the Division of Neurology, Children's National Hospital, and the Department of Neurology, George Washington School of Medicine and Health Sciences - both in Washington, D.C. (T.C.); the Department of Neonatology, Children's Minnesota, St. Paul (A.L.L.), and the Department of Pediatric and Adolescent Medicine, Mayo Clinic, Rochester (E.B.-S.) - both in Minnesota; the Department of Pediatrics, Saint Louis University School of Medicine (A.M.M.), and the Departments of Radiology (R.C.M., C.D.S.), Pediatrics (R.R., C.D.S.), and Neurology (C.D.S.), Washington University in St. Louis School of Medicine - both in St. Louis; the Department of Pediatrics, Cook Children's Medical Center, the Department of Pediatrics, Texas Christian University, and the Department of Pediatrics, University of North Texas Health Science Center, Ft. Worth (D.R.), the Department of Pediatrics, University of Texas Southwestern Medical Center, Dallas (L.C.), and Pediatrix Medical Group of San Antonio, Children's Hospital of San Antonio, and Methodist Children's Hospital, San Antonio (K.A.A.) - all in Texas; the Department of Pediatrics, Indiana University School of Medicine, Indianapolis (U.M., G.M.S.); the Department of Pediatrics, Children's Hospital of Philadelphia, and the Department of Pediatrics, University of Pennsylvania Perelman School of Medicine, Philadelphia (J.F.), and the Department of Pediatrics, University of Pittsburgh School of Medicine, the Department of Pediatrics, UPMC Children's Hospital of Pittsburgh, and the Department of Pediatrics, UPMC Magee-Womens Hospital, Pittsburgh (T.D.Y.) - all in Pennsylvania; the Department of Pediatrics, Vanderbilt University Medical Center, Nashville (J.-H.W.); the Department of Pediatrics, University of Utah, Salt Lake City (M.B.); the Department of Pediatrics, University of New Mexico School of Medicine, Albuquerque (J.R.L.); the Department of Pediatrics, Boston University Medical Center, Boston (K.C.K.K.); the Department of Pediatrics, University of North Carolina at Chapel Hill School of Medicine, Chapel Hill (T.M.O.); the Department of Pediatrics, Nationwide Children's Hospital, Columbus (K.L.B.), and the Department of Pediatrics, Cincinnati Children's Hospital Medical Center, and the Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati (S.M.) - all in Ohio; and the Department of Pediatrics, University of Chicago, Chicago (M.D.S.)
| | - Tai-Wei Wu
- From the Departments of Neurology (Y.W.W., A.M.G., H.C.G.), Pediatrics (Y.W.W., F.F.G., E.E.R., H.C.G.), and Epidemiology (H.C.G.), University of California, San Francisco, San Francisco, the Department of Pediatrics, Stanford University School of Medicine, Stanford (K.P.V.M., S. Bonifacio), and the Departments of Pediatrics (T.-W.W., J.L.W.) and Radiology (J.L.W., S. Bluml), Children's Hospital Los Angeles, and the Departments of Pediatrics (T.-W.W., J.L.W.) and Radiology (J.L.W., S. Bluml), University of Southern California Keck School of Medicine, Los Angeles - all in California; the Department of Biostatistics, University of Washington (B.A.C., P.J.H.), and the Department of Pediatrics, University of Washington School of Medicine (D.E.M., U.M., S.E.J.) - both in Seattle; the Department of Pediatrics, Children's Healthcare of Atlanta (N.L.M.), and the Department of Pediatrics, Emory University (N.L.M., B.B.P.) - both in Atlanta; the Division of Neurology, Children's National Hospital, and the Department of Neurology, George Washington School of Medicine and Health Sciences - both in Washington, D.C. (T.C.); the Department of Neonatology, Children's Minnesota, St. Paul (A.L.L.), and the Department of Pediatric and Adolescent Medicine, Mayo Clinic, Rochester (E.B.-S.) - both in Minnesota; the Department of Pediatrics, Saint Louis University School of Medicine (A.M.M.), and the Departments of Radiology (R.C.M., C.D.S.), Pediatrics (R.R., C.D.S.), and Neurology (C.D.S.), Washington University in St. Louis School of Medicine - both in St. Louis; the Department of Pediatrics, Cook Children's Medical Center, the Department of Pediatrics, Texas Christian University, and the Department of Pediatrics, University of North Texas Health Science Center, Ft. Worth (D.R.), the Department of Pediatrics, University of Texas Southwestern Medical Center, Dallas (L.C.), and Pediatrix Medical Group of San Antonio, Children's Hospital of San Antonio, and Methodist Children's Hospital, San Antonio (K.A.A.) - all in Texas; the Department of Pediatrics, Indiana University School of Medicine, Indianapolis (U.M., G.M.S.); the Department of Pediatrics, Children's Hospital of Philadelphia, and the Department of Pediatrics, University of Pennsylvania Perelman School of Medicine, Philadelphia (J.F.), and the Department of Pediatrics, University of Pittsburgh School of Medicine, the Department of Pediatrics, UPMC Children's Hospital of Pittsburgh, and the Department of Pediatrics, UPMC Magee-Womens Hospital, Pittsburgh (T.D.Y.) - all in Pennsylvania; the Department of Pediatrics, Vanderbilt University Medical Center, Nashville (J.-H.W.); the Department of Pediatrics, University of Utah, Salt Lake City (M.B.); the Department of Pediatrics, University of New Mexico School of Medicine, Albuquerque (J.R.L.); the Department of Pediatrics, Boston University Medical Center, Boston (K.C.K.K.); the Department of Pediatrics, University of North Carolina at Chapel Hill School of Medicine, Chapel Hill (T.M.O.); the Department of Pediatrics, Nationwide Children's Hospital, Columbus (K.L.B.), and the Department of Pediatrics, Cincinnati Children's Hospital Medical Center, and the Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati (S.M.) - all in Ohio; and the Department of Pediatrics, University of Chicago, Chicago (M.D.S.)
| | - David Riley
- From the Departments of Neurology (Y.W.W., A.M.G., H.C.G.), Pediatrics (Y.W.W., F.F.G., E.E.R., H.C.G.), and Epidemiology (H.C.G.), University of California, San Francisco, San Francisco, the Department of Pediatrics, Stanford University School of Medicine, Stanford (K.P.V.M., S. Bonifacio), and the Departments of Pediatrics (T.-W.W., J.L.W.) and Radiology (J.L.W., S. Bluml), Children's Hospital Los Angeles, and the Departments of Pediatrics (T.-W.W., J.L.W.) and Radiology (J.L.W., S. Bluml), University of Southern California Keck School of Medicine, Los Angeles - all in California; the Department of Biostatistics, University of Washington (B.A.C., P.J.H.), and the Department of Pediatrics, University of Washington School of Medicine (D.E.M., U.M., S.E.J.) - both in Seattle; the Department of Pediatrics, Children's Healthcare of Atlanta (N.L.M.), and the Department of Pediatrics, Emory University (N.L.M., B.B.P.) - both in Atlanta; the Division of Neurology, Children's National Hospital, and the Department of Neurology, George Washington School of Medicine and Health Sciences - both in Washington, D.C. (T.C.); the Department of Neonatology, Children's Minnesota, St. Paul (A.L.L.), and the Department of Pediatric and Adolescent Medicine, Mayo Clinic, Rochester (E.B.-S.) - both in Minnesota; the Department of Pediatrics, Saint Louis University School of Medicine (A.M.M.), and the Departments of Radiology (R.C.M., C.D.S.), Pediatrics (R.R., C.D.S.), and Neurology (C.D.S.), Washington University in St. Louis School of Medicine - both in St. Louis; the Department of Pediatrics, Cook Children's Medical Center, the Department of Pediatrics, Texas Christian University, and the Department of Pediatrics, University of North Texas Health Science Center, Ft. Worth (D.R.), the Department of Pediatrics, University of Texas Southwestern Medical Center, Dallas (L.C.), and Pediatrix Medical Group of San Antonio, Children's Hospital of San Antonio, and Methodist Children's Hospital, San Antonio (K.A.A.) - all in Texas; the Department of Pediatrics, Indiana University School of Medicine, Indianapolis (U.M., G.M.S.); the Department of Pediatrics, Children's Hospital of Philadelphia, and the Department of Pediatrics, University of Pennsylvania Perelman School of Medicine, Philadelphia (J.F.), and the Department of Pediatrics, University of Pittsburgh School of Medicine, the Department of Pediatrics, UPMC Children's Hospital of Pittsburgh, and the Department of Pediatrics, UPMC Magee-Womens Hospital, Pittsburgh (T.D.Y.) - all in Pennsylvania; the Department of Pediatrics, Vanderbilt University Medical Center, Nashville (J.-H.W.); the Department of Pediatrics, University of Utah, Salt Lake City (M.B.); the Department of Pediatrics, University of New Mexico School of Medicine, Albuquerque (J.R.L.); the Department of Pediatrics, Boston University Medical Center, Boston (K.C.K.K.); the Department of Pediatrics, University of North Carolina at Chapel Hill School of Medicine, Chapel Hill (T.M.O.); the Department of Pediatrics, Nationwide Children's Hospital, Columbus (K.L.B.), and the Department of Pediatrics, Cincinnati Children's Hospital Medical Center, and the Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati (S.M.) - all in Ohio; and the Department of Pediatrics, University of Chicago, Chicago (M.D.S.)
| | - Ulrike Mietzsch
- From the Departments of Neurology (Y.W.W., A.M.G., H.C.G.), Pediatrics (Y.W.W., F.F.G., E.E.R., H.C.G.), and Epidemiology (H.C.G.), University of California, San Francisco, San Francisco, the Department of Pediatrics, Stanford University School of Medicine, Stanford (K.P.V.M., S. Bonifacio), and the Departments of Pediatrics (T.-W.W., J.L.W.) and Radiology (J.L.W., S. Bluml), Children's Hospital Los Angeles, and the Departments of Pediatrics (T.-W.W., J.L.W.) and Radiology (J.L.W., S. Bluml), University of Southern California Keck School of Medicine, Los Angeles - all in California; the Department of Biostatistics, University of Washington (B.A.C., P.J.H.), and the Department of Pediatrics, University of Washington School of Medicine (D.E.M., U.M., S.E.J.) - both in Seattle; the Department of Pediatrics, Children's Healthcare of Atlanta (N.L.M.), and the Department of Pediatrics, Emory University (N.L.M., B.B.P.) - both in Atlanta; the Division of Neurology, Children's National Hospital, and the Department of Neurology, George Washington School of Medicine and Health Sciences - both in Washington, D.C. (T.C.); the Department of Neonatology, Children's Minnesota, St. Paul (A.L.L.), and the Department of Pediatric and Adolescent Medicine, Mayo Clinic, Rochester (E.B.-S.) - both in Minnesota; the Department of Pediatrics, Saint Louis University School of Medicine (A.M.M.), and the Departments of Radiology (R.C.M., C.D.S.), Pediatrics (R.R., C.D.S.), and Neurology (C.D.S.), Washington University in St. Louis School of Medicine - both in St. Louis; the Department of Pediatrics, Cook Children's Medical Center, the Department of Pediatrics, Texas Christian University, and the Department of Pediatrics, University of North Texas Health Science Center, Ft. Worth (D.R.), the Department of Pediatrics, University of Texas Southwestern Medical Center, Dallas (L.C.), and Pediatrix Medical Group of San Antonio, Children's Hospital of San Antonio, and Methodist Children's Hospital, San Antonio (K.A.A.) - all in Texas; the Department of Pediatrics, Indiana University School of Medicine, Indianapolis (U.M., G.M.S.); the Department of Pediatrics, Children's Hospital of Philadelphia, and the Department of Pediatrics, University of Pennsylvania Perelman School of Medicine, Philadelphia (J.F.), and the Department of Pediatrics, University of Pittsburgh School of Medicine, the Department of Pediatrics, UPMC Children's Hospital of Pittsburgh, and the Department of Pediatrics, UPMC Magee-Womens Hospital, Pittsburgh (T.D.Y.) - all in Pennsylvania; the Department of Pediatrics, Vanderbilt University Medical Center, Nashville (J.-H.W.); the Department of Pediatrics, University of Utah, Salt Lake City (M.B.); the Department of Pediatrics, University of New Mexico School of Medicine, Albuquerque (J.R.L.); the Department of Pediatrics, Boston University Medical Center, Boston (K.C.K.K.); the Department of Pediatrics, University of North Carolina at Chapel Hill School of Medicine, Chapel Hill (T.M.O.); the Department of Pediatrics, Nationwide Children's Hospital, Columbus (K.L.B.), and the Department of Pediatrics, Cincinnati Children's Hospital Medical Center, and the Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati (S.M.) - all in Ohio; and the Department of Pediatrics, University of Chicago, Chicago (M.D.S.)
| | - Lina Chalak
- From the Departments of Neurology (Y.W.W., A.M.G., H.C.G.), Pediatrics (Y.W.W., F.F.G., E.E.R., H.C.G.), and Epidemiology (H.C.G.), University of California, San Francisco, San Francisco, the Department of Pediatrics, Stanford University School of Medicine, Stanford (K.P.V.M., S. Bonifacio), and the Departments of Pediatrics (T.-W.W., J.L.W.) and Radiology (J.L.W., S. Bluml), Children's Hospital Los Angeles, and the Departments of Pediatrics (T.-W.W., J.L.W.) and Radiology (J.L.W., S. Bluml), University of Southern California Keck School of Medicine, Los Angeles - all in California; the Department of Biostatistics, University of Washington (B.A.C., P.J.H.), and the Department of Pediatrics, University of Washington School of Medicine (D.E.M., U.M., S.E.J.) - both in Seattle; the Department of Pediatrics, Children's Healthcare of Atlanta (N.L.M.), and the Department of Pediatrics, Emory University (N.L.M., B.B.P.) - both in Atlanta; the Division of Neurology, Children's National Hospital, and the Department of Neurology, George Washington School of Medicine and Health Sciences - both in Washington, D.C. (T.C.); the Department of Neonatology, Children's Minnesota, St. Paul (A.L.L.), and the Department of Pediatric and Adolescent Medicine, Mayo Clinic, Rochester (E.B.-S.) - both in Minnesota; the Department of Pediatrics, Saint Louis University School of Medicine (A.M.M.), and the Departments of Radiology (R.C.M., C.D.S.), Pediatrics (R.R., C.D.S.), and Neurology (C.D.S.), Washington University in St. Louis School of Medicine - both in St. Louis; the Department of Pediatrics, Cook Children's Medical Center, the Department of Pediatrics, Texas Christian University, and the Department of Pediatrics, University of North Texas Health Science Center, Ft. Worth (D.R.), the Department of Pediatrics, University of Texas Southwestern Medical Center, Dallas (L.C.), and Pediatrix Medical Group of San Antonio, Children's Hospital of San Antonio, and Methodist Children's Hospital, San Antonio (K.A.A.) - all in Texas; the Department of Pediatrics, Indiana University School of Medicine, Indianapolis (U.M., G.M.S.); the Department of Pediatrics, Children's Hospital of Philadelphia, and the Department of Pediatrics, University of Pennsylvania Perelman School of Medicine, Philadelphia (J.F.), and the Department of Pediatrics, University of Pittsburgh School of Medicine, the Department of Pediatrics, UPMC Children's Hospital of Pittsburgh, and the Department of Pediatrics, UPMC Magee-Womens Hospital, Pittsburgh (T.D.Y.) - all in Pennsylvania; the Department of Pediatrics, Vanderbilt University Medical Center, Nashville (J.-H.W.); the Department of Pediatrics, University of Utah, Salt Lake City (M.B.); the Department of Pediatrics, University of New Mexico School of Medicine, Albuquerque (J.R.L.); the Department of Pediatrics, Boston University Medical Center, Boston (K.C.K.K.); the Department of Pediatrics, University of North Carolina at Chapel Hill School of Medicine, Chapel Hill (T.M.O.); the Department of Pediatrics, Nationwide Children's Hospital, Columbus (K.L.B.), and the Department of Pediatrics, Cincinnati Children's Hospital Medical Center, and the Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati (S.M.) - all in Ohio; and the Department of Pediatrics, University of Chicago, Chicago (M.D.S.)
| | - John Flibotte
- From the Departments of Neurology (Y.W.W., A.M.G., H.C.G.), Pediatrics (Y.W.W., F.F.G., E.E.R., H.C.G.), and Epidemiology (H.C.G.), University of California, San Francisco, San Francisco, the Department of Pediatrics, Stanford University School of Medicine, Stanford (K.P.V.M., S. Bonifacio), and the Departments of Pediatrics (T.-W.W., J.L.W.) and Radiology (J.L.W., S. Bluml), Children's Hospital Los Angeles, and the Departments of Pediatrics (T.-W.W., J.L.W.) and Radiology (J.L.W., S. Bluml), University of Southern California Keck School of Medicine, Los Angeles - all in California; the Department of Biostatistics, University of Washington (B.A.C., P.J.H.), and the Department of Pediatrics, University of Washington School of Medicine (D.E.M., U.M., S.E.J.) - both in Seattle; the Department of Pediatrics, Children's Healthcare of Atlanta (N.L.M.), and the Department of Pediatrics, Emory University (N.L.M., B.B.P.) - both in Atlanta; the Division of Neurology, Children's National Hospital, and the Department of Neurology, George Washington School of Medicine and Health Sciences - both in Washington, D.C. (T.C.); the Department of Neonatology, Children's Minnesota, St. Paul (A.L.L.), and the Department of Pediatric and Adolescent Medicine, Mayo Clinic, Rochester (E.B.-S.) - both in Minnesota; the Department of Pediatrics, Saint Louis University School of Medicine (A.M.M.), and the Departments of Radiology (R.C.M., C.D.S.), Pediatrics (R.R., C.D.S.), and Neurology (C.D.S.), Washington University in St. Louis School of Medicine - both in St. Louis; the Department of Pediatrics, Cook Children's Medical Center, the Department of Pediatrics, Texas Christian University, and the Department of Pediatrics, University of North Texas Health Science Center, Ft. Worth (D.R.), the Department of Pediatrics, University of Texas Southwestern Medical Center, Dallas (L.C.), and Pediatrix Medical Group of San Antonio, Children's Hospital of San Antonio, and Methodist Children's Hospital, San Antonio (K.A.A.) - all in Texas; the Department of Pediatrics, Indiana University School of Medicine, Indianapolis (U.M., G.M.S.); the Department of Pediatrics, Children's Hospital of Philadelphia, and the Department of Pediatrics, University of Pennsylvania Perelman School of Medicine, Philadelphia (J.F.), and the Department of Pediatrics, University of Pittsburgh School of Medicine, the Department of Pediatrics, UPMC Children's Hospital of Pittsburgh, and the Department of Pediatrics, UPMC Magee-Womens Hospital, Pittsburgh (T.D.Y.) - all in Pennsylvania; the Department of Pediatrics, Vanderbilt University Medical Center, Nashville (J.-H.W.); the Department of Pediatrics, University of Utah, Salt Lake City (M.B.); the Department of Pediatrics, University of New Mexico School of Medicine, Albuquerque (J.R.L.); the Department of Pediatrics, Boston University Medical Center, Boston (K.C.K.K.); the Department of Pediatrics, University of North Carolina at Chapel Hill School of Medicine, Chapel Hill (T.M.O.); the Department of Pediatrics, Nationwide Children's Hospital, Columbus (K.L.B.), and the Department of Pediatrics, Cincinnati Children's Hospital Medical Center, and the Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati (S.M.) - all in Ohio; and the Department of Pediatrics, University of Chicago, Chicago (M.D.S.)
| | - Joern-Hendrik Weitkamp
- From the Departments of Neurology (Y.W.W., A.M.G., H.C.G.), Pediatrics (Y.W.W., F.F.G., E.E.R., H.C.G.), and Epidemiology (H.C.G.), University of California, San Francisco, San Francisco, the Department of Pediatrics, Stanford University School of Medicine, Stanford (K.P.V.M., S. Bonifacio), and the Departments of Pediatrics (T.-W.W., J.L.W.) and Radiology (J.L.W., S. Bluml), Children's Hospital Los Angeles, and the Departments of Pediatrics (T.-W.W., J.L.W.) and Radiology (J.L.W., S. Bluml), University of Southern California Keck School of Medicine, Los Angeles - all in California; the Department of Biostatistics, University of Washington (B.A.C., P.J.H.), and the Department of Pediatrics, University of Washington School of Medicine (D.E.M., U.M., S.E.J.) - both in Seattle; the Department of Pediatrics, Children's Healthcare of Atlanta (N.L.M.), and the Department of Pediatrics, Emory University (N.L.M., B.B.P.) - both in Atlanta; the Division of Neurology, Children's National Hospital, and the Department of Neurology, George Washington School of Medicine and Health Sciences - both in Washington, D.C. (T.C.); the Department of Neonatology, Children's Minnesota, St. Paul (A.L.L.), and the Department of Pediatric and Adolescent Medicine, Mayo Clinic, Rochester (E.B.-S.) - both in Minnesota; the Department of Pediatrics, Saint Louis University School of Medicine (A.M.M.), and the Departments of Radiology (R.C.M., C.D.S.), Pediatrics (R.R., C.D.S.), and Neurology (C.D.S.), Washington University in St. Louis School of Medicine - both in St. Louis; the Department of Pediatrics, Cook Children's Medical Center, the Department of Pediatrics, Texas Christian University, and the Department of Pediatrics, University of North Texas Health Science Center, Ft. Worth (D.R.), the Department of Pediatrics, University of Texas Southwestern Medical Center, Dallas (L.C.), and Pediatrix Medical Group of San Antonio, Children's Hospital of San Antonio, and Methodist Children's Hospital, San Antonio (K.A.A.) - all in Texas; the Department of Pediatrics, Indiana University School of Medicine, Indianapolis (U.M., G.M.S.); the Department of Pediatrics, Children's Hospital of Philadelphia, and the Department of Pediatrics, University of Pennsylvania Perelman School of Medicine, Philadelphia (J.F.), and the Department of Pediatrics, University of Pittsburgh School of Medicine, the Department of Pediatrics, UPMC Children's Hospital of Pittsburgh, and the Department of Pediatrics, UPMC Magee-Womens Hospital, Pittsburgh (T.D.Y.) - all in Pennsylvania; the Department of Pediatrics, Vanderbilt University Medical Center, Nashville (J.-H.W.); the Department of Pediatrics, University of Utah, Salt Lake City (M.B.); the Department of Pediatrics, University of New Mexico School of Medicine, Albuquerque (J.R.L.); the Department of Pediatrics, Boston University Medical Center, Boston (K.C.K.K.); the Department of Pediatrics, University of North Carolina at Chapel Hill School of Medicine, Chapel Hill (T.M.O.); the Department of Pediatrics, Nationwide Children's Hospital, Columbus (K.L.B.), and the Department of Pediatrics, Cincinnati Children's Hospital Medical Center, and the Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati (S.M.) - all in Ohio; and the Department of Pediatrics, University of Chicago, Chicago (M.D.S.)
| | - Kaashif A Ahmad
- From the Departments of Neurology (Y.W.W., A.M.G., H.C.G.), Pediatrics (Y.W.W., F.F.G., E.E.R., H.C.G.), and Epidemiology (H.C.G.), University of California, San Francisco, San Francisco, the Department of Pediatrics, Stanford University School of Medicine, Stanford (K.P.V.M., S. Bonifacio), and the Departments of Pediatrics (T.-W.W., J.L.W.) and Radiology (J.L.W., S. Bluml), Children's Hospital Los Angeles, and the Departments of Pediatrics (T.-W.W., J.L.W.) and Radiology (J.L.W., S. Bluml), University of Southern California Keck School of Medicine, Los Angeles - all in California; the Department of Biostatistics, University of Washington (B.A.C., P.J.H.), and the Department of Pediatrics, University of Washington School of Medicine (D.E.M., U.M., S.E.J.) - both in Seattle; the Department of Pediatrics, Children's Healthcare of Atlanta (N.L.M.), and the Department of Pediatrics, Emory University (N.L.M., B.B.P.) - both in Atlanta; the Division of Neurology, Children's National Hospital, and the Department of Neurology, George Washington School of Medicine and Health Sciences - both in Washington, D.C. (T.C.); the Department of Neonatology, Children's Minnesota, St. Paul (A.L.L.), and the Department of Pediatric and Adolescent Medicine, Mayo Clinic, Rochester (E.B.-S.) - both in Minnesota; the Department of Pediatrics, Saint Louis University School of Medicine (A.M.M.), and the Departments of Radiology (R.C.M., C.D.S.), Pediatrics (R.R., C.D.S.), and Neurology (C.D.S.), Washington University in St. Louis School of Medicine - both in St. Louis; the Department of Pediatrics, Cook Children's Medical Center, the Department of Pediatrics, Texas Christian University, and the Department of Pediatrics, University of North Texas Health Science Center, Ft. Worth (D.R.), the Department of Pediatrics, University of Texas Southwestern Medical Center, Dallas (L.C.), and Pediatrix Medical Group of San Antonio, Children's Hospital of San Antonio, and Methodist Children's Hospital, San Antonio (K.A.A.) - all in Texas; the Department of Pediatrics, Indiana University School of Medicine, Indianapolis (U.M., G.M.S.); the Department of Pediatrics, Children's Hospital of Philadelphia, and the Department of Pediatrics, University of Pennsylvania Perelman School of Medicine, Philadelphia (J.F.), and the Department of Pediatrics, University of Pittsburgh School of Medicine, the Department of Pediatrics, UPMC Children's Hospital of Pittsburgh, and the Department of Pediatrics, UPMC Magee-Womens Hospital, Pittsburgh (T.D.Y.) - all in Pennsylvania; the Department of Pediatrics, Vanderbilt University Medical Center, Nashville (J.-H.W.); the Department of Pediatrics, University of Utah, Salt Lake City (M.B.); the Department of Pediatrics, University of New Mexico School of Medicine, Albuquerque (J.R.L.); the Department of Pediatrics, Boston University Medical Center, Boston (K.C.K.K.); the Department of Pediatrics, University of North Carolina at Chapel Hill School of Medicine, Chapel Hill (T.M.O.); the Department of Pediatrics, Nationwide Children's Hospital, Columbus (K.L.B.), and the Department of Pediatrics, Cincinnati Children's Hospital Medical Center, and the Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati (S.M.) - all in Ohio; and the Department of Pediatrics, University of Chicago, Chicago (M.D.S.)
| | - Toby D Yanowitz
- From the Departments of Neurology (Y.W.W., A.M.G., H.C.G.), Pediatrics (Y.W.W., F.F.G., E.E.R., H.C.G.), and Epidemiology (H.C.G.), University of California, San Francisco, San Francisco, the Department of Pediatrics, Stanford University School of Medicine, Stanford (K.P.V.M., S. Bonifacio), and the Departments of Pediatrics (T.-W.W., J.L.W.) and Radiology (J.L.W., S. Bluml), Children's Hospital Los Angeles, and the Departments of Pediatrics (T.-W.W., J.L.W.) and Radiology (J.L.W., S. Bluml), University of Southern California Keck School of Medicine, Los Angeles - all in California; the Department of Biostatistics, University of Washington (B.A.C., P.J.H.), and the Department of Pediatrics, University of Washington School of Medicine (D.E.M., U.M., S.E.J.) - both in Seattle; the Department of Pediatrics, Children's Healthcare of Atlanta (N.L.M.), and the Department of Pediatrics, Emory University (N.L.M., B.B.P.) - both in Atlanta; the Division of Neurology, Children's National Hospital, and the Department of Neurology, George Washington School of Medicine and Health Sciences - both in Washington, D.C. (T.C.); the Department of Neonatology, Children's Minnesota, St. Paul (A.L.L.), and the Department of Pediatric and Adolescent Medicine, Mayo Clinic, Rochester (E.B.-S.) - both in Minnesota; the Department of Pediatrics, Saint Louis University School of Medicine (A.M.M.), and the Departments of Radiology (R.C.M., C.D.S.), Pediatrics (R.R., C.D.S.), and Neurology (C.D.S.), Washington University in St. Louis School of Medicine - both in St. Louis; the Department of Pediatrics, Cook Children's Medical Center, the Department of Pediatrics, Texas Christian University, and the Department of Pediatrics, University of North Texas Health Science Center, Ft. Worth (D.R.), the Department of Pediatrics, University of Texas Southwestern Medical Center, Dallas (L.C.), and Pediatrix Medical Group of San Antonio, Children's Hospital of San Antonio, and Methodist Children's Hospital, San Antonio (K.A.A.) - all in Texas; the Department of Pediatrics, Indiana University School of Medicine, Indianapolis (U.M., G.M.S.); the Department of Pediatrics, Children's Hospital of Philadelphia, and the Department of Pediatrics, University of Pennsylvania Perelman School of Medicine, Philadelphia (J.F.), and the Department of Pediatrics, University of Pittsburgh School of Medicine, the Department of Pediatrics, UPMC Children's Hospital of Pittsburgh, and the Department of Pediatrics, UPMC Magee-Womens Hospital, Pittsburgh (T.D.Y.) - all in Pennsylvania; the Department of Pediatrics, Vanderbilt University Medical Center, Nashville (J.-H.W.); the Department of Pediatrics, University of Utah, Salt Lake City (M.B.); the Department of Pediatrics, University of New Mexico School of Medicine, Albuquerque (J.R.L.); the Department of Pediatrics, Boston University Medical Center, Boston (K.C.K.K.); the Department of Pediatrics, University of North Carolina at Chapel Hill School of Medicine, Chapel Hill (T.M.O.); the Department of Pediatrics, Nationwide Children's Hospital, Columbus (K.L.B.), and the Department of Pediatrics, Cincinnati Children's Hospital Medical Center, and the Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati (S.M.) - all in Ohio; and the Department of Pediatrics, University of Chicago, Chicago (M.D.S.)
| | - Mariana Baserga
- From the Departments of Neurology (Y.W.W., A.M.G., H.C.G.), Pediatrics (Y.W.W., F.F.G., E.E.R., H.C.G.), and Epidemiology (H.C.G.), University of California, San Francisco, San Francisco, the Department of Pediatrics, Stanford University School of Medicine, Stanford (K.P.V.M., S. Bonifacio), and the Departments of Pediatrics (T.-W.W., J.L.W.) and Radiology (J.L.W., S. Bluml), Children's Hospital Los Angeles, and the Departments of Pediatrics (T.-W.W., J.L.W.) and Radiology (J.L.W., S. Bluml), University of Southern California Keck School of Medicine, Los Angeles - all in California; the Department of Biostatistics, University of Washington (B.A.C., P.J.H.), and the Department of Pediatrics, University of Washington School of Medicine (D.E.M., U.M., S.E.J.) - both in Seattle; the Department of Pediatrics, Children's Healthcare of Atlanta (N.L.M.), and the Department of Pediatrics, Emory University (N.L.M., B.B.P.) - both in Atlanta; the Division of Neurology, Children's National Hospital, and the Department of Neurology, George Washington School of Medicine and Health Sciences - both in Washington, D.C. (T.C.); the Department of Neonatology, Children's Minnesota, St. Paul (A.L.L.), and the Department of Pediatric and Adolescent Medicine, Mayo Clinic, Rochester (E.B.-S.) - both in Minnesota; the Department of Pediatrics, Saint Louis University School of Medicine (A.M.M.), and the Departments of Radiology (R.C.M., C.D.S.), Pediatrics (R.R., C.D.S.), and Neurology (C.D.S.), Washington University in St. Louis School of Medicine - both in St. Louis; the Department of Pediatrics, Cook Children's Medical Center, the Department of Pediatrics, Texas Christian University, and the Department of Pediatrics, University of North Texas Health Science Center, Ft. Worth (D.R.), the Department of Pediatrics, University of Texas Southwestern Medical Center, Dallas (L.C.), and Pediatrix Medical Group of San Antonio, Children's Hospital of San Antonio, and Methodist Children's Hospital, San Antonio (K.A.A.) - all in Texas; the Department of Pediatrics, Indiana University School of Medicine, Indianapolis (U.M., G.M.S.); the Department of Pediatrics, Children's Hospital of Philadelphia, and the Department of Pediatrics, University of Pennsylvania Perelman School of Medicine, Philadelphia (J.F.), and the Department of Pediatrics, University of Pittsburgh School of Medicine, the Department of Pediatrics, UPMC Children's Hospital of Pittsburgh, and the Department of Pediatrics, UPMC Magee-Womens Hospital, Pittsburgh (T.D.Y.) - all in Pennsylvania; the Department of Pediatrics, Vanderbilt University Medical Center, Nashville (J.-H.W.); the Department of Pediatrics, University of Utah, Salt Lake City (M.B.); the Department of Pediatrics, University of New Mexico School of Medicine, Albuquerque (J.R.L.); the Department of Pediatrics, Boston University Medical Center, Boston (K.C.K.K.); the Department of Pediatrics, University of North Carolina at Chapel Hill School of Medicine, Chapel Hill (T.M.O.); the Department of Pediatrics, Nationwide Children's Hospital, Columbus (K.L.B.), and the Department of Pediatrics, Cincinnati Children's Hospital Medical Center, and the Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati (S.M.) - all in Ohio; and the Department of Pediatrics, University of Chicago, Chicago (M.D.S.)
| | - Brenda B Poindexter
- From the Departments of Neurology (Y.W.W., A.M.G., H.C.G.), Pediatrics (Y.W.W., F.F.G., E.E.R., H.C.G.), and Epidemiology (H.C.G.), University of California, San Francisco, San Francisco, the Department of Pediatrics, Stanford University School of Medicine, Stanford (K.P.V.M., S. Bonifacio), and the Departments of Pediatrics (T.-W.W., J.L.W.) and Radiology (J.L.W., S. Bluml), Children's Hospital Los Angeles, and the Departments of Pediatrics (T.-W.W., J.L.W.) and Radiology (J.L.W., S. Bluml), University of Southern California Keck School of Medicine, Los Angeles - all in California; the Department of Biostatistics, University of Washington (B.A.C., P.J.H.), and the Department of Pediatrics, University of Washington School of Medicine (D.E.M., U.M., S.E.J.) - both in Seattle; the Department of Pediatrics, Children's Healthcare of Atlanta (N.L.M.), and the Department of Pediatrics, Emory University (N.L.M., B.B.P.) - both in Atlanta; the Division of Neurology, Children's National Hospital, and the Department of Neurology, George Washington School of Medicine and Health Sciences - both in Washington, D.C. (T.C.); the Department of Neonatology, Children's Minnesota, St. Paul (A.L.L.), and the Department of Pediatric and Adolescent Medicine, Mayo Clinic, Rochester (E.B.-S.) - both in Minnesota; the Department of Pediatrics, Saint Louis University School of Medicine (A.M.M.), and the Departments of Radiology (R.C.M., C.D.S.), Pediatrics (R.R., C.D.S.), and Neurology (C.D.S.), Washington University in St. Louis School of Medicine - both in St. Louis; the Department of Pediatrics, Cook Children's Medical Center, the Department of Pediatrics, Texas Christian University, and the Department of Pediatrics, University of North Texas Health Science Center, Ft. Worth (D.R.), the Department of Pediatrics, University of Texas Southwestern Medical Center, Dallas (L.C.), and Pediatrix Medical Group of San Antonio, Children's Hospital of San Antonio, and Methodist Children's Hospital, San Antonio (K.A.A.) - all in Texas; the Department of Pediatrics, Indiana University School of Medicine, Indianapolis (U.M., G.M.S.); the Department of Pediatrics, Children's Hospital of Philadelphia, and the Department of Pediatrics, University of Pennsylvania Perelman School of Medicine, Philadelphia (J.F.), and the Department of Pediatrics, University of Pittsburgh School of Medicine, the Department of Pediatrics, UPMC Children's Hospital of Pittsburgh, and the Department of Pediatrics, UPMC Magee-Womens Hospital, Pittsburgh (T.D.Y.) - all in Pennsylvania; the Department of Pediatrics, Vanderbilt University Medical Center, Nashville (J.-H.W.); the Department of Pediatrics, University of Utah, Salt Lake City (M.B.); the Department of Pediatrics, University of New Mexico School of Medicine, Albuquerque (J.R.L.); the Department of Pediatrics, Boston University Medical Center, Boston (K.C.K.K.); the Department of Pediatrics, University of North Carolina at Chapel Hill School of Medicine, Chapel Hill (T.M.O.); the Department of Pediatrics, Nationwide Children's Hospital, Columbus (K.L.B.), and the Department of Pediatrics, Cincinnati Children's Hospital Medical Center, and the Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati (S.M.) - all in Ohio; and the Department of Pediatrics, University of Chicago, Chicago (M.D.S.)
| | - Elizabeth E Rogers
- From the Departments of Neurology (Y.W.W., A.M.G., H.C.G.), Pediatrics (Y.W.W., F.F.G., E.E.R., H.C.G.), and Epidemiology (H.C.G.), University of California, San Francisco, San Francisco, the Department of Pediatrics, Stanford University School of Medicine, Stanford (K.P.V.M., S. Bonifacio), and the Departments of Pediatrics (T.-W.W., J.L.W.) and Radiology (J.L.W., S. Bluml), Children's Hospital Los Angeles, and the Departments of Pediatrics (T.-W.W., J.L.W.) and Radiology (J.L.W., S. Bluml), University of Southern California Keck School of Medicine, Los Angeles - all in California; the Department of Biostatistics, University of Washington (B.A.C., P.J.H.), and the Department of Pediatrics, University of Washington School of Medicine (D.E.M., U.M., S.E.J.) - both in Seattle; the Department of Pediatrics, Children's Healthcare of Atlanta (N.L.M.), and the Department of Pediatrics, Emory University (N.L.M., B.B.P.) - both in Atlanta; the Division of Neurology, Children's National Hospital, and the Department of Neurology, George Washington School of Medicine and Health Sciences - both in Washington, D.C. (T.C.); the Department of Neonatology, Children's Minnesota, St. Paul (A.L.L.), and the Department of Pediatric and Adolescent Medicine, Mayo Clinic, Rochester (E.B.-S.) - both in Minnesota; the Department of Pediatrics, Saint Louis University School of Medicine (A.M.M.), and the Departments of Radiology (R.C.M., C.D.S.), Pediatrics (R.R., C.D.S.), and Neurology (C.D.S.), Washington University in St. Louis School of Medicine - both in St. Louis; the Department of Pediatrics, Cook Children's Medical Center, the Department of Pediatrics, Texas Christian University, and the Department of Pediatrics, University of North Texas Health Science Center, Ft. Worth (D.R.), the Department of Pediatrics, University of Texas Southwestern Medical Center, Dallas (L.C.), and Pediatrix Medical Group of San Antonio, Children's Hospital of San Antonio, and Methodist Children's Hospital, San Antonio (K.A.A.) - all in Texas; the Department of Pediatrics, Indiana University School of Medicine, Indianapolis (U.M., G.M.S.); the Department of Pediatrics, Children's Hospital of Philadelphia, and the Department of Pediatrics, University of Pennsylvania Perelman School of Medicine, Philadelphia (J.F.), and the Department of Pediatrics, University of Pittsburgh School of Medicine, the Department of Pediatrics, UPMC Children's Hospital of Pittsburgh, and the Department of Pediatrics, UPMC Magee-Womens Hospital, Pittsburgh (T.D.Y.) - all in Pennsylvania; the Department of Pediatrics, Vanderbilt University Medical Center, Nashville (J.-H.W.); the Department of Pediatrics, University of Utah, Salt Lake City (M.B.); the Department of Pediatrics, University of New Mexico School of Medicine, Albuquerque (J.R.L.); the Department of Pediatrics, Boston University Medical Center, Boston (K.C.K.K.); the Department of Pediatrics, University of North Carolina at Chapel Hill School of Medicine, Chapel Hill (T.M.O.); the Department of Pediatrics, Nationwide Children's Hospital, Columbus (K.L.B.), and the Department of Pediatrics, Cincinnati Children's Hospital Medical Center, and the Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati (S.M.) - all in Ohio; and the Department of Pediatrics, University of Chicago, Chicago (M.D.S.)
| | - Jean R Lowe
- From the Departments of Neurology (Y.W.W., A.M.G., H.C.G.), Pediatrics (Y.W.W., F.F.G., E.E.R., H.C.G.), and Epidemiology (H.C.G.), University of California, San Francisco, San Francisco, the Department of Pediatrics, Stanford University School of Medicine, Stanford (K.P.V.M., S. Bonifacio), and the Departments of Pediatrics (T.-W.W., J.L.W.) and Radiology (J.L.W., S. Bluml), Children's Hospital Los Angeles, and the Departments of Pediatrics (T.-W.W., J.L.W.) and Radiology (J.L.W., S. Bluml), University of Southern California Keck School of Medicine, Los Angeles - all in California; the Department of Biostatistics, University of Washington (B.A.C., P.J.H.), and the Department of Pediatrics, University of Washington School of Medicine (D.E.M., U.M., S.E.J.) - both in Seattle; the Department of Pediatrics, Children's Healthcare of Atlanta (N.L.M.), and the Department of Pediatrics, Emory University (N.L.M., B.B.P.) - both in Atlanta; the Division of Neurology, Children's National Hospital, and the Department of Neurology, George Washington School of Medicine and Health Sciences - both in Washington, D.C. (T.C.); the Department of Neonatology, Children's Minnesota, St. Paul (A.L.L.), and the Department of Pediatric and Adolescent Medicine, Mayo Clinic, Rochester (E.B.-S.) - both in Minnesota; the Department of Pediatrics, Saint Louis University School of Medicine (A.M.M.), and the Departments of Radiology (R.C.M., C.D.S.), Pediatrics (R.R., C.D.S.), and Neurology (C.D.S.), Washington University in St. Louis School of Medicine - both in St. Louis; the Department of Pediatrics, Cook Children's Medical Center, the Department of Pediatrics, Texas Christian University, and the Department of Pediatrics, University of North Texas Health Science Center, Ft. Worth (D.R.), the Department of Pediatrics, University of Texas Southwestern Medical Center, Dallas (L.C.), and Pediatrix Medical Group of San Antonio, Children's Hospital of San Antonio, and Methodist Children's Hospital, San Antonio (K.A.A.) - all in Texas; the Department of Pediatrics, Indiana University School of Medicine, Indianapolis (U.M., G.M.S.); the Department of Pediatrics, Children's Hospital of Philadelphia, and the Department of Pediatrics, University of Pennsylvania Perelman School of Medicine, Philadelphia (J.F.), and the Department of Pediatrics, University of Pittsburgh School of Medicine, the Department of Pediatrics, UPMC Children's Hospital of Pittsburgh, and the Department of Pediatrics, UPMC Magee-Womens Hospital, Pittsburgh (T.D.Y.) - all in Pennsylvania; the Department of Pediatrics, Vanderbilt University Medical Center, Nashville (J.-H.W.); the Department of Pediatrics, University of Utah, Salt Lake City (M.B.); the Department of Pediatrics, University of New Mexico School of Medicine, Albuquerque (J.R.L.); the Department of Pediatrics, Boston University Medical Center, Boston (K.C.K.K.); the Department of Pediatrics, University of North Carolina at Chapel Hill School of Medicine, Chapel Hill (T.M.O.); the Department of Pediatrics, Nationwide Children's Hospital, Columbus (K.L.B.), and the Department of Pediatrics, Cincinnati Children's Hospital Medical Center, and the Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati (S.M.) - all in Ohio; and the Department of Pediatrics, University of Chicago, Chicago (M.D.S.)
| | - Karl C K Kuban
- From the Departments of Neurology (Y.W.W., A.M.G., H.C.G.), Pediatrics (Y.W.W., F.F.G., E.E.R., H.C.G.), and Epidemiology (H.C.G.), University of California, San Francisco, San Francisco, the Department of Pediatrics, Stanford University School of Medicine, Stanford (K.P.V.M., S. Bonifacio), and the Departments of Pediatrics (T.-W.W., J.L.W.) and Radiology (J.L.W., S. Bluml), Children's Hospital Los Angeles, and the Departments of Pediatrics (T.-W.W., J.L.W.) and Radiology (J.L.W., S. Bluml), University of Southern California Keck School of Medicine, Los Angeles - all in California; the Department of Biostatistics, University of Washington (B.A.C., P.J.H.), and the Department of Pediatrics, University of Washington School of Medicine (D.E.M., U.M., S.E.J.) - both in Seattle; the Department of Pediatrics, Children's Healthcare of Atlanta (N.L.M.), and the Department of Pediatrics, Emory University (N.L.M., B.B.P.) - both in Atlanta; the Division of Neurology, Children's National Hospital, and the Department of Neurology, George Washington School of Medicine and Health Sciences - both in Washington, D.C. (T.C.); the Department of Neonatology, Children's Minnesota, St. Paul (A.L.L.), and the Department of Pediatric and Adolescent Medicine, Mayo Clinic, Rochester (E.B.-S.) - both in Minnesota; the Department of Pediatrics, Saint Louis University School of Medicine (A.M.M.), and the Departments of Radiology (R.C.M., C.D.S.), Pediatrics (R.R., C.D.S.), and Neurology (C.D.S.), Washington University in St. Louis School of Medicine - both in St. Louis; the Department of Pediatrics, Cook Children's Medical Center, the Department of Pediatrics, Texas Christian University, and the Department of Pediatrics, University of North Texas Health Science Center, Ft. Worth (D.R.), the Department of Pediatrics, University of Texas Southwestern Medical Center, Dallas (L.C.), and Pediatrix Medical Group of San Antonio, Children's Hospital of San Antonio, and Methodist Children's Hospital, San Antonio (K.A.A.) - all in Texas; the Department of Pediatrics, Indiana University School of Medicine, Indianapolis (U.M., G.M.S.); the Department of Pediatrics, Children's Hospital of Philadelphia, and the Department of Pediatrics, University of Pennsylvania Perelman School of Medicine, Philadelphia (J.F.), and the Department of Pediatrics, University of Pittsburgh School of Medicine, the Department of Pediatrics, UPMC Children's Hospital of Pittsburgh, and the Department of Pediatrics, UPMC Magee-Womens Hospital, Pittsburgh (T.D.Y.) - all in Pennsylvania; the Department of Pediatrics, Vanderbilt University Medical Center, Nashville (J.-H.W.); the Department of Pediatrics, University of Utah, Salt Lake City (M.B.); the Department of Pediatrics, University of New Mexico School of Medicine, Albuquerque (J.R.L.); the Department of Pediatrics, Boston University Medical Center, Boston (K.C.K.K.); the Department of Pediatrics, University of North Carolina at Chapel Hill School of Medicine, Chapel Hill (T.M.O.); the Department of Pediatrics, Nationwide Children's Hospital, Columbus (K.L.B.), and the Department of Pediatrics, Cincinnati Children's Hospital Medical Center, and the Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati (S.M.) - all in Ohio; and the Department of Pediatrics, University of Chicago, Chicago (M.D.S.)
| | - T Michael O'Shea
- From the Departments of Neurology (Y.W.W., A.M.G., H.C.G.), Pediatrics (Y.W.W., F.F.G., E.E.R., H.C.G.), and Epidemiology (H.C.G.), University of California, San Francisco, San Francisco, the Department of Pediatrics, Stanford University School of Medicine, Stanford (K.P.V.M., S. Bonifacio), and the Departments of Pediatrics (T.-W.W., J.L.W.) and Radiology (J.L.W., S. Bluml), Children's Hospital Los Angeles, and the Departments of Pediatrics (T.-W.W., J.L.W.) and Radiology (J.L.W., S. Bluml), University of Southern California Keck School of Medicine, Los Angeles - all in California; the Department of Biostatistics, University of Washington (B.A.C., P.J.H.), and the Department of Pediatrics, University of Washington School of Medicine (D.E.M., U.M., S.E.J.) - both in Seattle; the Department of Pediatrics, Children's Healthcare of Atlanta (N.L.M.), and the Department of Pediatrics, Emory University (N.L.M., B.B.P.) - both in Atlanta; the Division of Neurology, Children's National Hospital, and the Department of Neurology, George Washington School of Medicine and Health Sciences - both in Washington, D.C. (T.C.); the Department of Neonatology, Children's Minnesota, St. Paul (A.L.L.), and the Department of Pediatric and Adolescent Medicine, Mayo Clinic, Rochester (E.B.-S.) - both in Minnesota; the Department of Pediatrics, Saint Louis University School of Medicine (A.M.M.), and the Departments of Radiology (R.C.M., C.D.S.), Pediatrics (R.R., C.D.S.), and Neurology (C.D.S.), Washington University in St. Louis School of Medicine - both in St. Louis; the Department of Pediatrics, Cook Children's Medical Center, the Department of Pediatrics, Texas Christian University, and the Department of Pediatrics, University of North Texas Health Science Center, Ft. Worth (D.R.), the Department of Pediatrics, University of Texas Southwestern Medical Center, Dallas (L.C.), and Pediatrix Medical Group of San Antonio, Children's Hospital of San Antonio, and Methodist Children's Hospital, San Antonio (K.A.A.) - all in Texas; the Department of Pediatrics, Indiana University School of Medicine, Indianapolis (U.M., G.M.S.); the Department of Pediatrics, Children's Hospital of Philadelphia, and the Department of Pediatrics, University of Pennsylvania Perelman School of Medicine, Philadelphia (J.F.), and the Department of Pediatrics, University of Pittsburgh School of Medicine, the Department of Pediatrics, UPMC Children's Hospital of Pittsburgh, and the Department of Pediatrics, UPMC Magee-Womens Hospital, Pittsburgh (T.D.Y.) - all in Pennsylvania; the Department of Pediatrics, Vanderbilt University Medical Center, Nashville (J.-H.W.); the Department of Pediatrics, University of Utah, Salt Lake City (M.B.); the Department of Pediatrics, University of New Mexico School of Medicine, Albuquerque (J.R.L.); the Department of Pediatrics, Boston University Medical Center, Boston (K.C.K.K.); the Department of Pediatrics, University of North Carolina at Chapel Hill School of Medicine, Chapel Hill (T.M.O.); the Department of Pediatrics, Nationwide Children's Hospital, Columbus (K.L.B.), and the Department of Pediatrics, Cincinnati Children's Hospital Medical Center, and the Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati (S.M.) - all in Ohio; and the Department of Pediatrics, University of Chicago, Chicago (M.D.S.)
| | - Jessica L Wisnowski
- From the Departments of Neurology (Y.W.W., A.M.G., H.C.G.), Pediatrics (Y.W.W., F.F.G., E.E.R., H.C.G.), and Epidemiology (H.C.G.), University of California, San Francisco, San Francisco, the Department of Pediatrics, Stanford University School of Medicine, Stanford (K.P.V.M., S. Bonifacio), and the Departments of Pediatrics (T.-W.W., J.L.W.) and Radiology (J.L.W., S. Bluml), Children's Hospital Los Angeles, and the Departments of Pediatrics (T.-W.W., J.L.W.) and Radiology (J.L.W., S. Bluml), University of Southern California Keck School of Medicine, Los Angeles - all in California; the Department of Biostatistics, University of Washington (B.A.C., P.J.H.), and the Department of Pediatrics, University of Washington School of Medicine (D.E.M., U.M., S.E.J.) - both in Seattle; the Department of Pediatrics, Children's Healthcare of Atlanta (N.L.M.), and the Department of Pediatrics, Emory University (N.L.M., B.B.P.) - both in Atlanta; the Division of Neurology, Children's National Hospital, and the Department of Neurology, George Washington School of Medicine and Health Sciences - both in Washington, D.C. (T.C.); the Department of Neonatology, Children's Minnesota, St. Paul (A.L.L.), and the Department of Pediatric and Adolescent Medicine, Mayo Clinic, Rochester (E.B.-S.) - both in Minnesota; the Department of Pediatrics, Saint Louis University School of Medicine (A.M.M.), and the Departments of Radiology (R.C.M., C.D.S.), Pediatrics (R.R., C.D.S.), and Neurology (C.D.S.), Washington University in St. Louis School of Medicine - both in St. Louis; the Department of Pediatrics, Cook Children's Medical Center, the Department of Pediatrics, Texas Christian University, and the Department of Pediatrics, University of North Texas Health Science Center, Ft. Worth (D.R.), the Department of Pediatrics, University of Texas Southwestern Medical Center, Dallas (L.C.), and Pediatrix Medical Group of San Antonio, Children's Hospital of San Antonio, and Methodist Children's Hospital, San Antonio (K.A.A.) - all in Texas; the Department of Pediatrics, Indiana University School of Medicine, Indianapolis (U.M., G.M.S.); the Department of Pediatrics, Children's Hospital of Philadelphia, and the Department of Pediatrics, University of Pennsylvania Perelman School of Medicine, Philadelphia (J.F.), and the Department of Pediatrics, University of Pittsburgh School of Medicine, the Department of Pediatrics, UPMC Children's Hospital of Pittsburgh, and the Department of Pediatrics, UPMC Magee-Womens Hospital, Pittsburgh (T.D.Y.) - all in Pennsylvania; the Department of Pediatrics, Vanderbilt University Medical Center, Nashville (J.-H.W.); the Department of Pediatrics, University of Utah, Salt Lake City (M.B.); the Department of Pediatrics, University of New Mexico School of Medicine, Albuquerque (J.R.L.); the Department of Pediatrics, Boston University Medical Center, Boston (K.C.K.K.); the Department of Pediatrics, University of North Carolina at Chapel Hill School of Medicine, Chapel Hill (T.M.O.); the Department of Pediatrics, Nationwide Children's Hospital, Columbus (K.L.B.), and the Department of Pediatrics, Cincinnati Children's Hospital Medical Center, and the Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati (S.M.) - all in Ohio; and the Department of Pediatrics, University of Chicago, Chicago (M.D.S.)
| | - Robert C McKinstry
- From the Departments of Neurology (Y.W.W., A.M.G., H.C.G.), Pediatrics (Y.W.W., F.F.G., E.E.R., H.C.G.), and Epidemiology (H.C.G.), University of California, San Francisco, San Francisco, the Department of Pediatrics, Stanford University School of Medicine, Stanford (K.P.V.M., S. Bonifacio), and the Departments of Pediatrics (T.-W.W., J.L.W.) and Radiology (J.L.W., S. Bluml), Children's Hospital Los Angeles, and the Departments of Pediatrics (T.-W.W., J.L.W.) and Radiology (J.L.W., S. Bluml), University of Southern California Keck School of Medicine, Los Angeles - all in California; the Department of Biostatistics, University of Washington (B.A.C., P.J.H.), and the Department of Pediatrics, University of Washington School of Medicine (D.E.M., U.M., S.E.J.) - both in Seattle; the Department of Pediatrics, Children's Healthcare of Atlanta (N.L.M.), and the Department of Pediatrics, Emory University (N.L.M., B.B.P.) - both in Atlanta; the Division of Neurology, Children's National Hospital, and the Department of Neurology, George Washington School of Medicine and Health Sciences - both in Washington, D.C. (T.C.); the Department of Neonatology, Children's Minnesota, St. Paul (A.L.L.), and the Department of Pediatric and Adolescent Medicine, Mayo Clinic, Rochester (E.B.-S.) - both in Minnesota; the Department of Pediatrics, Saint Louis University School of Medicine (A.M.M.), and the Departments of Radiology (R.C.M., C.D.S.), Pediatrics (R.R., C.D.S.), and Neurology (C.D.S.), Washington University in St. Louis School of Medicine - both in St. Louis; the Department of Pediatrics, Cook Children's Medical Center, the Department of Pediatrics, Texas Christian University, and the Department of Pediatrics, University of North Texas Health Science Center, Ft. Worth (D.R.), the Department of Pediatrics, University of Texas Southwestern Medical Center, Dallas (L.C.), and Pediatrix Medical Group of San Antonio, Children's Hospital of San Antonio, and Methodist Children's Hospital, San Antonio (K.A.A.) - all in Texas; the Department of Pediatrics, Indiana University School of Medicine, Indianapolis (U.M., G.M.S.); the Department of Pediatrics, Children's Hospital of Philadelphia, and the Department of Pediatrics, University of Pennsylvania Perelman School of Medicine, Philadelphia (J.F.), and the Department of Pediatrics, University of Pittsburgh School of Medicine, the Department of Pediatrics, UPMC Children's Hospital of Pittsburgh, and the Department of Pediatrics, UPMC Magee-Womens Hospital, Pittsburgh (T.D.Y.) - all in Pennsylvania; the Department of Pediatrics, Vanderbilt University Medical Center, Nashville (J.-H.W.); the Department of Pediatrics, University of Utah, Salt Lake City (M.B.); the Department of Pediatrics, University of New Mexico School of Medicine, Albuquerque (J.R.L.); the Department of Pediatrics, Boston University Medical Center, Boston (K.C.K.K.); the Department of Pediatrics, University of North Carolina at Chapel Hill School of Medicine, Chapel Hill (T.M.O.); the Department of Pediatrics, Nationwide Children's Hospital, Columbus (K.L.B.), and the Department of Pediatrics, Cincinnati Children's Hospital Medical Center, and the Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati (S.M.) - all in Ohio; and the Department of Pediatrics, University of Chicago, Chicago (M.D.S.)
| | - Stefan Bluml
- From the Departments of Neurology (Y.W.W., A.M.G., H.C.G.), Pediatrics (Y.W.W., F.F.G., E.E.R., H.C.G.), and Epidemiology (H.C.G.), University of California, San Francisco, San Francisco, the Department of Pediatrics, Stanford University School of Medicine, Stanford (K.P.V.M., S. Bonifacio), and the Departments of Pediatrics (T.-W.W., J.L.W.) and Radiology (J.L.W., S. Bluml), Children's Hospital Los Angeles, and the Departments of Pediatrics (T.-W.W., J.L.W.) and Radiology (J.L.W., S. Bluml), University of Southern California Keck School of Medicine, Los Angeles - all in California; the Department of Biostatistics, University of Washington (B.A.C., P.J.H.), and the Department of Pediatrics, University of Washington School of Medicine (D.E.M., U.M., S.E.J.) - both in Seattle; the Department of Pediatrics, Children's Healthcare of Atlanta (N.L.M.), and the Department of Pediatrics, Emory University (N.L.M., B.B.P.) - both in Atlanta; the Division of Neurology, Children's National Hospital, and the Department of Neurology, George Washington School of Medicine and Health Sciences - both in Washington, D.C. (T.C.); the Department of Neonatology, Children's Minnesota, St. Paul (A.L.L.), and the Department of Pediatric and Adolescent Medicine, Mayo Clinic, Rochester (E.B.-S.) - both in Minnesota; the Department of Pediatrics, Saint Louis University School of Medicine (A.M.M.), and the Departments of Radiology (R.C.M., C.D.S.), Pediatrics (R.R., C.D.S.), and Neurology (C.D.S.), Washington University in St. Louis School of Medicine - both in St. Louis; the Department of Pediatrics, Cook Children's Medical Center, the Department of Pediatrics, Texas Christian University, and the Department of Pediatrics, University of North Texas Health Science Center, Ft. Worth (D.R.), the Department of Pediatrics, University of Texas Southwestern Medical Center, Dallas (L.C.), and Pediatrix Medical Group of San Antonio, Children's Hospital of San Antonio, and Methodist Children's Hospital, San Antonio (K.A.A.) - all in Texas; the Department of Pediatrics, Indiana University School of Medicine, Indianapolis (U.M., G.M.S.); the Department of Pediatrics, Children's Hospital of Philadelphia, and the Department of Pediatrics, University of Pennsylvania Perelman School of Medicine, Philadelphia (J.F.), and the Department of Pediatrics, University of Pittsburgh School of Medicine, the Department of Pediatrics, UPMC Children's Hospital of Pittsburgh, and the Department of Pediatrics, UPMC Magee-Womens Hospital, Pittsburgh (T.D.Y.) - all in Pennsylvania; the Department of Pediatrics, Vanderbilt University Medical Center, Nashville (J.-H.W.); the Department of Pediatrics, University of Utah, Salt Lake City (M.B.); the Department of Pediatrics, University of New Mexico School of Medicine, Albuquerque (J.R.L.); the Department of Pediatrics, Boston University Medical Center, Boston (K.C.K.K.); the Department of Pediatrics, University of North Carolina at Chapel Hill School of Medicine, Chapel Hill (T.M.O.); the Department of Pediatrics, Nationwide Children's Hospital, Columbus (K.L.B.), and the Department of Pediatrics, Cincinnati Children's Hospital Medical Center, and the Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati (S.M.) - all in Ohio; and the Department of Pediatrics, University of Chicago, Chicago (M.D.S.)
| | - Sonia Bonifacio
- From the Departments of Neurology (Y.W.W., A.M.G., H.C.G.), Pediatrics (Y.W.W., F.F.G., E.E.R., H.C.G.), and Epidemiology (H.C.G.), University of California, San Francisco, San Francisco, the Department of Pediatrics, Stanford University School of Medicine, Stanford (K.P.V.M., S. Bonifacio), and the Departments of Pediatrics (T.-W.W., J.L.W.) and Radiology (J.L.W., S. Bluml), Children's Hospital Los Angeles, and the Departments of Pediatrics (T.-W.W., J.L.W.) and Radiology (J.L.W., S. Bluml), University of Southern California Keck School of Medicine, Los Angeles - all in California; the Department of Biostatistics, University of Washington (B.A.C., P.J.H.), and the Department of Pediatrics, University of Washington School of Medicine (D.E.M., U.M., S.E.J.) - both in Seattle; the Department of Pediatrics, Children's Healthcare of Atlanta (N.L.M.), and the Department of Pediatrics, Emory University (N.L.M., B.B.P.) - both in Atlanta; the Division of Neurology, Children's National Hospital, and the Department of Neurology, George Washington School of Medicine and Health Sciences - both in Washington, D.C. (T.C.); the Department of Neonatology, Children's Minnesota, St. Paul (A.L.L.), and the Department of Pediatric and Adolescent Medicine, Mayo Clinic, Rochester (E.B.-S.) - both in Minnesota; the Department of Pediatrics, Saint Louis University School of Medicine (A.M.M.), and the Departments of Radiology (R.C.M., C.D.S.), Pediatrics (R.R., C.D.S.), and Neurology (C.D.S.), Washington University in St. Louis School of Medicine - both in St. Louis; the Department of Pediatrics, Cook Children's Medical Center, the Department of Pediatrics, Texas Christian University, and the Department of Pediatrics, University of North Texas Health Science Center, Ft. Worth (D.R.), the Department of Pediatrics, University of Texas Southwestern Medical Center, Dallas (L.C.), and Pediatrix Medical Group of San Antonio, Children's Hospital of San Antonio, and Methodist Children's Hospital, San Antonio (K.A.A.) - all in Texas; the Department of Pediatrics, Indiana University School of Medicine, Indianapolis (U.M., G.M.S.); the Department of Pediatrics, Children's Hospital of Philadelphia, and the Department of Pediatrics, University of Pennsylvania Perelman School of Medicine, Philadelphia (J.F.), and the Department of Pediatrics, University of Pittsburgh School of Medicine, the Department of Pediatrics, UPMC Children's Hospital of Pittsburgh, and the Department of Pediatrics, UPMC Magee-Womens Hospital, Pittsburgh (T.D.Y.) - all in Pennsylvania; the Department of Pediatrics, Vanderbilt University Medical Center, Nashville (J.-H.W.); the Department of Pediatrics, University of Utah, Salt Lake City (M.B.); the Department of Pediatrics, University of New Mexico School of Medicine, Albuquerque (J.R.L.); the Department of Pediatrics, Boston University Medical Center, Boston (K.C.K.K.); the Department of Pediatrics, University of North Carolina at Chapel Hill School of Medicine, Chapel Hill (T.M.O.); the Department of Pediatrics, Nationwide Children's Hospital, Columbus (K.L.B.), and the Department of Pediatrics, Cincinnati Children's Hospital Medical Center, and the Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati (S.M.) - all in Ohio; and the Department of Pediatrics, University of Chicago, Chicago (M.D.S.)
| | - Kristen L Benninger
- From the Departments of Neurology (Y.W.W., A.M.G., H.C.G.), Pediatrics (Y.W.W., F.F.G., E.E.R., H.C.G.), and Epidemiology (H.C.G.), University of California, San Francisco, San Francisco, the Department of Pediatrics, Stanford University School of Medicine, Stanford (K.P.V.M., S. Bonifacio), and the Departments of Pediatrics (T.-W.W., J.L.W.) and Radiology (J.L.W., S. Bluml), Children's Hospital Los Angeles, and the Departments of Pediatrics (T.-W.W., J.L.W.) and Radiology (J.L.W., S. Bluml), University of Southern California Keck School of Medicine, Los Angeles - all in California; the Department of Biostatistics, University of Washington (B.A.C., P.J.H.), and the Department of Pediatrics, University of Washington School of Medicine (D.E.M., U.M., S.E.J.) - both in Seattle; the Department of Pediatrics, Children's Healthcare of Atlanta (N.L.M.), and the Department of Pediatrics, Emory University (N.L.M., B.B.P.) - both in Atlanta; the Division of Neurology, Children's National Hospital, and the Department of Neurology, George Washington School of Medicine and Health Sciences - both in Washington, D.C. (T.C.); the Department of Neonatology, Children's Minnesota, St. Paul (A.L.L.), and the Department of Pediatric and Adolescent Medicine, Mayo Clinic, Rochester (E.B.-S.) - both in Minnesota; the Department of Pediatrics, Saint Louis University School of Medicine (A.M.M.), and the Departments of Radiology (R.C.M., C.D.S.), Pediatrics (R.R., C.D.S.), and Neurology (C.D.S.), Washington University in St. Louis School of Medicine - both in St. Louis; the Department of Pediatrics, Cook Children's Medical Center, the Department of Pediatrics, Texas Christian University, and the Department of Pediatrics, University of North Texas Health Science Center, Ft. Worth (D.R.), the Department of Pediatrics, University of Texas Southwestern Medical Center, Dallas (L.C.), and Pediatrix Medical Group of San Antonio, Children's Hospital of San Antonio, and Methodist Children's Hospital, San Antonio (K.A.A.) - all in Texas; the Department of Pediatrics, Indiana University School of Medicine, Indianapolis (U.M., G.M.S.); the Department of Pediatrics, Children's Hospital of Philadelphia, and the Department of Pediatrics, University of Pennsylvania Perelman School of Medicine, Philadelphia (J.F.), and the Department of Pediatrics, University of Pittsburgh School of Medicine, the Department of Pediatrics, UPMC Children's Hospital of Pittsburgh, and the Department of Pediatrics, UPMC Magee-Womens Hospital, Pittsburgh (T.D.Y.) - all in Pennsylvania; the Department of Pediatrics, Vanderbilt University Medical Center, Nashville (J.-H.W.); the Department of Pediatrics, University of Utah, Salt Lake City (M.B.); the Department of Pediatrics, University of New Mexico School of Medicine, Albuquerque (J.R.L.); the Department of Pediatrics, Boston University Medical Center, Boston (K.C.K.K.); the Department of Pediatrics, University of North Carolina at Chapel Hill School of Medicine, Chapel Hill (T.M.O.); the Department of Pediatrics, Nationwide Children's Hospital, Columbus (K.L.B.), and the Department of Pediatrics, Cincinnati Children's Hospital Medical Center, and the Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati (S.M.) - all in Ohio; and the Department of Pediatrics, University of Chicago, Chicago (M.D.S.)
| | - Rakesh Rao
- From the Departments of Neurology (Y.W.W., A.M.G., H.C.G.), Pediatrics (Y.W.W., F.F.G., E.E.R., H.C.G.), and Epidemiology (H.C.G.), University of California, San Francisco, San Francisco, the Department of Pediatrics, Stanford University School of Medicine, Stanford (K.P.V.M., S. Bonifacio), and the Departments of Pediatrics (T.-W.W., J.L.W.) and Radiology (J.L.W., S. Bluml), Children's Hospital Los Angeles, and the Departments of Pediatrics (T.-W.W., J.L.W.) and Radiology (J.L.W., S. Bluml), University of Southern California Keck School of Medicine, Los Angeles - all in California; the Department of Biostatistics, University of Washington (B.A.C., P.J.H.), and the Department of Pediatrics, University of Washington School of Medicine (D.E.M., U.M., S.E.J.) - both in Seattle; the Department of Pediatrics, Children's Healthcare of Atlanta (N.L.M.), and the Department of Pediatrics, Emory University (N.L.M., B.B.P.) - both in Atlanta; the Division of Neurology, Children's National Hospital, and the Department of Neurology, George Washington School of Medicine and Health Sciences - both in Washington, D.C. (T.C.); the Department of Neonatology, Children's Minnesota, St. Paul (A.L.L.), and the Department of Pediatric and Adolescent Medicine, Mayo Clinic, Rochester (E.B.-S.) - both in Minnesota; the Department of Pediatrics, Saint Louis University School of Medicine (A.M.M.), and the Departments of Radiology (R.C.M., C.D.S.), Pediatrics (R.R., C.D.S.), and Neurology (C.D.S.), Washington University in St. Louis School of Medicine - both in St. Louis; the Department of Pediatrics, Cook Children's Medical Center, the Department of Pediatrics, Texas Christian University, and the Department of Pediatrics, University of North Texas Health Science Center, Ft. Worth (D.R.), the Department of Pediatrics, University of Texas Southwestern Medical Center, Dallas (L.C.), and Pediatrix Medical Group of San Antonio, Children's Hospital of San Antonio, and Methodist Children's Hospital, San Antonio (K.A.A.) - all in Texas; the Department of Pediatrics, Indiana University School of Medicine, Indianapolis (U.M., G.M.S.); the Department of Pediatrics, Children's Hospital of Philadelphia, and the Department of Pediatrics, University of Pennsylvania Perelman School of Medicine, Philadelphia (J.F.), and the Department of Pediatrics, University of Pittsburgh School of Medicine, the Department of Pediatrics, UPMC Children's Hospital of Pittsburgh, and the Department of Pediatrics, UPMC Magee-Womens Hospital, Pittsburgh (T.D.Y.) - all in Pennsylvania; the Department of Pediatrics, Vanderbilt University Medical Center, Nashville (J.-H.W.); the Department of Pediatrics, University of Utah, Salt Lake City (M.B.); the Department of Pediatrics, University of New Mexico School of Medicine, Albuquerque (J.R.L.); the Department of Pediatrics, Boston University Medical Center, Boston (K.C.K.K.); the Department of Pediatrics, University of North Carolina at Chapel Hill School of Medicine, Chapel Hill (T.M.O.); the Department of Pediatrics, Nationwide Children's Hospital, Columbus (K.L.B.), and the Department of Pediatrics, Cincinnati Children's Hospital Medical Center, and the Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati (S.M.) - all in Ohio; and the Department of Pediatrics, University of Chicago, Chicago (M.D.S.)
| | - Christopher D Smyser
- From the Departments of Neurology (Y.W.W., A.M.G., H.C.G.), Pediatrics (Y.W.W., F.F.G., E.E.R., H.C.G.), and Epidemiology (H.C.G.), University of California, San Francisco, San Francisco, the Department of Pediatrics, Stanford University School of Medicine, Stanford (K.P.V.M., S. Bonifacio), and the Departments of Pediatrics (T.-W.W., J.L.W.) and Radiology (J.L.W., S. Bluml), Children's Hospital Los Angeles, and the Departments of Pediatrics (T.-W.W., J.L.W.) and Radiology (J.L.W., S. Bluml), University of Southern California Keck School of Medicine, Los Angeles - all in California; the Department of Biostatistics, University of Washington (B.A.C., P.J.H.), and the Department of Pediatrics, University of Washington School of Medicine (D.E.M., U.M., S.E.J.) - both in Seattle; the Department of Pediatrics, Children's Healthcare of Atlanta (N.L.M.), and the Department of Pediatrics, Emory University (N.L.M., B.B.P.) - both in Atlanta; the Division of Neurology, Children's National Hospital, and the Department of Neurology, George Washington School of Medicine and Health Sciences - both in Washington, D.C. (T.C.); the Department of Neonatology, Children's Minnesota, St. Paul (A.L.L.), and the Department of Pediatric and Adolescent Medicine, Mayo Clinic, Rochester (E.B.-S.) - both in Minnesota; the Department of Pediatrics, Saint Louis University School of Medicine (A.M.M.), and the Departments of Radiology (R.C.M., C.D.S.), Pediatrics (R.R., C.D.S.), and Neurology (C.D.S.), Washington University in St. Louis School of Medicine - both in St. Louis; the Department of Pediatrics, Cook Children's Medical Center, the Department of Pediatrics, Texas Christian University, and the Department of Pediatrics, University of North Texas Health Science Center, Ft. Worth (D.R.), the Department of Pediatrics, University of Texas Southwestern Medical Center, Dallas (L.C.), and Pediatrix Medical Group of San Antonio, Children's Hospital of San Antonio, and Methodist Children's Hospital, San Antonio (K.A.A.) - all in Texas; the Department of Pediatrics, Indiana University School of Medicine, Indianapolis (U.M., G.M.S.); the Department of Pediatrics, Children's Hospital of Philadelphia, and the Department of Pediatrics, University of Pennsylvania Perelman School of Medicine, Philadelphia (J.F.), and the Department of Pediatrics, University of Pittsburgh School of Medicine, the Department of Pediatrics, UPMC Children's Hospital of Pittsburgh, and the Department of Pediatrics, UPMC Magee-Womens Hospital, Pittsburgh (T.D.Y.) - all in Pennsylvania; the Department of Pediatrics, Vanderbilt University Medical Center, Nashville (J.-H.W.); the Department of Pediatrics, University of Utah, Salt Lake City (M.B.); the Department of Pediatrics, University of New Mexico School of Medicine, Albuquerque (J.R.L.); the Department of Pediatrics, Boston University Medical Center, Boston (K.C.K.K.); the Department of Pediatrics, University of North Carolina at Chapel Hill School of Medicine, Chapel Hill (T.M.O.); the Department of Pediatrics, Nationwide Children's Hospital, Columbus (K.L.B.), and the Department of Pediatrics, Cincinnati Children's Hospital Medical Center, and the Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati (S.M.) - all in Ohio; and the Department of Pediatrics, University of Chicago, Chicago (M.D.S.)
| | - Gregory M Sokol
- From the Departments of Neurology (Y.W.W., A.M.G., H.C.G.), Pediatrics (Y.W.W., F.F.G., E.E.R., H.C.G.), and Epidemiology (H.C.G.), University of California, San Francisco, San Francisco, the Department of Pediatrics, Stanford University School of Medicine, Stanford (K.P.V.M., S. Bonifacio), and the Departments of Pediatrics (T.-W.W., J.L.W.) and Radiology (J.L.W., S. Bluml), Children's Hospital Los Angeles, and the Departments of Pediatrics (T.-W.W., J.L.W.) and Radiology (J.L.W., S. Bluml), University of Southern California Keck School of Medicine, Los Angeles - all in California; the Department of Biostatistics, University of Washington (B.A.C., P.J.H.), and the Department of Pediatrics, University of Washington School of Medicine (D.E.M., U.M., S.E.J.) - both in Seattle; the Department of Pediatrics, Children's Healthcare of Atlanta (N.L.M.), and the Department of Pediatrics, Emory University (N.L.M., B.B.P.) - both in Atlanta; the Division of Neurology, Children's National Hospital, and the Department of Neurology, George Washington School of Medicine and Health Sciences - both in Washington, D.C. (T.C.); the Department of Neonatology, Children's Minnesota, St. Paul (A.L.L.), and the Department of Pediatric and Adolescent Medicine, Mayo Clinic, Rochester (E.B.-S.) - both in Minnesota; the Department of Pediatrics, Saint Louis University School of Medicine (A.M.M.), and the Departments of Radiology (R.C.M., C.D.S.), Pediatrics (R.R., C.D.S.), and Neurology (C.D.S.), Washington University in St. Louis School of Medicine - both in St. Louis; the Department of Pediatrics, Cook Children's Medical Center, the Department of Pediatrics, Texas Christian University, and the Department of Pediatrics, University of North Texas Health Science Center, Ft. Worth (D.R.), the Department of Pediatrics, University of Texas Southwestern Medical Center, Dallas (L.C.), and Pediatrix Medical Group of San Antonio, Children's Hospital of San Antonio, and Methodist Children's Hospital, San Antonio (K.A.A.) - all in Texas; the Department of Pediatrics, Indiana University School of Medicine, Indianapolis (U.M., G.M.S.); the Department of Pediatrics, Children's Hospital of Philadelphia, and the Department of Pediatrics, University of Pennsylvania Perelman School of Medicine, Philadelphia (J.F.), and the Department of Pediatrics, University of Pittsburgh School of Medicine, the Department of Pediatrics, UPMC Children's Hospital of Pittsburgh, and the Department of Pediatrics, UPMC Magee-Womens Hospital, Pittsburgh (T.D.Y.) - all in Pennsylvania; the Department of Pediatrics, Vanderbilt University Medical Center, Nashville (J.-H.W.); the Department of Pediatrics, University of Utah, Salt Lake City (M.B.); the Department of Pediatrics, University of New Mexico School of Medicine, Albuquerque (J.R.L.); the Department of Pediatrics, Boston University Medical Center, Boston (K.C.K.K.); the Department of Pediatrics, University of North Carolina at Chapel Hill School of Medicine, Chapel Hill (T.M.O.); the Department of Pediatrics, Nationwide Children's Hospital, Columbus (K.L.B.), and the Department of Pediatrics, Cincinnati Children's Hospital Medical Center, and the Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati (S.M.) - all in Ohio; and the Department of Pediatrics, University of Chicago, Chicago (M.D.S.)
| | - Stephanie Merhar
- From the Departments of Neurology (Y.W.W., A.M.G., H.C.G.), Pediatrics (Y.W.W., F.F.G., E.E.R., H.C.G.), and Epidemiology (H.C.G.), University of California, San Francisco, San Francisco, the Department of Pediatrics, Stanford University School of Medicine, Stanford (K.P.V.M., S. Bonifacio), and the Departments of Pediatrics (T.-W.W., J.L.W.) and Radiology (J.L.W., S. Bluml), Children's Hospital Los Angeles, and the Departments of Pediatrics (T.-W.W., J.L.W.) and Radiology (J.L.W., S. Bluml), University of Southern California Keck School of Medicine, Los Angeles - all in California; the Department of Biostatistics, University of Washington (B.A.C., P.J.H.), and the Department of Pediatrics, University of Washington School of Medicine (D.E.M., U.M., S.E.J.) - both in Seattle; the Department of Pediatrics, Children's Healthcare of Atlanta (N.L.M.), and the Department of Pediatrics, Emory University (N.L.M., B.B.P.) - both in Atlanta; the Division of Neurology, Children's National Hospital, and the Department of Neurology, George Washington School of Medicine and Health Sciences - both in Washington, D.C. (T.C.); the Department of Neonatology, Children's Minnesota, St. Paul (A.L.L.), and the Department of Pediatric and Adolescent Medicine, Mayo Clinic, Rochester (E.B.-S.) - both in Minnesota; the Department of Pediatrics, Saint Louis University School of Medicine (A.M.M.), and the Departments of Radiology (R.C.M., C.D.S.), Pediatrics (R.R., C.D.S.), and Neurology (C.D.S.), Washington University in St. Louis School of Medicine - both in St. Louis; the Department of Pediatrics, Cook Children's Medical Center, the Department of Pediatrics, Texas Christian University, and the Department of Pediatrics, University of North Texas Health Science Center, Ft. Worth (D.R.), the Department of Pediatrics, University of Texas Southwestern Medical Center, Dallas (L.C.), and Pediatrix Medical Group of San Antonio, Children's Hospital of San Antonio, and Methodist Children's Hospital, San Antonio (K.A.A.) - all in Texas; the Department of Pediatrics, Indiana University School of Medicine, Indianapolis (U.M., G.M.S.); the Department of Pediatrics, Children's Hospital of Philadelphia, and the Department of Pediatrics, University of Pennsylvania Perelman School of Medicine, Philadelphia (J.F.), and the Department of Pediatrics, University of Pittsburgh School of Medicine, the Department of Pediatrics, UPMC Children's Hospital of Pittsburgh, and the Department of Pediatrics, UPMC Magee-Womens Hospital, Pittsburgh (T.D.Y.) - all in Pennsylvania; the Department of Pediatrics, Vanderbilt University Medical Center, Nashville (J.-H.W.); the Department of Pediatrics, University of Utah, Salt Lake City (M.B.); the Department of Pediatrics, University of New Mexico School of Medicine, Albuquerque (J.R.L.); the Department of Pediatrics, Boston University Medical Center, Boston (K.C.K.K.); the Department of Pediatrics, University of North Carolina at Chapel Hill School of Medicine, Chapel Hill (T.M.O.); the Department of Pediatrics, Nationwide Children's Hospital, Columbus (K.L.B.), and the Department of Pediatrics, Cincinnati Children's Hospital Medical Center, and the Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati (S.M.) - all in Ohio; and the Department of Pediatrics, University of Chicago, Chicago (M.D.S.)
| | - Michael D Schreiber
- From the Departments of Neurology (Y.W.W., A.M.G., H.C.G.), Pediatrics (Y.W.W., F.F.G., E.E.R., H.C.G.), and Epidemiology (H.C.G.), University of California, San Francisco, San Francisco, the Department of Pediatrics, Stanford University School of Medicine, Stanford (K.P.V.M., S. Bonifacio), and the Departments of Pediatrics (T.-W.W., J.L.W.) and Radiology (J.L.W., S. Bluml), Children's Hospital Los Angeles, and the Departments of Pediatrics (T.-W.W., J.L.W.) and Radiology (J.L.W., S. Bluml), University of Southern California Keck School of Medicine, Los Angeles - all in California; the Department of Biostatistics, University of Washington (B.A.C., P.J.H.), and the Department of Pediatrics, University of Washington School of Medicine (D.E.M., U.M., S.E.J.) - both in Seattle; the Department of Pediatrics, Children's Healthcare of Atlanta (N.L.M.), and the Department of Pediatrics, Emory University (N.L.M., B.B.P.) - both in Atlanta; the Division of Neurology, Children's National Hospital, and the Department of Neurology, George Washington School of Medicine and Health Sciences - both in Washington, D.C. (T.C.); the Department of Neonatology, Children's Minnesota, St. Paul (A.L.L.), and the Department of Pediatric and Adolescent Medicine, Mayo Clinic, Rochester (E.B.-S.) - both in Minnesota; the Department of Pediatrics, Saint Louis University School of Medicine (A.M.M.), and the Departments of Radiology (R.C.M., C.D.S.), Pediatrics (R.R., C.D.S.), and Neurology (C.D.S.), Washington University in St. Louis School of Medicine - both in St. Louis; the Department of Pediatrics, Cook Children's Medical Center, the Department of Pediatrics, Texas Christian University, and the Department of Pediatrics, University of North Texas Health Science Center, Ft. Worth (D.R.), the Department of Pediatrics, University of Texas Southwestern Medical Center, Dallas (L.C.), and Pediatrix Medical Group of San Antonio, Children's Hospital of San Antonio, and Methodist Children's Hospital, San Antonio (K.A.A.) - all in Texas; the Department of Pediatrics, Indiana University School of Medicine, Indianapolis (U.M., G.M.S.); the Department of Pediatrics, Children's Hospital of Philadelphia, and the Department of Pediatrics, University of Pennsylvania Perelman School of Medicine, Philadelphia (J.F.), and the Department of Pediatrics, University of Pittsburgh School of Medicine, the Department of Pediatrics, UPMC Children's Hospital of Pittsburgh, and the Department of Pediatrics, UPMC Magee-Womens Hospital, Pittsburgh (T.D.Y.) - all in Pennsylvania; the Department of Pediatrics, Vanderbilt University Medical Center, Nashville (J.-H.W.); the Department of Pediatrics, University of Utah, Salt Lake City (M.B.); the Department of Pediatrics, University of New Mexico School of Medicine, Albuquerque (J.R.L.); the Department of Pediatrics, Boston University Medical Center, Boston (K.C.K.K.); the Department of Pediatrics, University of North Carolina at Chapel Hill School of Medicine, Chapel Hill (T.M.O.); the Department of Pediatrics, Nationwide Children's Hospital, Columbus (K.L.B.), and the Department of Pediatrics, Cincinnati Children's Hospital Medical Center, and the Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati (S.M.) - all in Ohio; and the Department of Pediatrics, University of Chicago, Chicago (M.D.S.)
| | - Hannah C Glass
- From the Departments of Neurology (Y.W.W., A.M.G., H.C.G.), Pediatrics (Y.W.W., F.F.G., E.E.R., H.C.G.), and Epidemiology (H.C.G.), University of California, San Francisco, San Francisco, the Department of Pediatrics, Stanford University School of Medicine, Stanford (K.P.V.M., S. Bonifacio), and the Departments of Pediatrics (T.-W.W., J.L.W.) and Radiology (J.L.W., S. Bluml), Children's Hospital Los Angeles, and the Departments of Pediatrics (T.-W.W., J.L.W.) and Radiology (J.L.W., S. Bluml), University of Southern California Keck School of Medicine, Los Angeles - all in California; the Department of Biostatistics, University of Washington (B.A.C., P.J.H.), and the Department of Pediatrics, University of Washington School of Medicine (D.E.M., U.M., S.E.J.) - both in Seattle; the Department of Pediatrics, Children's Healthcare of Atlanta (N.L.M.), and the Department of Pediatrics, Emory University (N.L.M., B.B.P.) - both in Atlanta; the Division of Neurology, Children's National Hospital, and the Department of Neurology, George Washington School of Medicine and Health Sciences - both in Washington, D.C. (T.C.); the Department of Neonatology, Children's Minnesota, St. Paul (A.L.L.), and the Department of Pediatric and Adolescent Medicine, Mayo Clinic, Rochester (E.B.-S.) - both in Minnesota; the Department of Pediatrics, Saint Louis University School of Medicine (A.M.M.), and the Departments of Radiology (R.C.M., C.D.S.), Pediatrics (R.R., C.D.S.), and Neurology (C.D.S.), Washington University in St. Louis School of Medicine - both in St. Louis; the Department of Pediatrics, Cook Children's Medical Center, the Department of Pediatrics, Texas Christian University, and the Department of Pediatrics, University of North Texas Health Science Center, Ft. Worth (D.R.), the Department of Pediatrics, University of Texas Southwestern Medical Center, Dallas (L.C.), and Pediatrix Medical Group of San Antonio, Children's Hospital of San Antonio, and Methodist Children's Hospital, San Antonio (K.A.A.) - all in Texas; the Department of Pediatrics, Indiana University School of Medicine, Indianapolis (U.M., G.M.S.); the Department of Pediatrics, Children's Hospital of Philadelphia, and the Department of Pediatrics, University of Pennsylvania Perelman School of Medicine, Philadelphia (J.F.), and the Department of Pediatrics, University of Pittsburgh School of Medicine, the Department of Pediatrics, UPMC Children's Hospital of Pittsburgh, and the Department of Pediatrics, UPMC Magee-Womens Hospital, Pittsburgh (T.D.Y.) - all in Pennsylvania; the Department of Pediatrics, Vanderbilt University Medical Center, Nashville (J.-H.W.); the Department of Pediatrics, University of Utah, Salt Lake City (M.B.); the Department of Pediatrics, University of New Mexico School of Medicine, Albuquerque (J.R.L.); the Department of Pediatrics, Boston University Medical Center, Boston (K.C.K.K.); the Department of Pediatrics, University of North Carolina at Chapel Hill School of Medicine, Chapel Hill (T.M.O.); the Department of Pediatrics, Nationwide Children's Hospital, Columbus (K.L.B.), and the Department of Pediatrics, Cincinnati Children's Hospital Medical Center, and the Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati (S.M.) - all in Ohio; and the Department of Pediatrics, University of Chicago, Chicago (M.D.S.)
| | - Patrick J Heagerty
- From the Departments of Neurology (Y.W.W., A.M.G., H.C.G.), Pediatrics (Y.W.W., F.F.G., E.E.R., H.C.G.), and Epidemiology (H.C.G.), University of California, San Francisco, San Francisco, the Department of Pediatrics, Stanford University School of Medicine, Stanford (K.P.V.M., S. Bonifacio), and the Departments of Pediatrics (T.-W.W., J.L.W.) and Radiology (J.L.W., S. Bluml), Children's Hospital Los Angeles, and the Departments of Pediatrics (T.-W.W., J.L.W.) and Radiology (J.L.W., S. Bluml), University of Southern California Keck School of Medicine, Los Angeles - all in California; the Department of Biostatistics, University of Washington (B.A.C., P.J.H.), and the Department of Pediatrics, University of Washington School of Medicine (D.E.M., U.M., S.E.J.) - both in Seattle; the Department of Pediatrics, Children's Healthcare of Atlanta (N.L.M.), and the Department of Pediatrics, Emory University (N.L.M., B.B.P.) - both in Atlanta; the Division of Neurology, Children's National Hospital, and the Department of Neurology, George Washington School of Medicine and Health Sciences - both in Washington, D.C. (T.C.); the Department of Neonatology, Children's Minnesota, St. Paul (A.L.L.), and the Department of Pediatric and Adolescent Medicine, Mayo Clinic, Rochester (E.B.-S.) - both in Minnesota; the Department of Pediatrics, Saint Louis University School of Medicine (A.M.M.), and the Departments of Radiology (R.C.M., C.D.S.), Pediatrics (R.R., C.D.S.), and Neurology (C.D.S.), Washington University in St. Louis School of Medicine - both in St. Louis; the Department of Pediatrics, Cook Children's Medical Center, the Department of Pediatrics, Texas Christian University, and the Department of Pediatrics, University of North Texas Health Science Center, Ft. Worth (D.R.), the Department of Pediatrics, University of Texas Southwestern Medical Center, Dallas (L.C.), and Pediatrix Medical Group of San Antonio, Children's Hospital of San Antonio, and Methodist Children's Hospital, San Antonio (K.A.A.) - all in Texas; the Department of Pediatrics, Indiana University School of Medicine, Indianapolis (U.M., G.M.S.); the Department of Pediatrics, Children's Hospital of Philadelphia, and the Department of Pediatrics, University of Pennsylvania Perelman School of Medicine, Philadelphia (J.F.), and the Department of Pediatrics, University of Pittsburgh School of Medicine, the Department of Pediatrics, UPMC Children's Hospital of Pittsburgh, and the Department of Pediatrics, UPMC Magee-Womens Hospital, Pittsburgh (T.D.Y.) - all in Pennsylvania; the Department of Pediatrics, Vanderbilt University Medical Center, Nashville (J.-H.W.); the Department of Pediatrics, University of Utah, Salt Lake City (M.B.); the Department of Pediatrics, University of New Mexico School of Medicine, Albuquerque (J.R.L.); the Department of Pediatrics, Boston University Medical Center, Boston (K.C.K.K.); the Department of Pediatrics, University of North Carolina at Chapel Hill School of Medicine, Chapel Hill (T.M.O.); the Department of Pediatrics, Nationwide Children's Hospital, Columbus (K.L.B.), and the Department of Pediatrics, Cincinnati Children's Hospital Medical Center, and the Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati (S.M.) - all in Ohio; and the Department of Pediatrics, University of Chicago, Chicago (M.D.S.)
| | - Sandra E Juul
- From the Departments of Neurology (Y.W.W., A.M.G., H.C.G.), Pediatrics (Y.W.W., F.F.G., E.E.R., H.C.G.), and Epidemiology (H.C.G.), University of California, San Francisco, San Francisco, the Department of Pediatrics, Stanford University School of Medicine, Stanford (K.P.V.M., S. Bonifacio), and the Departments of Pediatrics (T.-W.W., J.L.W.) and Radiology (J.L.W., S. Bluml), Children's Hospital Los Angeles, and the Departments of Pediatrics (T.-W.W., J.L.W.) and Radiology (J.L.W., S. Bluml), University of Southern California Keck School of Medicine, Los Angeles - all in California; the Department of Biostatistics, University of Washington (B.A.C., P.J.H.), and the Department of Pediatrics, University of Washington School of Medicine (D.E.M., U.M., S.E.J.) - both in Seattle; the Department of Pediatrics, Children's Healthcare of Atlanta (N.L.M.), and the Department of Pediatrics, Emory University (N.L.M., B.B.P.) - both in Atlanta; the Division of Neurology, Children's National Hospital, and the Department of Neurology, George Washington School of Medicine and Health Sciences - both in Washington, D.C. (T.C.); the Department of Neonatology, Children's Minnesota, St. Paul (A.L.L.), and the Department of Pediatric and Adolescent Medicine, Mayo Clinic, Rochester (E.B.-S.) - both in Minnesota; the Department of Pediatrics, Saint Louis University School of Medicine (A.M.M.), and the Departments of Radiology (R.C.M., C.D.S.), Pediatrics (R.R., C.D.S.), and Neurology (C.D.S.), Washington University in St. Louis School of Medicine - both in St. Louis; the Department of Pediatrics, Cook Children's Medical Center, the Department of Pediatrics, Texas Christian University, and the Department of Pediatrics, University of North Texas Health Science Center, Ft. Worth (D.R.), the Department of Pediatrics, University of Texas Southwestern Medical Center, Dallas (L.C.), and Pediatrix Medical Group of San Antonio, Children's Hospital of San Antonio, and Methodist Children's Hospital, San Antonio (K.A.A.) - all in Texas; the Department of Pediatrics, Indiana University School of Medicine, Indianapolis (U.M., G.M.S.); the Department of Pediatrics, Children's Hospital of Philadelphia, and the Department of Pediatrics, University of Pennsylvania Perelman School of Medicine, Philadelphia (J.F.), and the Department of Pediatrics, University of Pittsburgh School of Medicine, the Department of Pediatrics, UPMC Children's Hospital of Pittsburgh, and the Department of Pediatrics, UPMC Magee-Womens Hospital, Pittsburgh (T.D.Y.) - all in Pennsylvania; the Department of Pediatrics, Vanderbilt University Medical Center, Nashville (J.-H.W.); the Department of Pediatrics, University of Utah, Salt Lake City (M.B.); the Department of Pediatrics, University of New Mexico School of Medicine, Albuquerque (J.R.L.); the Department of Pediatrics, Boston University Medical Center, Boston (K.C.K.K.); the Department of Pediatrics, University of North Carolina at Chapel Hill School of Medicine, Chapel Hill (T.M.O.); the Department of Pediatrics, Nationwide Children's Hospital, Columbus (K.L.B.), and the Department of Pediatrics, Cincinnati Children's Hospital Medical Center, and the Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati (S.M.) - all in Ohio; and the Department of Pediatrics, University of Chicago, Chicago (M.D.S.)
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10
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Radhakrishnan R, Vishnubhotla RV, Guckien Z, Zhao Y, Sokol GM, Haas DM, Sadhasivam S. Thalamocortical functional connectivity in infants with prenatal opioid exposure correlates with severity of neonatal opioid withdrawal syndrome. Neuroradiology 2022; 64:1649-1659. [PMID: 35410397 DOI: 10.1007/s00234-022-02939-4] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2021] [Accepted: 03/28/2022] [Indexed: 11/26/2022]
Abstract
PURPOSE Prenatal opioid exposure (POE) is a growing public health concern due to its associated adverse outcomes including neonatal opioid withdrawal syndrome (NOWS). The aim of this study was to assess alterations in thalamic functional connectivity in neonates with POE using resting-state functional magnetic resonance imaging (rs-fMRI) and identify whether these altered connectivity measures were associated with NOWS severity. METHODS In this prospective, IRB-approved study, we performed rs-fMRI in 19 infants with POE and 20 healthy control infants without POE. Following standard pre-processing, we performed seed-based functional connectivity analysis with the right and left thalamus as the regions of interest. We performed post hoc analysis in the prenatal opioid exposure group to identify associations of altered thalamocortical connectivity with severity of NOWS. P value of < .05 was considered statistically significant. RESULTS There were several regions of significantly altered thalamic to cortical functional connectivity in infants with POE compared to the healthy infants. Distinct regions of thalamocortical functional connectivity correlated with maximum modified Finnegan score. Association between thalamocortical connectivity and severity of NOWS was nominally modified by maternal psychological conditions and polysubstance use. CONCLUSION Our findings reveal prenatal opioid exposure-related alterations in thalamic functional connectivity in the infant brain that are correlated with severity of NOWS. Future studies may benefit from evaluation of thalamocortical resting state functional connectivity in infants with POE to help stratify risk of long term neurodevelopmental outcomes.
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Affiliation(s)
- Rupa Radhakrishnan
- Department of Radiology and Imaging Sciences, Indiana University School of Medicine, 705 Riley Hospital Drive, Indianapolis, IN, 46202, USA.
| | - Ramana V Vishnubhotla
- Department of Radiology and Imaging Sciences, Indiana University School of Medicine, 705 Riley Hospital Drive, Indianapolis, IN, 46202, USA
| | - Zoe Guckien
- Indiana University School of Medicine, Indianapolis, IN, USA
| | - Yi Zhao
- Department of Biostatistics and Health Data Science, Indiana University School of Medicine, Indianapolis, IN, USA
| | - Gregory M Sokol
- Department of Pediatrics, Indiana University School of Medicine, Indianapolis, IN, USA
| | - David M Haas
- Department of Obstetrics and Gynecology, Indiana University School of Medicine, Indianapolis, IN, USA
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11
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Watterberg KL, Walsh MC, Li L, Chawla S, D'Angio CT, Goldberg RN, Hintz SR, Laughon MM, Yoder BA, Kennedy KA, McDavid GE, Backstrom-Lacy C, Das A, Crawford MM, Keszler M, Sokol GM, Poindexter BB, Ambalavanan N, Hibbs AM, Truog WE, Schmidt B, Wyckoff MH, Khan AM, Garg M, Chess PR, Reynolds AM, Moallem M, Bell EF, Meyer LR, Patel RM, Van Meurs KP, Cotten CM, McGowan EC, Hines AC, Merhar S, Peralta-Carcelen M, Wilson-Costello DE, Kilbride HW, DeMauro SB, Heyne RJ, Mosquera RA, Natarajan G, Purdy IB, Lowe JR, Maitre NL, Harmon HM, Hogden LA, Adams-Chapman I, Winter S, Malcolm WF, Higgins RD. Hydrocortisone to Improve Survival without Bronchopulmonary Dysplasia. N Engl J Med 2022; 386:1121-1131. [PMID: 35320643 PMCID: PMC9107291 DOI: 10.1056/nejmoa2114897] [Citation(s) in RCA: 44] [Impact Index Per Article: 22.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/13/2023]
Abstract
BACKGROUND Bronchopulmonary dysplasia is a prevalent complication after extremely preterm birth. Inflammation with mechanical ventilation may contribute to its development. Whether hydrocortisone treatment after the second postnatal week can improve survival without bronchopulmonary dysplasia and without adverse neurodevelopmental effects is unknown. METHODS We conducted a trial involving infants who had a gestational age of less than 30 weeks and who had been intubated for at least 7 days at 14 to 28 days. Infants were randomly assigned to receive either hydrocortisone (4 mg per kilogram of body weight per day tapered over a period of 10 days) or placebo. Mandatory extubation thresholds were specified. The primary efficacy outcome was survival without moderate or severe bronchopulmonary dysplasia at 36 weeks of postmenstrual age, and the primary safety outcome was survival without moderate or severe neurodevelopmental impairment at 22 to 26 months of corrected age. RESULTS We enrolled 800 infants (mean [±SD] birth weight, 715±167 g; mean gestational age, 24.9±1.5 weeks). Survival without moderate or severe bronchopulmonary dysplasia at 36 weeks occurred in 66 of 398 infants (16.6%) in the hydrocortisone group and in 53 of 402 (13.2%) in the placebo group (adjusted rate ratio, 1.27; 95% confidence interval [CI], 0.93 to 1.74). Two-year outcomes were known for 91.0% of the infants. Survival without moderate or severe neurodevelopmental impairment occurred in 132 of 358 infants (36.9%) in the hydrocortisone group and in 134 of 359 (37.3%) in the placebo group (adjusted rate ratio, 0.98; 95% CI, 0.81 to 1.18). Hypertension that was treated with medication occurred more frequently with hydrocortisone than with placebo (4.3% vs. 1.0%). Other adverse events were similar in the two groups. CONCLUSIONS In this trial involving preterm infants, hydrocortisone treatment starting on postnatal day 14 to 28 did not result in substantially higher survival without moderate or severe bronchopulmonary dysplasia than placebo. Survival without moderate or severe neurodevelopmental impairment did not differ substantially between the two groups. (Funded by the National Institutes of Health; ClinicalTrials.gov number, NCT01353313.).
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Affiliation(s)
- Kristi L Watterberg
- From the University of New Mexico Health Sciences Center, Albuquerque (K.L.W., C.B.-L., J.R.L.); the Department of Pediatrics, Rainbow Babies and Children's Hospital, Case Western Reserve University, Cleveland (M.C.W., A.M.H., D.E.W.-C.), Cincinnati Children's Hospital Medical Center, Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati (B.B.P., S.M.), and the Department of Pediatrics, Nationwide Children's Hospital, Ohio State University College of Medicine, Columbus (M.M., N.L.M.) - all in Ohio; the Social, Statistical, and Environmental Sciences Unit, RTI International, Research Triangle Park (L.L.), the Department of Pediatrics, Duke University, Durham (R.N.G., C.M.C., W.F.M.), and the Division of Neonatal-Perinatal Medicine, Department of Pediatrics, University of North Carolina at Chapel Hill, Chapel Hill (M.M.L.) - all in North Carolina; the Department of Pediatrics, Wayne State University (S.C., G.N.), and the Department of Pediatrics, Central Michigan University (S.C.) - both in Detroit; the University of Rochester School of Medicine and Dentistry, Rochester (C.T.D., P.R.C.), and the Department of Pediatrics, University of Buffalo Women's and Children's Hospital of Buffalo, Buffalo (A.M.R.) - both in New York; the Department of Pediatrics, Division of Neonatal and Developmental Medicine, Stanford University School of Medicine and Lucile Packard Children's Hospital, Palo Alto (S.R.H., K.P.V.M.), and the Department of Pediatrics, University of California, Los Angeles, Los Angeles (M.G., I.B.P.) - both in California; the Department of Pediatrics, Division of Neonatology, University of Utah School of Medicine, Salt Lake City (B.A.Y., S.W.); the Department of Pediatrics, McGovern Medical School at the University of Texas Health Science Center at Houston, Houston (K.A.K., G.E.M., A.M.K., R.A.M.), and the Department of Pediatrics, University of Texas Southwestern Medical Center, Dallas (M.H.W., R.J.H.) - both in Texas; the Social, Statistical, and Environmental Sciences Unit, RTI International, Rockville (A.D., M.M.C.), and the Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, Bethesda (R.D.H.) - both in Maryland; the Department of Pediatrics, Women and Infants Hospital, Brown University, Providence, RI (M.K., E.C.M.); the Department of Pediatrics, Indiana University School of Medicine, Indianapolis (G.M.S., A.C.H.); Emory University School of Medicine, Department of Pediatrics, Children's Healthcare of Atlanta, Atlanta (B.B.P., R.M.P., N.L.M., I.A.-C.); the Division of Neonatology, University of Alabama at Birmingham, Birmingham (N.A., M.P.-C.); the Department of Pediatrics, Children's Mercy Hospital, Kansas City, MO (W.E.T., H.W.K.); the Department of Pediatrics, University of Pennsylvania Perelman School of Medicine, Philadelphia (B.S., S.B.D.); the Department of Pediatrics, University of Iowa, Iowa City (E.F.B., H.M.H.); the Department of Pediatrics, Sanford School of Medicine, University of South Dakota, Sioux Falls (L.R.M., L.A.H.); and the College of Health and Human Services, George Mason University, Fairfax, VA (R.D.H.)
| | - Michele C Walsh
- From the University of New Mexico Health Sciences Center, Albuquerque (K.L.W., C.B.-L., J.R.L.); the Department of Pediatrics, Rainbow Babies and Children's Hospital, Case Western Reserve University, Cleveland (M.C.W., A.M.H., D.E.W.-C.), Cincinnati Children's Hospital Medical Center, Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati (B.B.P., S.M.), and the Department of Pediatrics, Nationwide Children's Hospital, Ohio State University College of Medicine, Columbus (M.M., N.L.M.) - all in Ohio; the Social, Statistical, and Environmental Sciences Unit, RTI International, Research Triangle Park (L.L.), the Department of Pediatrics, Duke University, Durham (R.N.G., C.M.C., W.F.M.), and the Division of Neonatal-Perinatal Medicine, Department of Pediatrics, University of North Carolina at Chapel Hill, Chapel Hill (M.M.L.) - all in North Carolina; the Department of Pediatrics, Wayne State University (S.C., G.N.), and the Department of Pediatrics, Central Michigan University (S.C.) - both in Detroit; the University of Rochester School of Medicine and Dentistry, Rochester (C.T.D., P.R.C.), and the Department of Pediatrics, University of Buffalo Women's and Children's Hospital of Buffalo, Buffalo (A.M.R.) - both in New York; the Department of Pediatrics, Division of Neonatal and Developmental Medicine, Stanford University School of Medicine and Lucile Packard Children's Hospital, Palo Alto (S.R.H., K.P.V.M.), and the Department of Pediatrics, University of California, Los Angeles, Los Angeles (M.G., I.B.P.) - both in California; the Department of Pediatrics, Division of Neonatology, University of Utah School of Medicine, Salt Lake City (B.A.Y., S.W.); the Department of Pediatrics, McGovern Medical School at the University of Texas Health Science Center at Houston, Houston (K.A.K., G.E.M., A.M.K., R.A.M.), and the Department of Pediatrics, University of Texas Southwestern Medical Center, Dallas (M.H.W., R.J.H.) - both in Texas; the Social, Statistical, and Environmental Sciences Unit, RTI International, Rockville (A.D., M.M.C.), and the Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, Bethesda (R.D.H.) - both in Maryland; the Department of Pediatrics, Women and Infants Hospital, Brown University, Providence, RI (M.K., E.C.M.); the Department of Pediatrics, Indiana University School of Medicine, Indianapolis (G.M.S., A.C.H.); Emory University School of Medicine, Department of Pediatrics, Children's Healthcare of Atlanta, Atlanta (B.B.P., R.M.P., N.L.M., I.A.-C.); the Division of Neonatology, University of Alabama at Birmingham, Birmingham (N.A., M.P.-C.); the Department of Pediatrics, Children's Mercy Hospital, Kansas City, MO (W.E.T., H.W.K.); the Department of Pediatrics, University of Pennsylvania Perelman School of Medicine, Philadelphia (B.S., S.B.D.); the Department of Pediatrics, University of Iowa, Iowa City (E.F.B., H.M.H.); the Department of Pediatrics, Sanford School of Medicine, University of South Dakota, Sioux Falls (L.R.M., L.A.H.); and the College of Health and Human Services, George Mason University, Fairfax, VA (R.D.H.)
| | - Lei Li
- From the University of New Mexico Health Sciences Center, Albuquerque (K.L.W., C.B.-L., J.R.L.); the Department of Pediatrics, Rainbow Babies and Children's Hospital, Case Western Reserve University, Cleveland (M.C.W., A.M.H., D.E.W.-C.), Cincinnati Children's Hospital Medical Center, Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati (B.B.P., S.M.), and the Department of Pediatrics, Nationwide Children's Hospital, Ohio State University College of Medicine, Columbus (M.M., N.L.M.) - all in Ohio; the Social, Statistical, and Environmental Sciences Unit, RTI International, Research Triangle Park (L.L.), the Department of Pediatrics, Duke University, Durham (R.N.G., C.M.C., W.F.M.), and the Division of Neonatal-Perinatal Medicine, Department of Pediatrics, University of North Carolina at Chapel Hill, Chapel Hill (M.M.L.) - all in North Carolina; the Department of Pediatrics, Wayne State University (S.C., G.N.), and the Department of Pediatrics, Central Michigan University (S.C.) - both in Detroit; the University of Rochester School of Medicine and Dentistry, Rochester (C.T.D., P.R.C.), and the Department of Pediatrics, University of Buffalo Women's and Children's Hospital of Buffalo, Buffalo (A.M.R.) - both in New York; the Department of Pediatrics, Division of Neonatal and Developmental Medicine, Stanford University School of Medicine and Lucile Packard Children's Hospital, Palo Alto (S.R.H., K.P.V.M.), and the Department of Pediatrics, University of California, Los Angeles, Los Angeles (M.G., I.B.P.) - both in California; the Department of Pediatrics, Division of Neonatology, University of Utah School of Medicine, Salt Lake City (B.A.Y., S.W.); the Department of Pediatrics, McGovern Medical School at the University of Texas Health Science Center at Houston, Houston (K.A.K., G.E.M., A.M.K., R.A.M.), and the Department of Pediatrics, University of Texas Southwestern Medical Center, Dallas (M.H.W., R.J.H.) - both in Texas; the Social, Statistical, and Environmental Sciences Unit, RTI International, Rockville (A.D., M.M.C.), and the Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, Bethesda (R.D.H.) - both in Maryland; the Department of Pediatrics, Women and Infants Hospital, Brown University, Providence, RI (M.K., E.C.M.); the Department of Pediatrics, Indiana University School of Medicine, Indianapolis (G.M.S., A.C.H.); Emory University School of Medicine, Department of Pediatrics, Children's Healthcare of Atlanta, Atlanta (B.B.P., R.M.P., N.L.M., I.A.-C.); the Division of Neonatology, University of Alabama at Birmingham, Birmingham (N.A., M.P.-C.); the Department of Pediatrics, Children's Mercy Hospital, Kansas City, MO (W.E.T., H.W.K.); the Department of Pediatrics, University of Pennsylvania Perelman School of Medicine, Philadelphia (B.S., S.B.D.); the Department of Pediatrics, University of Iowa, Iowa City (E.F.B., H.M.H.); the Department of Pediatrics, Sanford School of Medicine, University of South Dakota, Sioux Falls (L.R.M., L.A.H.); and the College of Health and Human Services, George Mason University, Fairfax, VA (R.D.H.)
| | - Sanjay Chawla
- From the University of New Mexico Health Sciences Center, Albuquerque (K.L.W., C.B.-L., J.R.L.); the Department of Pediatrics, Rainbow Babies and Children's Hospital, Case Western Reserve University, Cleveland (M.C.W., A.M.H., D.E.W.-C.), Cincinnati Children's Hospital Medical Center, Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati (B.B.P., S.M.), and the Department of Pediatrics, Nationwide Children's Hospital, Ohio State University College of Medicine, Columbus (M.M., N.L.M.) - all in Ohio; the Social, Statistical, and Environmental Sciences Unit, RTI International, Research Triangle Park (L.L.), the Department of Pediatrics, Duke University, Durham (R.N.G., C.M.C., W.F.M.), and the Division of Neonatal-Perinatal Medicine, Department of Pediatrics, University of North Carolina at Chapel Hill, Chapel Hill (M.M.L.) - all in North Carolina; the Department of Pediatrics, Wayne State University (S.C., G.N.), and the Department of Pediatrics, Central Michigan University (S.C.) - both in Detroit; the University of Rochester School of Medicine and Dentistry, Rochester (C.T.D., P.R.C.), and the Department of Pediatrics, University of Buffalo Women's and Children's Hospital of Buffalo, Buffalo (A.M.R.) - both in New York; the Department of Pediatrics, Division of Neonatal and Developmental Medicine, Stanford University School of Medicine and Lucile Packard Children's Hospital, Palo Alto (S.R.H., K.P.V.M.), and the Department of Pediatrics, University of California, Los Angeles, Los Angeles (M.G., I.B.P.) - both in California; the Department of Pediatrics, Division of Neonatology, University of Utah School of Medicine, Salt Lake City (B.A.Y., S.W.); the Department of Pediatrics, McGovern Medical School at the University of Texas Health Science Center at Houston, Houston (K.A.K., G.E.M., A.M.K., R.A.M.), and the Department of Pediatrics, University of Texas Southwestern Medical Center, Dallas (M.H.W., R.J.H.) - both in Texas; the Social, Statistical, and Environmental Sciences Unit, RTI International, Rockville (A.D., M.M.C.), and the Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, Bethesda (R.D.H.) - both in Maryland; the Department of Pediatrics, Women and Infants Hospital, Brown University, Providence, RI (M.K., E.C.M.); the Department of Pediatrics, Indiana University School of Medicine, Indianapolis (G.M.S., A.C.H.); Emory University School of Medicine, Department of Pediatrics, Children's Healthcare of Atlanta, Atlanta (B.B.P., R.M.P., N.L.M., I.A.-C.); the Division of Neonatology, University of Alabama at Birmingham, Birmingham (N.A., M.P.-C.); the Department of Pediatrics, Children's Mercy Hospital, Kansas City, MO (W.E.T., H.W.K.); the Department of Pediatrics, University of Pennsylvania Perelman School of Medicine, Philadelphia (B.S., S.B.D.); the Department of Pediatrics, University of Iowa, Iowa City (E.F.B., H.M.H.); the Department of Pediatrics, Sanford School of Medicine, University of South Dakota, Sioux Falls (L.R.M., L.A.H.); and the College of Health and Human Services, George Mason University, Fairfax, VA (R.D.H.)
| | - Carl T D'Angio
- From the University of New Mexico Health Sciences Center, Albuquerque (K.L.W., C.B.-L., J.R.L.); the Department of Pediatrics, Rainbow Babies and Children's Hospital, Case Western Reserve University, Cleveland (M.C.W., A.M.H., D.E.W.-C.), Cincinnati Children's Hospital Medical Center, Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati (B.B.P., S.M.), and the Department of Pediatrics, Nationwide Children's Hospital, Ohio State University College of Medicine, Columbus (M.M., N.L.M.) - all in Ohio; the Social, Statistical, and Environmental Sciences Unit, RTI International, Research Triangle Park (L.L.), the Department of Pediatrics, Duke University, Durham (R.N.G., C.M.C., W.F.M.), and the Division of Neonatal-Perinatal Medicine, Department of Pediatrics, University of North Carolina at Chapel Hill, Chapel Hill (M.M.L.) - all in North Carolina; the Department of Pediatrics, Wayne State University (S.C., G.N.), and the Department of Pediatrics, Central Michigan University (S.C.) - both in Detroit; the University of Rochester School of Medicine and Dentistry, Rochester (C.T.D., P.R.C.), and the Department of Pediatrics, University of Buffalo Women's and Children's Hospital of Buffalo, Buffalo (A.M.R.) - both in New York; the Department of Pediatrics, Division of Neonatal and Developmental Medicine, Stanford University School of Medicine and Lucile Packard Children's Hospital, Palo Alto (S.R.H., K.P.V.M.), and the Department of Pediatrics, University of California, Los Angeles, Los Angeles (M.G., I.B.P.) - both in California; the Department of Pediatrics, Division of Neonatology, University of Utah School of Medicine, Salt Lake City (B.A.Y., S.W.); the Department of Pediatrics, McGovern Medical School at the University of Texas Health Science Center at Houston, Houston (K.A.K., G.E.M., A.M.K., R.A.M.), and the Department of Pediatrics, University of Texas Southwestern Medical Center, Dallas (M.H.W., R.J.H.) - both in Texas; the Social, Statistical, and Environmental Sciences Unit, RTI International, Rockville (A.D., M.M.C.), and the Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, Bethesda (R.D.H.) - both in Maryland; the Department of Pediatrics, Women and Infants Hospital, Brown University, Providence, RI (M.K., E.C.M.); the Department of Pediatrics, Indiana University School of Medicine, Indianapolis (G.M.S., A.C.H.); Emory University School of Medicine, Department of Pediatrics, Children's Healthcare of Atlanta, Atlanta (B.B.P., R.M.P., N.L.M., I.A.-C.); the Division of Neonatology, University of Alabama at Birmingham, Birmingham (N.A., M.P.-C.); the Department of Pediatrics, Children's Mercy Hospital, Kansas City, MO (W.E.T., H.W.K.); the Department of Pediatrics, University of Pennsylvania Perelman School of Medicine, Philadelphia (B.S., S.B.D.); the Department of Pediatrics, University of Iowa, Iowa City (E.F.B., H.M.H.); the Department of Pediatrics, Sanford School of Medicine, University of South Dakota, Sioux Falls (L.R.M., L.A.H.); and the College of Health and Human Services, George Mason University, Fairfax, VA (R.D.H.)
| | - Ronald N Goldberg
- From the University of New Mexico Health Sciences Center, Albuquerque (K.L.W., C.B.-L., J.R.L.); the Department of Pediatrics, Rainbow Babies and Children's Hospital, Case Western Reserve University, Cleveland (M.C.W., A.M.H., D.E.W.-C.), Cincinnati Children's Hospital Medical Center, Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati (B.B.P., S.M.), and the Department of Pediatrics, Nationwide Children's Hospital, Ohio State University College of Medicine, Columbus (M.M., N.L.M.) - all in Ohio; the Social, Statistical, and Environmental Sciences Unit, RTI International, Research Triangle Park (L.L.), the Department of Pediatrics, Duke University, Durham (R.N.G., C.M.C., W.F.M.), and the Division of Neonatal-Perinatal Medicine, Department of Pediatrics, University of North Carolina at Chapel Hill, Chapel Hill (M.M.L.) - all in North Carolina; the Department of Pediatrics, Wayne State University (S.C., G.N.), and the Department of Pediatrics, Central Michigan University (S.C.) - both in Detroit; the University of Rochester School of Medicine and Dentistry, Rochester (C.T.D., P.R.C.), and the Department of Pediatrics, University of Buffalo Women's and Children's Hospital of Buffalo, Buffalo (A.M.R.) - both in New York; the Department of Pediatrics, Division of Neonatal and Developmental Medicine, Stanford University School of Medicine and Lucile Packard Children's Hospital, Palo Alto (S.R.H., K.P.V.M.), and the Department of Pediatrics, University of California, Los Angeles, Los Angeles (M.G., I.B.P.) - both in California; the Department of Pediatrics, Division of Neonatology, University of Utah School of Medicine, Salt Lake City (B.A.Y., S.W.); the Department of Pediatrics, McGovern Medical School at the University of Texas Health Science Center at Houston, Houston (K.A.K., G.E.M., A.M.K., R.A.M.), and the Department of Pediatrics, University of Texas Southwestern Medical Center, Dallas (M.H.W., R.J.H.) - both in Texas; the Social, Statistical, and Environmental Sciences Unit, RTI International, Rockville (A.D., M.M.C.), and the Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, Bethesda (R.D.H.) - both in Maryland; the Department of Pediatrics, Women and Infants Hospital, Brown University, Providence, RI (M.K., E.C.M.); the Department of Pediatrics, Indiana University School of Medicine, Indianapolis (G.M.S., A.C.H.); Emory University School of Medicine, Department of Pediatrics, Children's Healthcare of Atlanta, Atlanta (B.B.P., R.M.P., N.L.M., I.A.-C.); the Division of Neonatology, University of Alabama at Birmingham, Birmingham (N.A., M.P.-C.); the Department of Pediatrics, Children's Mercy Hospital, Kansas City, MO (W.E.T., H.W.K.); the Department of Pediatrics, University of Pennsylvania Perelman School of Medicine, Philadelphia (B.S., S.B.D.); the Department of Pediatrics, University of Iowa, Iowa City (E.F.B., H.M.H.); the Department of Pediatrics, Sanford School of Medicine, University of South Dakota, Sioux Falls (L.R.M., L.A.H.); and the College of Health and Human Services, George Mason University, Fairfax, VA (R.D.H.)
| | - Susan R Hintz
- From the University of New Mexico Health Sciences Center, Albuquerque (K.L.W., C.B.-L., J.R.L.); the Department of Pediatrics, Rainbow Babies and Children's Hospital, Case Western Reserve University, Cleveland (M.C.W., A.M.H., D.E.W.-C.), Cincinnati Children's Hospital Medical Center, Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati (B.B.P., S.M.), and the Department of Pediatrics, Nationwide Children's Hospital, Ohio State University College of Medicine, Columbus (M.M., N.L.M.) - all in Ohio; the Social, Statistical, and Environmental Sciences Unit, RTI International, Research Triangle Park (L.L.), the Department of Pediatrics, Duke University, Durham (R.N.G., C.M.C., W.F.M.), and the Division of Neonatal-Perinatal Medicine, Department of Pediatrics, University of North Carolina at Chapel Hill, Chapel Hill (M.M.L.) - all in North Carolina; the Department of Pediatrics, Wayne State University (S.C., G.N.), and the Department of Pediatrics, Central Michigan University (S.C.) - both in Detroit; the University of Rochester School of Medicine and Dentistry, Rochester (C.T.D., P.R.C.), and the Department of Pediatrics, University of Buffalo Women's and Children's Hospital of Buffalo, Buffalo (A.M.R.) - both in New York; the Department of Pediatrics, Division of Neonatal and Developmental Medicine, Stanford University School of Medicine and Lucile Packard Children's Hospital, Palo Alto (S.R.H., K.P.V.M.), and the Department of Pediatrics, University of California, Los Angeles, Los Angeles (M.G., I.B.P.) - both in California; the Department of Pediatrics, Division of Neonatology, University of Utah School of Medicine, Salt Lake City (B.A.Y., S.W.); the Department of Pediatrics, McGovern Medical School at the University of Texas Health Science Center at Houston, Houston (K.A.K., G.E.M., A.M.K., R.A.M.), and the Department of Pediatrics, University of Texas Southwestern Medical Center, Dallas (M.H.W., R.J.H.) - both in Texas; the Social, Statistical, and Environmental Sciences Unit, RTI International, Rockville (A.D., M.M.C.), and the Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, Bethesda (R.D.H.) - both in Maryland; the Department of Pediatrics, Women and Infants Hospital, Brown University, Providence, RI (M.K., E.C.M.); the Department of Pediatrics, Indiana University School of Medicine, Indianapolis (G.M.S., A.C.H.); Emory University School of Medicine, Department of Pediatrics, Children's Healthcare of Atlanta, Atlanta (B.B.P., R.M.P., N.L.M., I.A.-C.); the Division of Neonatology, University of Alabama at Birmingham, Birmingham (N.A., M.P.-C.); the Department of Pediatrics, Children's Mercy Hospital, Kansas City, MO (W.E.T., H.W.K.); the Department of Pediatrics, University of Pennsylvania Perelman School of Medicine, Philadelphia (B.S., S.B.D.); the Department of Pediatrics, University of Iowa, Iowa City (E.F.B., H.M.H.); the Department of Pediatrics, Sanford School of Medicine, University of South Dakota, Sioux Falls (L.R.M., L.A.H.); and the College of Health and Human Services, George Mason University, Fairfax, VA (R.D.H.)
| | - Matthew M Laughon
- From the University of New Mexico Health Sciences Center, Albuquerque (K.L.W., C.B.-L., J.R.L.); the Department of Pediatrics, Rainbow Babies and Children's Hospital, Case Western Reserve University, Cleveland (M.C.W., A.M.H., D.E.W.-C.), Cincinnati Children's Hospital Medical Center, Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati (B.B.P., S.M.), and the Department of Pediatrics, Nationwide Children's Hospital, Ohio State University College of Medicine, Columbus (M.M., N.L.M.) - all in Ohio; the Social, Statistical, and Environmental Sciences Unit, RTI International, Research Triangle Park (L.L.), the Department of Pediatrics, Duke University, Durham (R.N.G., C.M.C., W.F.M.), and the Division of Neonatal-Perinatal Medicine, Department of Pediatrics, University of North Carolina at Chapel Hill, Chapel Hill (M.M.L.) - all in North Carolina; the Department of Pediatrics, Wayne State University (S.C., G.N.), and the Department of Pediatrics, Central Michigan University (S.C.) - both in Detroit; the University of Rochester School of Medicine and Dentistry, Rochester (C.T.D., P.R.C.), and the Department of Pediatrics, University of Buffalo Women's and Children's Hospital of Buffalo, Buffalo (A.M.R.) - both in New York; the Department of Pediatrics, Division of Neonatal and Developmental Medicine, Stanford University School of Medicine and Lucile Packard Children's Hospital, Palo Alto (S.R.H., K.P.V.M.), and the Department of Pediatrics, University of California, Los Angeles, Los Angeles (M.G., I.B.P.) - both in California; the Department of Pediatrics, Division of Neonatology, University of Utah School of Medicine, Salt Lake City (B.A.Y., S.W.); the Department of Pediatrics, McGovern Medical School at the University of Texas Health Science Center at Houston, Houston (K.A.K., G.E.M., A.M.K., R.A.M.), and the Department of Pediatrics, University of Texas Southwestern Medical Center, Dallas (M.H.W., R.J.H.) - both in Texas; the Social, Statistical, and Environmental Sciences Unit, RTI International, Rockville (A.D., M.M.C.), and the Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, Bethesda (R.D.H.) - both in Maryland; the Department of Pediatrics, Women and Infants Hospital, Brown University, Providence, RI (M.K., E.C.M.); the Department of Pediatrics, Indiana University School of Medicine, Indianapolis (G.M.S., A.C.H.); Emory University School of Medicine, Department of Pediatrics, Children's Healthcare of Atlanta, Atlanta (B.B.P., R.M.P., N.L.M., I.A.-C.); the Division of Neonatology, University of Alabama at Birmingham, Birmingham (N.A., M.P.-C.); the Department of Pediatrics, Children's Mercy Hospital, Kansas City, MO (W.E.T., H.W.K.); the Department of Pediatrics, University of Pennsylvania Perelman School of Medicine, Philadelphia (B.S., S.B.D.); the Department of Pediatrics, University of Iowa, Iowa City (E.F.B., H.M.H.); the Department of Pediatrics, Sanford School of Medicine, University of South Dakota, Sioux Falls (L.R.M., L.A.H.); and the College of Health and Human Services, George Mason University, Fairfax, VA (R.D.H.)
| | - Bradley A Yoder
- From the University of New Mexico Health Sciences Center, Albuquerque (K.L.W., C.B.-L., J.R.L.); the Department of Pediatrics, Rainbow Babies and Children's Hospital, Case Western Reserve University, Cleveland (M.C.W., A.M.H., D.E.W.-C.), Cincinnati Children's Hospital Medical Center, Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati (B.B.P., S.M.), and the Department of Pediatrics, Nationwide Children's Hospital, Ohio State University College of Medicine, Columbus (M.M., N.L.M.) - all in Ohio; the Social, Statistical, and Environmental Sciences Unit, RTI International, Research Triangle Park (L.L.), the Department of Pediatrics, Duke University, Durham (R.N.G., C.M.C., W.F.M.), and the Division of Neonatal-Perinatal Medicine, Department of Pediatrics, University of North Carolina at Chapel Hill, Chapel Hill (M.M.L.) - all in North Carolina; the Department of Pediatrics, Wayne State University (S.C., G.N.), and the Department of Pediatrics, Central Michigan University (S.C.) - both in Detroit; the University of Rochester School of Medicine and Dentistry, Rochester (C.T.D., P.R.C.), and the Department of Pediatrics, University of Buffalo Women's and Children's Hospital of Buffalo, Buffalo (A.M.R.) - both in New York; the Department of Pediatrics, Division of Neonatal and Developmental Medicine, Stanford University School of Medicine and Lucile Packard Children's Hospital, Palo Alto (S.R.H., K.P.V.M.), and the Department of Pediatrics, University of California, Los Angeles, Los Angeles (M.G., I.B.P.) - both in California; the Department of Pediatrics, Division of Neonatology, University of Utah School of Medicine, Salt Lake City (B.A.Y., S.W.); the Department of Pediatrics, McGovern Medical School at the University of Texas Health Science Center at Houston, Houston (K.A.K., G.E.M., A.M.K., R.A.M.), and the Department of Pediatrics, University of Texas Southwestern Medical Center, Dallas (M.H.W., R.J.H.) - both in Texas; the Social, Statistical, and Environmental Sciences Unit, RTI International, Rockville (A.D., M.M.C.), and the Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, Bethesda (R.D.H.) - both in Maryland; the Department of Pediatrics, Women and Infants Hospital, Brown University, Providence, RI (M.K., E.C.M.); the Department of Pediatrics, Indiana University School of Medicine, Indianapolis (G.M.S., A.C.H.); Emory University School of Medicine, Department of Pediatrics, Children's Healthcare of Atlanta, Atlanta (B.B.P., R.M.P., N.L.M., I.A.-C.); the Division of Neonatology, University of Alabama at Birmingham, Birmingham (N.A., M.P.-C.); the Department of Pediatrics, Children's Mercy Hospital, Kansas City, MO (W.E.T., H.W.K.); the Department of Pediatrics, University of Pennsylvania Perelman School of Medicine, Philadelphia (B.S., S.B.D.); the Department of Pediatrics, University of Iowa, Iowa City (E.F.B., H.M.H.); the Department of Pediatrics, Sanford School of Medicine, University of South Dakota, Sioux Falls (L.R.M., L.A.H.); and the College of Health and Human Services, George Mason University, Fairfax, VA (R.D.H.)
| | - Kathleen A Kennedy
- From the University of New Mexico Health Sciences Center, Albuquerque (K.L.W., C.B.-L., J.R.L.); the Department of Pediatrics, Rainbow Babies and Children's Hospital, Case Western Reserve University, Cleveland (M.C.W., A.M.H., D.E.W.-C.), Cincinnati Children's Hospital Medical Center, Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati (B.B.P., S.M.), and the Department of Pediatrics, Nationwide Children's Hospital, Ohio State University College of Medicine, Columbus (M.M., N.L.M.) - all in Ohio; the Social, Statistical, and Environmental Sciences Unit, RTI International, Research Triangle Park (L.L.), the Department of Pediatrics, Duke University, Durham (R.N.G., C.M.C., W.F.M.), and the Division of Neonatal-Perinatal Medicine, Department of Pediatrics, University of North Carolina at Chapel Hill, Chapel Hill (M.M.L.) - all in North Carolina; the Department of Pediatrics, Wayne State University (S.C., G.N.), and the Department of Pediatrics, Central Michigan University (S.C.) - both in Detroit; the University of Rochester School of Medicine and Dentistry, Rochester (C.T.D., P.R.C.), and the Department of Pediatrics, University of Buffalo Women's and Children's Hospital of Buffalo, Buffalo (A.M.R.) - both in New York; the Department of Pediatrics, Division of Neonatal and Developmental Medicine, Stanford University School of Medicine and Lucile Packard Children's Hospital, Palo Alto (S.R.H., K.P.V.M.), and the Department of Pediatrics, University of California, Los Angeles, Los Angeles (M.G., I.B.P.) - both in California; the Department of Pediatrics, Division of Neonatology, University of Utah School of Medicine, Salt Lake City (B.A.Y., S.W.); the Department of Pediatrics, McGovern Medical School at the University of Texas Health Science Center at Houston, Houston (K.A.K., G.E.M., A.M.K., R.A.M.), and the Department of Pediatrics, University of Texas Southwestern Medical Center, Dallas (M.H.W., R.J.H.) - both in Texas; the Social, Statistical, and Environmental Sciences Unit, RTI International, Rockville (A.D., M.M.C.), and the Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, Bethesda (R.D.H.) - both in Maryland; the Department of Pediatrics, Women and Infants Hospital, Brown University, Providence, RI (M.K., E.C.M.); the Department of Pediatrics, Indiana University School of Medicine, Indianapolis (G.M.S., A.C.H.); Emory University School of Medicine, Department of Pediatrics, Children's Healthcare of Atlanta, Atlanta (B.B.P., R.M.P., N.L.M., I.A.-C.); the Division of Neonatology, University of Alabama at Birmingham, Birmingham (N.A., M.P.-C.); the Department of Pediatrics, Children's Mercy Hospital, Kansas City, MO (W.E.T., H.W.K.); the Department of Pediatrics, University of Pennsylvania Perelman School of Medicine, Philadelphia (B.S., S.B.D.); the Department of Pediatrics, University of Iowa, Iowa City (E.F.B., H.M.H.); the Department of Pediatrics, Sanford School of Medicine, University of South Dakota, Sioux Falls (L.R.M., L.A.H.); and the College of Health and Human Services, George Mason University, Fairfax, VA (R.D.H.)
| | - Georgia E McDavid
- From the University of New Mexico Health Sciences Center, Albuquerque (K.L.W., C.B.-L., J.R.L.); the Department of Pediatrics, Rainbow Babies and Children's Hospital, Case Western Reserve University, Cleveland (M.C.W., A.M.H., D.E.W.-C.), Cincinnati Children's Hospital Medical Center, Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati (B.B.P., S.M.), and the Department of Pediatrics, Nationwide Children's Hospital, Ohio State University College of Medicine, Columbus (M.M., N.L.M.) - all in Ohio; the Social, Statistical, and Environmental Sciences Unit, RTI International, Research Triangle Park (L.L.), the Department of Pediatrics, Duke University, Durham (R.N.G., C.M.C., W.F.M.), and the Division of Neonatal-Perinatal Medicine, Department of Pediatrics, University of North Carolina at Chapel Hill, Chapel Hill (M.M.L.) - all in North Carolina; the Department of Pediatrics, Wayne State University (S.C., G.N.), and the Department of Pediatrics, Central Michigan University (S.C.) - both in Detroit; the University of Rochester School of Medicine and Dentistry, Rochester (C.T.D., P.R.C.), and the Department of Pediatrics, University of Buffalo Women's and Children's Hospital of Buffalo, Buffalo (A.M.R.) - both in New York; the Department of Pediatrics, Division of Neonatal and Developmental Medicine, Stanford University School of Medicine and Lucile Packard Children's Hospital, Palo Alto (S.R.H., K.P.V.M.), and the Department of Pediatrics, University of California, Los Angeles, Los Angeles (M.G., I.B.P.) - both in California; the Department of Pediatrics, Division of Neonatology, University of Utah School of Medicine, Salt Lake City (B.A.Y., S.W.); the Department of Pediatrics, McGovern Medical School at the University of Texas Health Science Center at Houston, Houston (K.A.K., G.E.M., A.M.K., R.A.M.), and the Department of Pediatrics, University of Texas Southwestern Medical Center, Dallas (M.H.W., R.J.H.) - both in Texas; the Social, Statistical, and Environmental Sciences Unit, RTI International, Rockville (A.D., M.M.C.), and the Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, Bethesda (R.D.H.) - both in Maryland; the Department of Pediatrics, Women and Infants Hospital, Brown University, Providence, RI (M.K., E.C.M.); the Department of Pediatrics, Indiana University School of Medicine, Indianapolis (G.M.S., A.C.H.); Emory University School of Medicine, Department of Pediatrics, Children's Healthcare of Atlanta, Atlanta (B.B.P., R.M.P., N.L.M., I.A.-C.); the Division of Neonatology, University of Alabama at Birmingham, Birmingham (N.A., M.P.-C.); the Department of Pediatrics, Children's Mercy Hospital, Kansas City, MO (W.E.T., H.W.K.); the Department of Pediatrics, University of Pennsylvania Perelman School of Medicine, Philadelphia (B.S., S.B.D.); the Department of Pediatrics, University of Iowa, Iowa City (E.F.B., H.M.H.); the Department of Pediatrics, Sanford School of Medicine, University of South Dakota, Sioux Falls (L.R.M., L.A.H.); and the College of Health and Human Services, George Mason University, Fairfax, VA (R.D.H.)
| | - Conra Backstrom-Lacy
- From the University of New Mexico Health Sciences Center, Albuquerque (K.L.W., C.B.-L., J.R.L.); the Department of Pediatrics, Rainbow Babies and Children's Hospital, Case Western Reserve University, Cleveland (M.C.W., A.M.H., D.E.W.-C.), Cincinnati Children's Hospital Medical Center, Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati (B.B.P., S.M.), and the Department of Pediatrics, Nationwide Children's Hospital, Ohio State University College of Medicine, Columbus (M.M., N.L.M.) - all in Ohio; the Social, Statistical, and Environmental Sciences Unit, RTI International, Research Triangle Park (L.L.), the Department of Pediatrics, Duke University, Durham (R.N.G., C.M.C., W.F.M.), and the Division of Neonatal-Perinatal Medicine, Department of Pediatrics, University of North Carolina at Chapel Hill, Chapel Hill (M.M.L.) - all in North Carolina; the Department of Pediatrics, Wayne State University (S.C., G.N.), and the Department of Pediatrics, Central Michigan University (S.C.) - both in Detroit; the University of Rochester School of Medicine and Dentistry, Rochester (C.T.D., P.R.C.), and the Department of Pediatrics, University of Buffalo Women's and Children's Hospital of Buffalo, Buffalo (A.M.R.) - both in New York; the Department of Pediatrics, Division of Neonatal and Developmental Medicine, Stanford University School of Medicine and Lucile Packard Children's Hospital, Palo Alto (S.R.H., K.P.V.M.), and the Department of Pediatrics, University of California, Los Angeles, Los Angeles (M.G., I.B.P.) - both in California; the Department of Pediatrics, Division of Neonatology, University of Utah School of Medicine, Salt Lake City (B.A.Y., S.W.); the Department of Pediatrics, McGovern Medical School at the University of Texas Health Science Center at Houston, Houston (K.A.K., G.E.M., A.M.K., R.A.M.), and the Department of Pediatrics, University of Texas Southwestern Medical Center, Dallas (M.H.W., R.J.H.) - both in Texas; the Social, Statistical, and Environmental Sciences Unit, RTI International, Rockville (A.D., M.M.C.), and the Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, Bethesda (R.D.H.) - both in Maryland; the Department of Pediatrics, Women and Infants Hospital, Brown University, Providence, RI (M.K., E.C.M.); the Department of Pediatrics, Indiana University School of Medicine, Indianapolis (G.M.S., A.C.H.); Emory University School of Medicine, Department of Pediatrics, Children's Healthcare of Atlanta, Atlanta (B.B.P., R.M.P., N.L.M., I.A.-C.); the Division of Neonatology, University of Alabama at Birmingham, Birmingham (N.A., M.P.-C.); the Department of Pediatrics, Children's Mercy Hospital, Kansas City, MO (W.E.T., H.W.K.); the Department of Pediatrics, University of Pennsylvania Perelman School of Medicine, Philadelphia (B.S., S.B.D.); the Department of Pediatrics, University of Iowa, Iowa City (E.F.B., H.M.H.); the Department of Pediatrics, Sanford School of Medicine, University of South Dakota, Sioux Falls (L.R.M., L.A.H.); and the College of Health and Human Services, George Mason University, Fairfax, VA (R.D.H.)
| | - Abhik Das
- From the University of New Mexico Health Sciences Center, Albuquerque (K.L.W., C.B.-L., J.R.L.); the Department of Pediatrics, Rainbow Babies and Children's Hospital, Case Western Reserve University, Cleveland (M.C.W., A.M.H., D.E.W.-C.), Cincinnati Children's Hospital Medical Center, Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati (B.B.P., S.M.), and the Department of Pediatrics, Nationwide Children's Hospital, Ohio State University College of Medicine, Columbus (M.M., N.L.M.) - all in Ohio; the Social, Statistical, and Environmental Sciences Unit, RTI International, Research Triangle Park (L.L.), the Department of Pediatrics, Duke University, Durham (R.N.G., C.M.C., W.F.M.), and the Division of Neonatal-Perinatal Medicine, Department of Pediatrics, University of North Carolina at Chapel Hill, Chapel Hill (M.M.L.) - all in North Carolina; the Department of Pediatrics, Wayne State University (S.C., G.N.), and the Department of Pediatrics, Central Michigan University (S.C.) - both in Detroit; the University of Rochester School of Medicine and Dentistry, Rochester (C.T.D., P.R.C.), and the Department of Pediatrics, University of Buffalo Women's and Children's Hospital of Buffalo, Buffalo (A.M.R.) - both in New York; the Department of Pediatrics, Division of Neonatal and Developmental Medicine, Stanford University School of Medicine and Lucile Packard Children's Hospital, Palo Alto (S.R.H., K.P.V.M.), and the Department of Pediatrics, University of California, Los Angeles, Los Angeles (M.G., I.B.P.) - both in California; the Department of Pediatrics, Division of Neonatology, University of Utah School of Medicine, Salt Lake City (B.A.Y., S.W.); the Department of Pediatrics, McGovern Medical School at the University of Texas Health Science Center at Houston, Houston (K.A.K., G.E.M., A.M.K., R.A.M.), and the Department of Pediatrics, University of Texas Southwestern Medical Center, Dallas (M.H.W., R.J.H.) - both in Texas; the Social, Statistical, and Environmental Sciences Unit, RTI International, Rockville (A.D., M.M.C.), and the Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, Bethesda (R.D.H.) - both in Maryland; the Department of Pediatrics, Women and Infants Hospital, Brown University, Providence, RI (M.K., E.C.M.); the Department of Pediatrics, Indiana University School of Medicine, Indianapolis (G.M.S., A.C.H.); Emory University School of Medicine, Department of Pediatrics, Children's Healthcare of Atlanta, Atlanta (B.B.P., R.M.P., N.L.M., I.A.-C.); the Division of Neonatology, University of Alabama at Birmingham, Birmingham (N.A., M.P.-C.); the Department of Pediatrics, Children's Mercy Hospital, Kansas City, MO (W.E.T., H.W.K.); the Department of Pediatrics, University of Pennsylvania Perelman School of Medicine, Philadelphia (B.S., S.B.D.); the Department of Pediatrics, University of Iowa, Iowa City (E.F.B., H.M.H.); the Department of Pediatrics, Sanford School of Medicine, University of South Dakota, Sioux Falls (L.R.M., L.A.H.); and the College of Health and Human Services, George Mason University, Fairfax, VA (R.D.H.)
| | - Margaret M Crawford
- From the University of New Mexico Health Sciences Center, Albuquerque (K.L.W., C.B.-L., J.R.L.); the Department of Pediatrics, Rainbow Babies and Children's Hospital, Case Western Reserve University, Cleveland (M.C.W., A.M.H., D.E.W.-C.), Cincinnati Children's Hospital Medical Center, Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati (B.B.P., S.M.), and the Department of Pediatrics, Nationwide Children's Hospital, Ohio State University College of Medicine, Columbus (M.M., N.L.M.) - all in Ohio; the Social, Statistical, and Environmental Sciences Unit, RTI International, Research Triangle Park (L.L.), the Department of Pediatrics, Duke University, Durham (R.N.G., C.M.C., W.F.M.), and the Division of Neonatal-Perinatal Medicine, Department of Pediatrics, University of North Carolina at Chapel Hill, Chapel Hill (M.M.L.) - all in North Carolina; the Department of Pediatrics, Wayne State University (S.C., G.N.), and the Department of Pediatrics, Central Michigan University (S.C.) - both in Detroit; the University of Rochester School of Medicine and Dentistry, Rochester (C.T.D., P.R.C.), and the Department of Pediatrics, University of Buffalo Women's and Children's Hospital of Buffalo, Buffalo (A.M.R.) - both in New York; the Department of Pediatrics, Division of Neonatal and Developmental Medicine, Stanford University School of Medicine and Lucile Packard Children's Hospital, Palo Alto (S.R.H., K.P.V.M.), and the Department of Pediatrics, University of California, Los Angeles, Los Angeles (M.G., I.B.P.) - both in California; the Department of Pediatrics, Division of Neonatology, University of Utah School of Medicine, Salt Lake City (B.A.Y., S.W.); the Department of Pediatrics, McGovern Medical School at the University of Texas Health Science Center at Houston, Houston (K.A.K., G.E.M., A.M.K., R.A.M.), and the Department of Pediatrics, University of Texas Southwestern Medical Center, Dallas (M.H.W., R.J.H.) - both in Texas; the Social, Statistical, and Environmental Sciences Unit, RTI International, Rockville (A.D., M.M.C.), and the Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, Bethesda (R.D.H.) - both in Maryland; the Department of Pediatrics, Women and Infants Hospital, Brown University, Providence, RI (M.K., E.C.M.); the Department of Pediatrics, Indiana University School of Medicine, Indianapolis (G.M.S., A.C.H.); Emory University School of Medicine, Department of Pediatrics, Children's Healthcare of Atlanta, Atlanta (B.B.P., R.M.P., N.L.M., I.A.-C.); the Division of Neonatology, University of Alabama at Birmingham, Birmingham (N.A., M.P.-C.); the Department of Pediatrics, Children's Mercy Hospital, Kansas City, MO (W.E.T., H.W.K.); the Department of Pediatrics, University of Pennsylvania Perelman School of Medicine, Philadelphia (B.S., S.B.D.); the Department of Pediatrics, University of Iowa, Iowa City (E.F.B., H.M.H.); the Department of Pediatrics, Sanford School of Medicine, University of South Dakota, Sioux Falls (L.R.M., L.A.H.); and the College of Health and Human Services, George Mason University, Fairfax, VA (R.D.H.)
| | - Martin Keszler
- From the University of New Mexico Health Sciences Center, Albuquerque (K.L.W., C.B.-L., J.R.L.); the Department of Pediatrics, Rainbow Babies and Children's Hospital, Case Western Reserve University, Cleveland (M.C.W., A.M.H., D.E.W.-C.), Cincinnati Children's Hospital Medical Center, Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati (B.B.P., S.M.), and the Department of Pediatrics, Nationwide Children's Hospital, Ohio State University College of Medicine, Columbus (M.M., N.L.M.) - all in Ohio; the Social, Statistical, and Environmental Sciences Unit, RTI International, Research Triangle Park (L.L.), the Department of Pediatrics, Duke University, Durham (R.N.G., C.M.C., W.F.M.), and the Division of Neonatal-Perinatal Medicine, Department of Pediatrics, University of North Carolina at Chapel Hill, Chapel Hill (M.M.L.) - all in North Carolina; the Department of Pediatrics, Wayne State University (S.C., G.N.), and the Department of Pediatrics, Central Michigan University (S.C.) - both in Detroit; the University of Rochester School of Medicine and Dentistry, Rochester (C.T.D., P.R.C.), and the Department of Pediatrics, University of Buffalo Women's and Children's Hospital of Buffalo, Buffalo (A.M.R.) - both in New York; the Department of Pediatrics, Division of Neonatal and Developmental Medicine, Stanford University School of Medicine and Lucile Packard Children's Hospital, Palo Alto (S.R.H., K.P.V.M.), and the Department of Pediatrics, University of California, Los Angeles, Los Angeles (M.G., I.B.P.) - both in California; the Department of Pediatrics, Division of Neonatology, University of Utah School of Medicine, Salt Lake City (B.A.Y., S.W.); the Department of Pediatrics, McGovern Medical School at the University of Texas Health Science Center at Houston, Houston (K.A.K., G.E.M., A.M.K., R.A.M.), and the Department of Pediatrics, University of Texas Southwestern Medical Center, Dallas (M.H.W., R.J.H.) - both in Texas; the Social, Statistical, and Environmental Sciences Unit, RTI International, Rockville (A.D., M.M.C.), and the Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, Bethesda (R.D.H.) - both in Maryland; the Department of Pediatrics, Women and Infants Hospital, Brown University, Providence, RI (M.K., E.C.M.); the Department of Pediatrics, Indiana University School of Medicine, Indianapolis (G.M.S., A.C.H.); Emory University School of Medicine, Department of Pediatrics, Children's Healthcare of Atlanta, Atlanta (B.B.P., R.M.P., N.L.M., I.A.-C.); the Division of Neonatology, University of Alabama at Birmingham, Birmingham (N.A., M.P.-C.); the Department of Pediatrics, Children's Mercy Hospital, Kansas City, MO (W.E.T., H.W.K.); the Department of Pediatrics, University of Pennsylvania Perelman School of Medicine, Philadelphia (B.S., S.B.D.); the Department of Pediatrics, University of Iowa, Iowa City (E.F.B., H.M.H.); the Department of Pediatrics, Sanford School of Medicine, University of South Dakota, Sioux Falls (L.R.M., L.A.H.); and the College of Health and Human Services, George Mason University, Fairfax, VA (R.D.H.)
| | - Gregory M Sokol
- From the University of New Mexico Health Sciences Center, Albuquerque (K.L.W., C.B.-L., J.R.L.); the Department of Pediatrics, Rainbow Babies and Children's Hospital, Case Western Reserve University, Cleveland (M.C.W., A.M.H., D.E.W.-C.), Cincinnati Children's Hospital Medical Center, Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati (B.B.P., S.M.), and the Department of Pediatrics, Nationwide Children's Hospital, Ohio State University College of Medicine, Columbus (M.M., N.L.M.) - all in Ohio; the Social, Statistical, and Environmental Sciences Unit, RTI International, Research Triangle Park (L.L.), the Department of Pediatrics, Duke University, Durham (R.N.G., C.M.C., W.F.M.), and the Division of Neonatal-Perinatal Medicine, Department of Pediatrics, University of North Carolina at Chapel Hill, Chapel Hill (M.M.L.) - all in North Carolina; the Department of Pediatrics, Wayne State University (S.C., G.N.), and the Department of Pediatrics, Central Michigan University (S.C.) - both in Detroit; the University of Rochester School of Medicine and Dentistry, Rochester (C.T.D., P.R.C.), and the Department of Pediatrics, University of Buffalo Women's and Children's Hospital of Buffalo, Buffalo (A.M.R.) - both in New York; the Department of Pediatrics, Division of Neonatal and Developmental Medicine, Stanford University School of Medicine and Lucile Packard Children's Hospital, Palo Alto (S.R.H., K.P.V.M.), and the Department of Pediatrics, University of California, Los Angeles, Los Angeles (M.G., I.B.P.) - both in California; the Department of Pediatrics, Division of Neonatology, University of Utah School of Medicine, Salt Lake City (B.A.Y., S.W.); the Department of Pediatrics, McGovern Medical School at the University of Texas Health Science Center at Houston, Houston (K.A.K., G.E.M., A.M.K., R.A.M.), and the Department of Pediatrics, University of Texas Southwestern Medical Center, Dallas (M.H.W., R.J.H.) - both in Texas; the Social, Statistical, and Environmental Sciences Unit, RTI International, Rockville (A.D., M.M.C.), and the Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, Bethesda (R.D.H.) - both in Maryland; the Department of Pediatrics, Women and Infants Hospital, Brown University, Providence, RI (M.K., E.C.M.); the Department of Pediatrics, Indiana University School of Medicine, Indianapolis (G.M.S., A.C.H.); Emory University School of Medicine, Department of Pediatrics, Children's Healthcare of Atlanta, Atlanta (B.B.P., R.M.P., N.L.M., I.A.-C.); the Division of Neonatology, University of Alabama at Birmingham, Birmingham (N.A., M.P.-C.); the Department of Pediatrics, Children's Mercy Hospital, Kansas City, MO (W.E.T., H.W.K.); the Department of Pediatrics, University of Pennsylvania Perelman School of Medicine, Philadelphia (B.S., S.B.D.); the Department of Pediatrics, University of Iowa, Iowa City (E.F.B., H.M.H.); the Department of Pediatrics, Sanford School of Medicine, University of South Dakota, Sioux Falls (L.R.M., L.A.H.); and the College of Health and Human Services, George Mason University, Fairfax, VA (R.D.H.)
| | - Brenda B Poindexter
- From the University of New Mexico Health Sciences Center, Albuquerque (K.L.W., C.B.-L., J.R.L.); the Department of Pediatrics, Rainbow Babies and Children's Hospital, Case Western Reserve University, Cleveland (M.C.W., A.M.H., D.E.W.-C.), Cincinnati Children's Hospital Medical Center, Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati (B.B.P., S.M.), and the Department of Pediatrics, Nationwide Children's Hospital, Ohio State University College of Medicine, Columbus (M.M., N.L.M.) - all in Ohio; the Social, Statistical, and Environmental Sciences Unit, RTI International, Research Triangle Park (L.L.), the Department of Pediatrics, Duke University, Durham (R.N.G., C.M.C., W.F.M.), and the Division of Neonatal-Perinatal Medicine, Department of Pediatrics, University of North Carolina at Chapel Hill, Chapel Hill (M.M.L.) - all in North Carolina; the Department of Pediatrics, Wayne State University (S.C., G.N.), and the Department of Pediatrics, Central Michigan University (S.C.) - both in Detroit; the University of Rochester School of Medicine and Dentistry, Rochester (C.T.D., P.R.C.), and the Department of Pediatrics, University of Buffalo Women's and Children's Hospital of Buffalo, Buffalo (A.M.R.) - both in New York; the Department of Pediatrics, Division of Neonatal and Developmental Medicine, Stanford University School of Medicine and Lucile Packard Children's Hospital, Palo Alto (S.R.H., K.P.V.M.), and the Department of Pediatrics, University of California, Los Angeles, Los Angeles (M.G., I.B.P.) - both in California; the Department of Pediatrics, Division of Neonatology, University of Utah School of Medicine, Salt Lake City (B.A.Y., S.W.); the Department of Pediatrics, McGovern Medical School at the University of Texas Health Science Center at Houston, Houston (K.A.K., G.E.M., A.M.K., R.A.M.), and the Department of Pediatrics, University of Texas Southwestern Medical Center, Dallas (M.H.W., R.J.H.) - both in Texas; the Social, Statistical, and Environmental Sciences Unit, RTI International, Rockville (A.D., M.M.C.), and the Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, Bethesda (R.D.H.) - both in Maryland; the Department of Pediatrics, Women and Infants Hospital, Brown University, Providence, RI (M.K., E.C.M.); the Department of Pediatrics, Indiana University School of Medicine, Indianapolis (G.M.S., A.C.H.); Emory University School of Medicine, Department of Pediatrics, Children's Healthcare of Atlanta, Atlanta (B.B.P., R.M.P., N.L.M., I.A.-C.); the Division of Neonatology, University of Alabama at Birmingham, Birmingham (N.A., M.P.-C.); the Department of Pediatrics, Children's Mercy Hospital, Kansas City, MO (W.E.T., H.W.K.); the Department of Pediatrics, University of Pennsylvania Perelman School of Medicine, Philadelphia (B.S., S.B.D.); the Department of Pediatrics, University of Iowa, Iowa City (E.F.B., H.M.H.); the Department of Pediatrics, Sanford School of Medicine, University of South Dakota, Sioux Falls (L.R.M., L.A.H.); and the College of Health and Human Services, George Mason University, Fairfax, VA (R.D.H.)
| | - Namasivayam Ambalavanan
- From the University of New Mexico Health Sciences Center, Albuquerque (K.L.W., C.B.-L., J.R.L.); the Department of Pediatrics, Rainbow Babies and Children's Hospital, Case Western Reserve University, Cleveland (M.C.W., A.M.H., D.E.W.-C.), Cincinnati Children's Hospital Medical Center, Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati (B.B.P., S.M.), and the Department of Pediatrics, Nationwide Children's Hospital, Ohio State University College of Medicine, Columbus (M.M., N.L.M.) - all in Ohio; the Social, Statistical, and Environmental Sciences Unit, RTI International, Research Triangle Park (L.L.), the Department of Pediatrics, Duke University, Durham (R.N.G., C.M.C., W.F.M.), and the Division of Neonatal-Perinatal Medicine, Department of Pediatrics, University of North Carolina at Chapel Hill, Chapel Hill (M.M.L.) - all in North Carolina; the Department of Pediatrics, Wayne State University (S.C., G.N.), and the Department of Pediatrics, Central Michigan University (S.C.) - both in Detroit; the University of Rochester School of Medicine and Dentistry, Rochester (C.T.D., P.R.C.), and the Department of Pediatrics, University of Buffalo Women's and Children's Hospital of Buffalo, Buffalo (A.M.R.) - both in New York; the Department of Pediatrics, Division of Neonatal and Developmental Medicine, Stanford University School of Medicine and Lucile Packard Children's Hospital, Palo Alto (S.R.H., K.P.V.M.), and the Department of Pediatrics, University of California, Los Angeles, Los Angeles (M.G., I.B.P.) - both in California; the Department of Pediatrics, Division of Neonatology, University of Utah School of Medicine, Salt Lake City (B.A.Y., S.W.); the Department of Pediatrics, McGovern Medical School at the University of Texas Health Science Center at Houston, Houston (K.A.K., G.E.M., A.M.K., R.A.M.), and the Department of Pediatrics, University of Texas Southwestern Medical Center, Dallas (M.H.W., R.J.H.) - both in Texas; the Social, Statistical, and Environmental Sciences Unit, RTI International, Rockville (A.D., M.M.C.), and the Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, Bethesda (R.D.H.) - both in Maryland; the Department of Pediatrics, Women and Infants Hospital, Brown University, Providence, RI (M.K., E.C.M.); the Department of Pediatrics, Indiana University School of Medicine, Indianapolis (G.M.S., A.C.H.); Emory University School of Medicine, Department of Pediatrics, Children's Healthcare of Atlanta, Atlanta (B.B.P., R.M.P., N.L.M., I.A.-C.); the Division of Neonatology, University of Alabama at Birmingham, Birmingham (N.A., M.P.-C.); the Department of Pediatrics, Children's Mercy Hospital, Kansas City, MO (W.E.T., H.W.K.); the Department of Pediatrics, University of Pennsylvania Perelman School of Medicine, Philadelphia (B.S., S.B.D.); the Department of Pediatrics, University of Iowa, Iowa City (E.F.B., H.M.H.); the Department of Pediatrics, Sanford School of Medicine, University of South Dakota, Sioux Falls (L.R.M., L.A.H.); and the College of Health and Human Services, George Mason University, Fairfax, VA (R.D.H.)
| | - Anna Maria Hibbs
- From the University of New Mexico Health Sciences Center, Albuquerque (K.L.W., C.B.-L., J.R.L.); the Department of Pediatrics, Rainbow Babies and Children's Hospital, Case Western Reserve University, Cleveland (M.C.W., A.M.H., D.E.W.-C.), Cincinnati Children's Hospital Medical Center, Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati (B.B.P., S.M.), and the Department of Pediatrics, Nationwide Children's Hospital, Ohio State University College of Medicine, Columbus (M.M., N.L.M.) - all in Ohio; the Social, Statistical, and Environmental Sciences Unit, RTI International, Research Triangle Park (L.L.), the Department of Pediatrics, Duke University, Durham (R.N.G., C.M.C., W.F.M.), and the Division of Neonatal-Perinatal Medicine, Department of Pediatrics, University of North Carolina at Chapel Hill, Chapel Hill (M.M.L.) - all in North Carolina; the Department of Pediatrics, Wayne State University (S.C., G.N.), and the Department of Pediatrics, Central Michigan University (S.C.) - both in Detroit; the University of Rochester School of Medicine and Dentistry, Rochester (C.T.D., P.R.C.), and the Department of Pediatrics, University of Buffalo Women's and Children's Hospital of Buffalo, Buffalo (A.M.R.) - both in New York; the Department of Pediatrics, Division of Neonatal and Developmental Medicine, Stanford University School of Medicine and Lucile Packard Children's Hospital, Palo Alto (S.R.H., K.P.V.M.), and the Department of Pediatrics, University of California, Los Angeles, Los Angeles (M.G., I.B.P.) - both in California; the Department of Pediatrics, Division of Neonatology, University of Utah School of Medicine, Salt Lake City (B.A.Y., S.W.); the Department of Pediatrics, McGovern Medical School at the University of Texas Health Science Center at Houston, Houston (K.A.K., G.E.M., A.M.K., R.A.M.), and the Department of Pediatrics, University of Texas Southwestern Medical Center, Dallas (M.H.W., R.J.H.) - both in Texas; the Social, Statistical, and Environmental Sciences Unit, RTI International, Rockville (A.D., M.M.C.), and the Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, Bethesda (R.D.H.) - both in Maryland; the Department of Pediatrics, Women and Infants Hospital, Brown University, Providence, RI (M.K., E.C.M.); the Department of Pediatrics, Indiana University School of Medicine, Indianapolis (G.M.S., A.C.H.); Emory University School of Medicine, Department of Pediatrics, Children's Healthcare of Atlanta, Atlanta (B.B.P., R.M.P., N.L.M., I.A.-C.); the Division of Neonatology, University of Alabama at Birmingham, Birmingham (N.A., M.P.-C.); the Department of Pediatrics, Children's Mercy Hospital, Kansas City, MO (W.E.T., H.W.K.); the Department of Pediatrics, University of Pennsylvania Perelman School of Medicine, Philadelphia (B.S., S.B.D.); the Department of Pediatrics, University of Iowa, Iowa City (E.F.B., H.M.H.); the Department of Pediatrics, Sanford School of Medicine, University of South Dakota, Sioux Falls (L.R.M., L.A.H.); and the College of Health and Human Services, George Mason University, Fairfax, VA (R.D.H.)
| | - William E Truog
- From the University of New Mexico Health Sciences Center, Albuquerque (K.L.W., C.B.-L., J.R.L.); the Department of Pediatrics, Rainbow Babies and Children's Hospital, Case Western Reserve University, Cleveland (M.C.W., A.M.H., D.E.W.-C.), Cincinnati Children's Hospital Medical Center, Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati (B.B.P., S.M.), and the Department of Pediatrics, Nationwide Children's Hospital, Ohio State University College of Medicine, Columbus (M.M., N.L.M.) - all in Ohio; the Social, Statistical, and Environmental Sciences Unit, RTI International, Research Triangle Park (L.L.), the Department of Pediatrics, Duke University, Durham (R.N.G., C.M.C., W.F.M.), and the Division of Neonatal-Perinatal Medicine, Department of Pediatrics, University of North Carolina at Chapel Hill, Chapel Hill (M.M.L.) - all in North Carolina; the Department of Pediatrics, Wayne State University (S.C., G.N.), and the Department of Pediatrics, Central Michigan University (S.C.) - both in Detroit; the University of Rochester School of Medicine and Dentistry, Rochester (C.T.D., P.R.C.), and the Department of Pediatrics, University of Buffalo Women's and Children's Hospital of Buffalo, Buffalo (A.M.R.) - both in New York; the Department of Pediatrics, Division of Neonatal and Developmental Medicine, Stanford University School of Medicine and Lucile Packard Children's Hospital, Palo Alto (S.R.H., K.P.V.M.), and the Department of Pediatrics, University of California, Los Angeles, Los Angeles (M.G., I.B.P.) - both in California; the Department of Pediatrics, Division of Neonatology, University of Utah School of Medicine, Salt Lake City (B.A.Y., S.W.); the Department of Pediatrics, McGovern Medical School at the University of Texas Health Science Center at Houston, Houston (K.A.K., G.E.M., A.M.K., R.A.M.), and the Department of Pediatrics, University of Texas Southwestern Medical Center, Dallas (M.H.W., R.J.H.) - both in Texas; the Social, Statistical, and Environmental Sciences Unit, RTI International, Rockville (A.D., M.M.C.), and the Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, Bethesda (R.D.H.) - both in Maryland; the Department of Pediatrics, Women and Infants Hospital, Brown University, Providence, RI (M.K., E.C.M.); the Department of Pediatrics, Indiana University School of Medicine, Indianapolis (G.M.S., A.C.H.); Emory University School of Medicine, Department of Pediatrics, Children's Healthcare of Atlanta, Atlanta (B.B.P., R.M.P., N.L.M., I.A.-C.); the Division of Neonatology, University of Alabama at Birmingham, Birmingham (N.A., M.P.-C.); the Department of Pediatrics, Children's Mercy Hospital, Kansas City, MO (W.E.T., H.W.K.); the Department of Pediatrics, University of Pennsylvania Perelman School of Medicine, Philadelphia (B.S., S.B.D.); the Department of Pediatrics, University of Iowa, Iowa City (E.F.B., H.M.H.); the Department of Pediatrics, Sanford School of Medicine, University of South Dakota, Sioux Falls (L.R.M., L.A.H.); and the College of Health and Human Services, George Mason University, Fairfax, VA (R.D.H.)
| | - Barbara Schmidt
- From the University of New Mexico Health Sciences Center, Albuquerque (K.L.W., C.B.-L., J.R.L.); the Department of Pediatrics, Rainbow Babies and Children's Hospital, Case Western Reserve University, Cleveland (M.C.W., A.M.H., D.E.W.-C.), Cincinnati Children's Hospital Medical Center, Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati (B.B.P., S.M.), and the Department of Pediatrics, Nationwide Children's Hospital, Ohio State University College of Medicine, Columbus (M.M., N.L.M.) - all in Ohio; the Social, Statistical, and Environmental Sciences Unit, RTI International, Research Triangle Park (L.L.), the Department of Pediatrics, Duke University, Durham (R.N.G., C.M.C., W.F.M.), and the Division of Neonatal-Perinatal Medicine, Department of Pediatrics, University of North Carolina at Chapel Hill, Chapel Hill (M.M.L.) - all in North Carolina; the Department of Pediatrics, Wayne State University (S.C., G.N.), and the Department of Pediatrics, Central Michigan University (S.C.) - both in Detroit; the University of Rochester School of Medicine and Dentistry, Rochester (C.T.D., P.R.C.), and the Department of Pediatrics, University of Buffalo Women's and Children's Hospital of Buffalo, Buffalo (A.M.R.) - both in New York; the Department of Pediatrics, Division of Neonatal and Developmental Medicine, Stanford University School of Medicine and Lucile Packard Children's Hospital, Palo Alto (S.R.H., K.P.V.M.), and the Department of Pediatrics, University of California, Los Angeles, Los Angeles (M.G., I.B.P.) - both in California; the Department of Pediatrics, Division of Neonatology, University of Utah School of Medicine, Salt Lake City (B.A.Y., S.W.); the Department of Pediatrics, McGovern Medical School at the University of Texas Health Science Center at Houston, Houston (K.A.K., G.E.M., A.M.K., R.A.M.), and the Department of Pediatrics, University of Texas Southwestern Medical Center, Dallas (M.H.W., R.J.H.) - both in Texas; the Social, Statistical, and Environmental Sciences Unit, RTI International, Rockville (A.D., M.M.C.), and the Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, Bethesda (R.D.H.) - both in Maryland; the Department of Pediatrics, Women and Infants Hospital, Brown University, Providence, RI (M.K., E.C.M.); the Department of Pediatrics, Indiana University School of Medicine, Indianapolis (G.M.S., A.C.H.); Emory University School of Medicine, Department of Pediatrics, Children's Healthcare of Atlanta, Atlanta (B.B.P., R.M.P., N.L.M., I.A.-C.); the Division of Neonatology, University of Alabama at Birmingham, Birmingham (N.A., M.P.-C.); the Department of Pediatrics, Children's Mercy Hospital, Kansas City, MO (W.E.T., H.W.K.); the Department of Pediatrics, University of Pennsylvania Perelman School of Medicine, Philadelphia (B.S., S.B.D.); the Department of Pediatrics, University of Iowa, Iowa City (E.F.B., H.M.H.); the Department of Pediatrics, Sanford School of Medicine, University of South Dakota, Sioux Falls (L.R.M., L.A.H.); and the College of Health and Human Services, George Mason University, Fairfax, VA (R.D.H.)
| | - Myra H Wyckoff
- From the University of New Mexico Health Sciences Center, Albuquerque (K.L.W., C.B.-L., J.R.L.); the Department of Pediatrics, Rainbow Babies and Children's Hospital, Case Western Reserve University, Cleveland (M.C.W., A.M.H., D.E.W.-C.), Cincinnati Children's Hospital Medical Center, Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati (B.B.P., S.M.), and the Department of Pediatrics, Nationwide Children's Hospital, Ohio State University College of Medicine, Columbus (M.M., N.L.M.) - all in Ohio; the Social, Statistical, and Environmental Sciences Unit, RTI International, Research Triangle Park (L.L.), the Department of Pediatrics, Duke University, Durham (R.N.G., C.M.C., W.F.M.), and the Division of Neonatal-Perinatal Medicine, Department of Pediatrics, University of North Carolina at Chapel Hill, Chapel Hill (M.M.L.) - all in North Carolina; the Department of Pediatrics, Wayne State University (S.C., G.N.), and the Department of Pediatrics, Central Michigan University (S.C.) - both in Detroit; the University of Rochester School of Medicine and Dentistry, Rochester (C.T.D., P.R.C.), and the Department of Pediatrics, University of Buffalo Women's and Children's Hospital of Buffalo, Buffalo (A.M.R.) - both in New York; the Department of Pediatrics, Division of Neonatal and Developmental Medicine, Stanford University School of Medicine and Lucile Packard Children's Hospital, Palo Alto (S.R.H., K.P.V.M.), and the Department of Pediatrics, University of California, Los Angeles, Los Angeles (M.G., I.B.P.) - both in California; the Department of Pediatrics, Division of Neonatology, University of Utah School of Medicine, Salt Lake City (B.A.Y., S.W.); the Department of Pediatrics, McGovern Medical School at the University of Texas Health Science Center at Houston, Houston (K.A.K., G.E.M., A.M.K., R.A.M.), and the Department of Pediatrics, University of Texas Southwestern Medical Center, Dallas (M.H.W., R.J.H.) - both in Texas; the Social, Statistical, and Environmental Sciences Unit, RTI International, Rockville (A.D., M.M.C.), and the Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, Bethesda (R.D.H.) - both in Maryland; the Department of Pediatrics, Women and Infants Hospital, Brown University, Providence, RI (M.K., E.C.M.); the Department of Pediatrics, Indiana University School of Medicine, Indianapolis (G.M.S., A.C.H.); Emory University School of Medicine, Department of Pediatrics, Children's Healthcare of Atlanta, Atlanta (B.B.P., R.M.P., N.L.M., I.A.-C.); the Division of Neonatology, University of Alabama at Birmingham, Birmingham (N.A., M.P.-C.); the Department of Pediatrics, Children's Mercy Hospital, Kansas City, MO (W.E.T., H.W.K.); the Department of Pediatrics, University of Pennsylvania Perelman School of Medicine, Philadelphia (B.S., S.B.D.); the Department of Pediatrics, University of Iowa, Iowa City (E.F.B., H.M.H.); the Department of Pediatrics, Sanford School of Medicine, University of South Dakota, Sioux Falls (L.R.M., L.A.H.); and the College of Health and Human Services, George Mason University, Fairfax, VA (R.D.H.)
| | - Amir M Khan
- From the University of New Mexico Health Sciences Center, Albuquerque (K.L.W., C.B.-L., J.R.L.); the Department of Pediatrics, Rainbow Babies and Children's Hospital, Case Western Reserve University, Cleveland (M.C.W., A.M.H., D.E.W.-C.), Cincinnati Children's Hospital Medical Center, Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati (B.B.P., S.M.), and the Department of Pediatrics, Nationwide Children's Hospital, Ohio State University College of Medicine, Columbus (M.M., N.L.M.) - all in Ohio; the Social, Statistical, and Environmental Sciences Unit, RTI International, Research Triangle Park (L.L.), the Department of Pediatrics, Duke University, Durham (R.N.G., C.M.C., W.F.M.), and the Division of Neonatal-Perinatal Medicine, Department of Pediatrics, University of North Carolina at Chapel Hill, Chapel Hill (M.M.L.) - all in North Carolina; the Department of Pediatrics, Wayne State University (S.C., G.N.), and the Department of Pediatrics, Central Michigan University (S.C.) - both in Detroit; the University of Rochester School of Medicine and Dentistry, Rochester (C.T.D., P.R.C.), and the Department of Pediatrics, University of Buffalo Women's and Children's Hospital of Buffalo, Buffalo (A.M.R.) - both in New York; the Department of Pediatrics, Division of Neonatal and Developmental Medicine, Stanford University School of Medicine and Lucile Packard Children's Hospital, Palo Alto (S.R.H., K.P.V.M.), and the Department of Pediatrics, University of California, Los Angeles, Los Angeles (M.G., I.B.P.) - both in California; the Department of Pediatrics, Division of Neonatology, University of Utah School of Medicine, Salt Lake City (B.A.Y., S.W.); the Department of Pediatrics, McGovern Medical School at the University of Texas Health Science Center at Houston, Houston (K.A.K., G.E.M., A.M.K., R.A.M.), and the Department of Pediatrics, University of Texas Southwestern Medical Center, Dallas (M.H.W., R.J.H.) - both in Texas; the Social, Statistical, and Environmental Sciences Unit, RTI International, Rockville (A.D., M.M.C.), and the Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, Bethesda (R.D.H.) - both in Maryland; the Department of Pediatrics, Women and Infants Hospital, Brown University, Providence, RI (M.K., E.C.M.); the Department of Pediatrics, Indiana University School of Medicine, Indianapolis (G.M.S., A.C.H.); Emory University School of Medicine, Department of Pediatrics, Children's Healthcare of Atlanta, Atlanta (B.B.P., R.M.P., N.L.M., I.A.-C.); the Division of Neonatology, University of Alabama at Birmingham, Birmingham (N.A., M.P.-C.); the Department of Pediatrics, Children's Mercy Hospital, Kansas City, MO (W.E.T., H.W.K.); the Department of Pediatrics, University of Pennsylvania Perelman School of Medicine, Philadelphia (B.S., S.B.D.); the Department of Pediatrics, University of Iowa, Iowa City (E.F.B., H.M.H.); the Department of Pediatrics, Sanford School of Medicine, University of South Dakota, Sioux Falls (L.R.M., L.A.H.); and the College of Health and Human Services, George Mason University, Fairfax, VA (R.D.H.)
| | - Meena Garg
- From the University of New Mexico Health Sciences Center, Albuquerque (K.L.W., C.B.-L., J.R.L.); the Department of Pediatrics, Rainbow Babies and Children's Hospital, Case Western Reserve University, Cleveland (M.C.W., A.M.H., D.E.W.-C.), Cincinnati Children's Hospital Medical Center, Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati (B.B.P., S.M.), and the Department of Pediatrics, Nationwide Children's Hospital, Ohio State University College of Medicine, Columbus (M.M., N.L.M.) - all in Ohio; the Social, Statistical, and Environmental Sciences Unit, RTI International, Research Triangle Park (L.L.), the Department of Pediatrics, Duke University, Durham (R.N.G., C.M.C., W.F.M.), and the Division of Neonatal-Perinatal Medicine, Department of Pediatrics, University of North Carolina at Chapel Hill, Chapel Hill (M.M.L.) - all in North Carolina; the Department of Pediatrics, Wayne State University (S.C., G.N.), and the Department of Pediatrics, Central Michigan University (S.C.) - both in Detroit; the University of Rochester School of Medicine and Dentistry, Rochester (C.T.D., P.R.C.), and the Department of Pediatrics, University of Buffalo Women's and Children's Hospital of Buffalo, Buffalo (A.M.R.) - both in New York; the Department of Pediatrics, Division of Neonatal and Developmental Medicine, Stanford University School of Medicine and Lucile Packard Children's Hospital, Palo Alto (S.R.H., K.P.V.M.), and the Department of Pediatrics, University of California, Los Angeles, Los Angeles (M.G., I.B.P.) - both in California; the Department of Pediatrics, Division of Neonatology, University of Utah School of Medicine, Salt Lake City (B.A.Y., S.W.); the Department of Pediatrics, McGovern Medical School at the University of Texas Health Science Center at Houston, Houston (K.A.K., G.E.M., A.M.K., R.A.M.), and the Department of Pediatrics, University of Texas Southwestern Medical Center, Dallas (M.H.W., R.J.H.) - both in Texas; the Social, Statistical, and Environmental Sciences Unit, RTI International, Rockville (A.D., M.M.C.), and the Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, Bethesda (R.D.H.) - both in Maryland; the Department of Pediatrics, Women and Infants Hospital, Brown University, Providence, RI (M.K., E.C.M.); the Department of Pediatrics, Indiana University School of Medicine, Indianapolis (G.M.S., A.C.H.); Emory University School of Medicine, Department of Pediatrics, Children's Healthcare of Atlanta, Atlanta (B.B.P., R.M.P., N.L.M., I.A.-C.); the Division of Neonatology, University of Alabama at Birmingham, Birmingham (N.A., M.P.-C.); the Department of Pediatrics, Children's Mercy Hospital, Kansas City, MO (W.E.T., H.W.K.); the Department of Pediatrics, University of Pennsylvania Perelman School of Medicine, Philadelphia (B.S., S.B.D.); the Department of Pediatrics, University of Iowa, Iowa City (E.F.B., H.M.H.); the Department of Pediatrics, Sanford School of Medicine, University of South Dakota, Sioux Falls (L.R.M., L.A.H.); and the College of Health and Human Services, George Mason University, Fairfax, VA (R.D.H.)
| | - Patricia R Chess
- From the University of New Mexico Health Sciences Center, Albuquerque (K.L.W., C.B.-L., J.R.L.); the Department of Pediatrics, Rainbow Babies and Children's Hospital, Case Western Reserve University, Cleveland (M.C.W., A.M.H., D.E.W.-C.), Cincinnati Children's Hospital Medical Center, Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati (B.B.P., S.M.), and the Department of Pediatrics, Nationwide Children's Hospital, Ohio State University College of Medicine, Columbus (M.M., N.L.M.) - all in Ohio; the Social, Statistical, and Environmental Sciences Unit, RTI International, Research Triangle Park (L.L.), the Department of Pediatrics, Duke University, Durham (R.N.G., C.M.C., W.F.M.), and the Division of Neonatal-Perinatal Medicine, Department of Pediatrics, University of North Carolina at Chapel Hill, Chapel Hill (M.M.L.) - all in North Carolina; the Department of Pediatrics, Wayne State University (S.C., G.N.), and the Department of Pediatrics, Central Michigan University (S.C.) - both in Detroit; the University of Rochester School of Medicine and Dentistry, Rochester (C.T.D., P.R.C.), and the Department of Pediatrics, University of Buffalo Women's and Children's Hospital of Buffalo, Buffalo (A.M.R.) - both in New York; the Department of Pediatrics, Division of Neonatal and Developmental Medicine, Stanford University School of Medicine and Lucile Packard Children's Hospital, Palo Alto (S.R.H., K.P.V.M.), and the Department of Pediatrics, University of California, Los Angeles, Los Angeles (M.G., I.B.P.) - both in California; the Department of Pediatrics, Division of Neonatology, University of Utah School of Medicine, Salt Lake City (B.A.Y., S.W.); the Department of Pediatrics, McGovern Medical School at the University of Texas Health Science Center at Houston, Houston (K.A.K., G.E.M., A.M.K., R.A.M.), and the Department of Pediatrics, University of Texas Southwestern Medical Center, Dallas (M.H.W., R.J.H.) - both in Texas; the Social, Statistical, and Environmental Sciences Unit, RTI International, Rockville (A.D., M.M.C.), and the Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, Bethesda (R.D.H.) - both in Maryland; the Department of Pediatrics, Women and Infants Hospital, Brown University, Providence, RI (M.K., E.C.M.); the Department of Pediatrics, Indiana University School of Medicine, Indianapolis (G.M.S., A.C.H.); Emory University School of Medicine, Department of Pediatrics, Children's Healthcare of Atlanta, Atlanta (B.B.P., R.M.P., N.L.M., I.A.-C.); the Division of Neonatology, University of Alabama at Birmingham, Birmingham (N.A., M.P.-C.); the Department of Pediatrics, Children's Mercy Hospital, Kansas City, MO (W.E.T., H.W.K.); the Department of Pediatrics, University of Pennsylvania Perelman School of Medicine, Philadelphia (B.S., S.B.D.); the Department of Pediatrics, University of Iowa, Iowa City (E.F.B., H.M.H.); the Department of Pediatrics, Sanford School of Medicine, University of South Dakota, Sioux Falls (L.R.M., L.A.H.); and the College of Health and Human Services, George Mason University, Fairfax, VA (R.D.H.)
| | - Anne M Reynolds
- From the University of New Mexico Health Sciences Center, Albuquerque (K.L.W., C.B.-L., J.R.L.); the Department of Pediatrics, Rainbow Babies and Children's Hospital, Case Western Reserve University, Cleveland (M.C.W., A.M.H., D.E.W.-C.), Cincinnati Children's Hospital Medical Center, Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati (B.B.P., S.M.), and the Department of Pediatrics, Nationwide Children's Hospital, Ohio State University College of Medicine, Columbus (M.M., N.L.M.) - all in Ohio; the Social, Statistical, and Environmental Sciences Unit, RTI International, Research Triangle Park (L.L.), the Department of Pediatrics, Duke University, Durham (R.N.G., C.M.C., W.F.M.), and the Division of Neonatal-Perinatal Medicine, Department of Pediatrics, University of North Carolina at Chapel Hill, Chapel Hill (M.M.L.) - all in North Carolina; the Department of Pediatrics, Wayne State University (S.C., G.N.), and the Department of Pediatrics, Central Michigan University (S.C.) - both in Detroit; the University of Rochester School of Medicine and Dentistry, Rochester (C.T.D., P.R.C.), and the Department of Pediatrics, University of Buffalo Women's and Children's Hospital of Buffalo, Buffalo (A.M.R.) - both in New York; the Department of Pediatrics, Division of Neonatal and Developmental Medicine, Stanford University School of Medicine and Lucile Packard Children's Hospital, Palo Alto (S.R.H., K.P.V.M.), and the Department of Pediatrics, University of California, Los Angeles, Los Angeles (M.G., I.B.P.) - both in California; the Department of Pediatrics, Division of Neonatology, University of Utah School of Medicine, Salt Lake City (B.A.Y., S.W.); the Department of Pediatrics, McGovern Medical School at the University of Texas Health Science Center at Houston, Houston (K.A.K., G.E.M., A.M.K., R.A.M.), and the Department of Pediatrics, University of Texas Southwestern Medical Center, Dallas (M.H.W., R.J.H.) - both in Texas; the Social, Statistical, and Environmental Sciences Unit, RTI International, Rockville (A.D., M.M.C.), and the Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, Bethesda (R.D.H.) - both in Maryland; the Department of Pediatrics, Women and Infants Hospital, Brown University, Providence, RI (M.K., E.C.M.); the Department of Pediatrics, Indiana University School of Medicine, Indianapolis (G.M.S., A.C.H.); Emory University School of Medicine, Department of Pediatrics, Children's Healthcare of Atlanta, Atlanta (B.B.P., R.M.P., N.L.M., I.A.-C.); the Division of Neonatology, University of Alabama at Birmingham, Birmingham (N.A., M.P.-C.); the Department of Pediatrics, Children's Mercy Hospital, Kansas City, MO (W.E.T., H.W.K.); the Department of Pediatrics, University of Pennsylvania Perelman School of Medicine, Philadelphia (B.S., S.B.D.); the Department of Pediatrics, University of Iowa, Iowa City (E.F.B., H.M.H.); the Department of Pediatrics, Sanford School of Medicine, University of South Dakota, Sioux Falls (L.R.M., L.A.H.); and the College of Health and Human Services, George Mason University, Fairfax, VA (R.D.H.)
| | - Mohannad Moallem
- From the University of New Mexico Health Sciences Center, Albuquerque (K.L.W., C.B.-L., J.R.L.); the Department of Pediatrics, Rainbow Babies and Children's Hospital, Case Western Reserve University, Cleveland (M.C.W., A.M.H., D.E.W.-C.), Cincinnati Children's Hospital Medical Center, Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati (B.B.P., S.M.), and the Department of Pediatrics, Nationwide Children's Hospital, Ohio State University College of Medicine, Columbus (M.M., N.L.M.) - all in Ohio; the Social, Statistical, and Environmental Sciences Unit, RTI International, Research Triangle Park (L.L.), the Department of Pediatrics, Duke University, Durham (R.N.G., C.M.C., W.F.M.), and the Division of Neonatal-Perinatal Medicine, Department of Pediatrics, University of North Carolina at Chapel Hill, Chapel Hill (M.M.L.) - all in North Carolina; the Department of Pediatrics, Wayne State University (S.C., G.N.), and the Department of Pediatrics, Central Michigan University (S.C.) - both in Detroit; the University of Rochester School of Medicine and Dentistry, Rochester (C.T.D., P.R.C.), and the Department of Pediatrics, University of Buffalo Women's and Children's Hospital of Buffalo, Buffalo (A.M.R.) - both in New York; the Department of Pediatrics, Division of Neonatal and Developmental Medicine, Stanford University School of Medicine and Lucile Packard Children's Hospital, Palo Alto (S.R.H., K.P.V.M.), and the Department of Pediatrics, University of California, Los Angeles, Los Angeles (M.G., I.B.P.) - both in California; the Department of Pediatrics, Division of Neonatology, University of Utah School of Medicine, Salt Lake City (B.A.Y., S.W.); the Department of Pediatrics, McGovern Medical School at the University of Texas Health Science Center at Houston, Houston (K.A.K., G.E.M., A.M.K., R.A.M.), and the Department of Pediatrics, University of Texas Southwestern Medical Center, Dallas (M.H.W., R.J.H.) - both in Texas; the Social, Statistical, and Environmental Sciences Unit, RTI International, Rockville (A.D., M.M.C.), and the Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, Bethesda (R.D.H.) - both in Maryland; the Department of Pediatrics, Women and Infants Hospital, Brown University, Providence, RI (M.K., E.C.M.); the Department of Pediatrics, Indiana University School of Medicine, Indianapolis (G.M.S., A.C.H.); Emory University School of Medicine, Department of Pediatrics, Children's Healthcare of Atlanta, Atlanta (B.B.P., R.M.P., N.L.M., I.A.-C.); the Division of Neonatology, University of Alabama at Birmingham, Birmingham (N.A., M.P.-C.); the Department of Pediatrics, Children's Mercy Hospital, Kansas City, MO (W.E.T., H.W.K.); the Department of Pediatrics, University of Pennsylvania Perelman School of Medicine, Philadelphia (B.S., S.B.D.); the Department of Pediatrics, University of Iowa, Iowa City (E.F.B., H.M.H.); the Department of Pediatrics, Sanford School of Medicine, University of South Dakota, Sioux Falls (L.R.M., L.A.H.); and the College of Health and Human Services, George Mason University, Fairfax, VA (R.D.H.)
| | - Edward F Bell
- From the University of New Mexico Health Sciences Center, Albuquerque (K.L.W., C.B.-L., J.R.L.); the Department of Pediatrics, Rainbow Babies and Children's Hospital, Case Western Reserve University, Cleveland (M.C.W., A.M.H., D.E.W.-C.), Cincinnati Children's Hospital Medical Center, Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati (B.B.P., S.M.), and the Department of Pediatrics, Nationwide Children's Hospital, Ohio State University College of Medicine, Columbus (M.M., N.L.M.) - all in Ohio; the Social, Statistical, and Environmental Sciences Unit, RTI International, Research Triangle Park (L.L.), the Department of Pediatrics, Duke University, Durham (R.N.G., C.M.C., W.F.M.), and the Division of Neonatal-Perinatal Medicine, Department of Pediatrics, University of North Carolina at Chapel Hill, Chapel Hill (M.M.L.) - all in North Carolina; the Department of Pediatrics, Wayne State University (S.C., G.N.), and the Department of Pediatrics, Central Michigan University (S.C.) - both in Detroit; the University of Rochester School of Medicine and Dentistry, Rochester (C.T.D., P.R.C.), and the Department of Pediatrics, University of Buffalo Women's and Children's Hospital of Buffalo, Buffalo (A.M.R.) - both in New York; the Department of Pediatrics, Division of Neonatal and Developmental Medicine, Stanford University School of Medicine and Lucile Packard Children's Hospital, Palo Alto (S.R.H., K.P.V.M.), and the Department of Pediatrics, University of California, Los Angeles, Los Angeles (M.G., I.B.P.) - both in California; the Department of Pediatrics, Division of Neonatology, University of Utah School of Medicine, Salt Lake City (B.A.Y., S.W.); the Department of Pediatrics, McGovern Medical School at the University of Texas Health Science Center at Houston, Houston (K.A.K., G.E.M., A.M.K., R.A.M.), and the Department of Pediatrics, University of Texas Southwestern Medical Center, Dallas (M.H.W., R.J.H.) - both in Texas; the Social, Statistical, and Environmental Sciences Unit, RTI International, Rockville (A.D., M.M.C.), and the Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, Bethesda (R.D.H.) - both in Maryland; the Department of Pediatrics, Women and Infants Hospital, Brown University, Providence, RI (M.K., E.C.M.); the Department of Pediatrics, Indiana University School of Medicine, Indianapolis (G.M.S., A.C.H.); Emory University School of Medicine, Department of Pediatrics, Children's Healthcare of Atlanta, Atlanta (B.B.P., R.M.P., N.L.M., I.A.-C.); the Division of Neonatology, University of Alabama at Birmingham, Birmingham (N.A., M.P.-C.); the Department of Pediatrics, Children's Mercy Hospital, Kansas City, MO (W.E.T., H.W.K.); the Department of Pediatrics, University of Pennsylvania Perelman School of Medicine, Philadelphia (B.S., S.B.D.); the Department of Pediatrics, University of Iowa, Iowa City (E.F.B., H.M.H.); the Department of Pediatrics, Sanford School of Medicine, University of South Dakota, Sioux Falls (L.R.M., L.A.H.); and the College of Health and Human Services, George Mason University, Fairfax, VA (R.D.H.)
| | - Lauritz R Meyer
- From the University of New Mexico Health Sciences Center, Albuquerque (K.L.W., C.B.-L., J.R.L.); the Department of Pediatrics, Rainbow Babies and Children's Hospital, Case Western Reserve University, Cleveland (M.C.W., A.M.H., D.E.W.-C.), Cincinnati Children's Hospital Medical Center, Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati (B.B.P., S.M.), and the Department of Pediatrics, Nationwide Children's Hospital, Ohio State University College of Medicine, Columbus (M.M., N.L.M.) - all in Ohio; the Social, Statistical, and Environmental Sciences Unit, RTI International, Research Triangle Park (L.L.), the Department of Pediatrics, Duke University, Durham (R.N.G., C.M.C., W.F.M.), and the Division of Neonatal-Perinatal Medicine, Department of Pediatrics, University of North Carolina at Chapel Hill, Chapel Hill (M.M.L.) - all in North Carolina; the Department of Pediatrics, Wayne State University (S.C., G.N.), and the Department of Pediatrics, Central Michigan University (S.C.) - both in Detroit; the University of Rochester School of Medicine and Dentistry, Rochester (C.T.D., P.R.C.), and the Department of Pediatrics, University of Buffalo Women's and Children's Hospital of Buffalo, Buffalo (A.M.R.) - both in New York; the Department of Pediatrics, Division of Neonatal and Developmental Medicine, Stanford University School of Medicine and Lucile Packard Children's Hospital, Palo Alto (S.R.H., K.P.V.M.), and the Department of Pediatrics, University of California, Los Angeles, Los Angeles (M.G., I.B.P.) - both in California; the Department of Pediatrics, Division of Neonatology, University of Utah School of Medicine, Salt Lake City (B.A.Y., S.W.); the Department of Pediatrics, McGovern Medical School at the University of Texas Health Science Center at Houston, Houston (K.A.K., G.E.M., A.M.K., R.A.M.), and the Department of Pediatrics, University of Texas Southwestern Medical Center, Dallas (M.H.W., R.J.H.) - both in Texas; the Social, Statistical, and Environmental Sciences Unit, RTI International, Rockville (A.D., M.M.C.), and the Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, Bethesda (R.D.H.) - both in Maryland; the Department of Pediatrics, Women and Infants Hospital, Brown University, Providence, RI (M.K., E.C.M.); the Department of Pediatrics, Indiana University School of Medicine, Indianapolis (G.M.S., A.C.H.); Emory University School of Medicine, Department of Pediatrics, Children's Healthcare of Atlanta, Atlanta (B.B.P., R.M.P., N.L.M., I.A.-C.); the Division of Neonatology, University of Alabama at Birmingham, Birmingham (N.A., M.P.-C.); the Department of Pediatrics, Children's Mercy Hospital, Kansas City, MO (W.E.T., H.W.K.); the Department of Pediatrics, University of Pennsylvania Perelman School of Medicine, Philadelphia (B.S., S.B.D.); the Department of Pediatrics, University of Iowa, Iowa City (E.F.B., H.M.H.); the Department of Pediatrics, Sanford School of Medicine, University of South Dakota, Sioux Falls (L.R.M., L.A.H.); and the College of Health and Human Services, George Mason University, Fairfax, VA (R.D.H.)
| | - Ravi M Patel
- From the University of New Mexico Health Sciences Center, Albuquerque (K.L.W., C.B.-L., J.R.L.); the Department of Pediatrics, Rainbow Babies and Children's Hospital, Case Western Reserve University, Cleveland (M.C.W., A.M.H., D.E.W.-C.), Cincinnati Children's Hospital Medical Center, Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati (B.B.P., S.M.), and the Department of Pediatrics, Nationwide Children's Hospital, Ohio State University College of Medicine, Columbus (M.M., N.L.M.) - all in Ohio; the Social, Statistical, and Environmental Sciences Unit, RTI International, Research Triangle Park (L.L.), the Department of Pediatrics, Duke University, Durham (R.N.G., C.M.C., W.F.M.), and the Division of Neonatal-Perinatal Medicine, Department of Pediatrics, University of North Carolina at Chapel Hill, Chapel Hill (M.M.L.) - all in North Carolina; the Department of Pediatrics, Wayne State University (S.C., G.N.), and the Department of Pediatrics, Central Michigan University (S.C.) - both in Detroit; the University of Rochester School of Medicine and Dentistry, Rochester (C.T.D., P.R.C.), and the Department of Pediatrics, University of Buffalo Women's and Children's Hospital of Buffalo, Buffalo (A.M.R.) - both in New York; the Department of Pediatrics, Division of Neonatal and Developmental Medicine, Stanford University School of Medicine and Lucile Packard Children's Hospital, Palo Alto (S.R.H., K.P.V.M.), and the Department of Pediatrics, University of California, Los Angeles, Los Angeles (M.G., I.B.P.) - both in California; the Department of Pediatrics, Division of Neonatology, University of Utah School of Medicine, Salt Lake City (B.A.Y., S.W.); the Department of Pediatrics, McGovern Medical School at the University of Texas Health Science Center at Houston, Houston (K.A.K., G.E.M., A.M.K., R.A.M.), and the Department of Pediatrics, University of Texas Southwestern Medical Center, Dallas (M.H.W., R.J.H.) - both in Texas; the Social, Statistical, and Environmental Sciences Unit, RTI International, Rockville (A.D., M.M.C.), and the Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, Bethesda (R.D.H.) - both in Maryland; the Department of Pediatrics, Women and Infants Hospital, Brown University, Providence, RI (M.K., E.C.M.); the Department of Pediatrics, Indiana University School of Medicine, Indianapolis (G.M.S., A.C.H.); Emory University School of Medicine, Department of Pediatrics, Children's Healthcare of Atlanta, Atlanta (B.B.P., R.M.P., N.L.M., I.A.-C.); the Division of Neonatology, University of Alabama at Birmingham, Birmingham (N.A., M.P.-C.); the Department of Pediatrics, Children's Mercy Hospital, Kansas City, MO (W.E.T., H.W.K.); the Department of Pediatrics, University of Pennsylvania Perelman School of Medicine, Philadelphia (B.S., S.B.D.); the Department of Pediatrics, University of Iowa, Iowa City (E.F.B., H.M.H.); the Department of Pediatrics, Sanford School of Medicine, University of South Dakota, Sioux Falls (L.R.M., L.A.H.); and the College of Health and Human Services, George Mason University, Fairfax, VA (R.D.H.)
| | - Krisa P Van Meurs
- From the University of New Mexico Health Sciences Center, Albuquerque (K.L.W., C.B.-L., J.R.L.); the Department of Pediatrics, Rainbow Babies and Children's Hospital, Case Western Reserve University, Cleveland (M.C.W., A.M.H., D.E.W.-C.), Cincinnati Children's Hospital Medical Center, Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati (B.B.P., S.M.), and the Department of Pediatrics, Nationwide Children's Hospital, Ohio State University College of Medicine, Columbus (M.M., N.L.M.) - all in Ohio; the Social, Statistical, and Environmental Sciences Unit, RTI International, Research Triangle Park (L.L.), the Department of Pediatrics, Duke University, Durham (R.N.G., C.M.C., W.F.M.), and the Division of Neonatal-Perinatal Medicine, Department of Pediatrics, University of North Carolina at Chapel Hill, Chapel Hill (M.M.L.) - all in North Carolina; the Department of Pediatrics, Wayne State University (S.C., G.N.), and the Department of Pediatrics, Central Michigan University (S.C.) - both in Detroit; the University of Rochester School of Medicine and Dentistry, Rochester (C.T.D., P.R.C.), and the Department of Pediatrics, University of Buffalo Women's and Children's Hospital of Buffalo, Buffalo (A.M.R.) - both in New York; the Department of Pediatrics, Division of Neonatal and Developmental Medicine, Stanford University School of Medicine and Lucile Packard Children's Hospital, Palo Alto (S.R.H., K.P.V.M.), and the Department of Pediatrics, University of California, Los Angeles, Los Angeles (M.G., I.B.P.) - both in California; the Department of Pediatrics, Division of Neonatology, University of Utah School of Medicine, Salt Lake City (B.A.Y., S.W.); the Department of Pediatrics, McGovern Medical School at the University of Texas Health Science Center at Houston, Houston (K.A.K., G.E.M., A.M.K., R.A.M.), and the Department of Pediatrics, University of Texas Southwestern Medical Center, Dallas (M.H.W., R.J.H.) - both in Texas; the Social, Statistical, and Environmental Sciences Unit, RTI International, Rockville (A.D., M.M.C.), and the Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, Bethesda (R.D.H.) - both in Maryland; the Department of Pediatrics, Women and Infants Hospital, Brown University, Providence, RI (M.K., E.C.M.); the Department of Pediatrics, Indiana University School of Medicine, Indianapolis (G.M.S., A.C.H.); Emory University School of Medicine, Department of Pediatrics, Children's Healthcare of Atlanta, Atlanta (B.B.P., R.M.P., N.L.M., I.A.-C.); the Division of Neonatology, University of Alabama at Birmingham, Birmingham (N.A., M.P.-C.); the Department of Pediatrics, Children's Mercy Hospital, Kansas City, MO (W.E.T., H.W.K.); the Department of Pediatrics, University of Pennsylvania Perelman School of Medicine, Philadelphia (B.S., S.B.D.); the Department of Pediatrics, University of Iowa, Iowa City (E.F.B., H.M.H.); the Department of Pediatrics, Sanford School of Medicine, University of South Dakota, Sioux Falls (L.R.M., L.A.H.); and the College of Health and Human Services, George Mason University, Fairfax, VA (R.D.H.)
| | - C Michael Cotten
- From the University of New Mexico Health Sciences Center, Albuquerque (K.L.W., C.B.-L., J.R.L.); the Department of Pediatrics, Rainbow Babies and Children's Hospital, Case Western Reserve University, Cleveland (M.C.W., A.M.H., D.E.W.-C.), Cincinnati Children's Hospital Medical Center, Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati (B.B.P., S.M.), and the Department of Pediatrics, Nationwide Children's Hospital, Ohio State University College of Medicine, Columbus (M.M., N.L.M.) - all in Ohio; the Social, Statistical, and Environmental Sciences Unit, RTI International, Research Triangle Park (L.L.), the Department of Pediatrics, Duke University, Durham (R.N.G., C.M.C., W.F.M.), and the Division of Neonatal-Perinatal Medicine, Department of Pediatrics, University of North Carolina at Chapel Hill, Chapel Hill (M.M.L.) - all in North Carolina; the Department of Pediatrics, Wayne State University (S.C., G.N.), and the Department of Pediatrics, Central Michigan University (S.C.) - both in Detroit; the University of Rochester School of Medicine and Dentistry, Rochester (C.T.D., P.R.C.), and the Department of Pediatrics, University of Buffalo Women's and Children's Hospital of Buffalo, Buffalo (A.M.R.) - both in New York; the Department of Pediatrics, Division of Neonatal and Developmental Medicine, Stanford University School of Medicine and Lucile Packard Children's Hospital, Palo Alto (S.R.H., K.P.V.M.), and the Department of Pediatrics, University of California, Los Angeles, Los Angeles (M.G., I.B.P.) - both in California; the Department of Pediatrics, Division of Neonatology, University of Utah School of Medicine, Salt Lake City (B.A.Y., S.W.); the Department of Pediatrics, McGovern Medical School at the University of Texas Health Science Center at Houston, Houston (K.A.K., G.E.M., A.M.K., R.A.M.), and the Department of Pediatrics, University of Texas Southwestern Medical Center, Dallas (M.H.W., R.J.H.) - both in Texas; the Social, Statistical, and Environmental Sciences Unit, RTI International, Rockville (A.D., M.M.C.), and the Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, Bethesda (R.D.H.) - both in Maryland; the Department of Pediatrics, Women and Infants Hospital, Brown University, Providence, RI (M.K., E.C.M.); the Department of Pediatrics, Indiana University School of Medicine, Indianapolis (G.M.S., A.C.H.); Emory University School of Medicine, Department of Pediatrics, Children's Healthcare of Atlanta, Atlanta (B.B.P., R.M.P., N.L.M., I.A.-C.); the Division of Neonatology, University of Alabama at Birmingham, Birmingham (N.A., M.P.-C.); the Department of Pediatrics, Children's Mercy Hospital, Kansas City, MO (W.E.T., H.W.K.); the Department of Pediatrics, University of Pennsylvania Perelman School of Medicine, Philadelphia (B.S., S.B.D.); the Department of Pediatrics, University of Iowa, Iowa City (E.F.B., H.M.H.); the Department of Pediatrics, Sanford School of Medicine, University of South Dakota, Sioux Falls (L.R.M., L.A.H.); and the College of Health and Human Services, George Mason University, Fairfax, VA (R.D.H.)
| | - Elisabeth C McGowan
- From the University of New Mexico Health Sciences Center, Albuquerque (K.L.W., C.B.-L., J.R.L.); the Department of Pediatrics, Rainbow Babies and Children's Hospital, Case Western Reserve University, Cleveland (M.C.W., A.M.H., D.E.W.-C.), Cincinnati Children's Hospital Medical Center, Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati (B.B.P., S.M.), and the Department of Pediatrics, Nationwide Children's Hospital, Ohio State University College of Medicine, Columbus (M.M., N.L.M.) - all in Ohio; the Social, Statistical, and Environmental Sciences Unit, RTI International, Research Triangle Park (L.L.), the Department of Pediatrics, Duke University, Durham (R.N.G., C.M.C., W.F.M.), and the Division of Neonatal-Perinatal Medicine, Department of Pediatrics, University of North Carolina at Chapel Hill, Chapel Hill (M.M.L.) - all in North Carolina; the Department of Pediatrics, Wayne State University (S.C., G.N.), and the Department of Pediatrics, Central Michigan University (S.C.) - both in Detroit; the University of Rochester School of Medicine and Dentistry, Rochester (C.T.D., P.R.C.), and the Department of Pediatrics, University of Buffalo Women's and Children's Hospital of Buffalo, Buffalo (A.M.R.) - both in New York; the Department of Pediatrics, Division of Neonatal and Developmental Medicine, Stanford University School of Medicine and Lucile Packard Children's Hospital, Palo Alto (S.R.H., K.P.V.M.), and the Department of Pediatrics, University of California, Los Angeles, Los Angeles (M.G., I.B.P.) - both in California; the Department of Pediatrics, Division of Neonatology, University of Utah School of Medicine, Salt Lake City (B.A.Y., S.W.); the Department of Pediatrics, McGovern Medical School at the University of Texas Health Science Center at Houston, Houston (K.A.K., G.E.M., A.M.K., R.A.M.), and the Department of Pediatrics, University of Texas Southwestern Medical Center, Dallas (M.H.W., R.J.H.) - both in Texas; the Social, Statistical, and Environmental Sciences Unit, RTI International, Rockville (A.D., M.M.C.), and the Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, Bethesda (R.D.H.) - both in Maryland; the Department of Pediatrics, Women and Infants Hospital, Brown University, Providence, RI (M.K., E.C.M.); the Department of Pediatrics, Indiana University School of Medicine, Indianapolis (G.M.S., A.C.H.); Emory University School of Medicine, Department of Pediatrics, Children's Healthcare of Atlanta, Atlanta (B.B.P., R.M.P., N.L.M., I.A.-C.); the Division of Neonatology, University of Alabama at Birmingham, Birmingham (N.A., M.P.-C.); the Department of Pediatrics, Children's Mercy Hospital, Kansas City, MO (W.E.T., H.W.K.); the Department of Pediatrics, University of Pennsylvania Perelman School of Medicine, Philadelphia (B.S., S.B.D.); the Department of Pediatrics, University of Iowa, Iowa City (E.F.B., H.M.H.); the Department of Pediatrics, Sanford School of Medicine, University of South Dakota, Sioux Falls (L.R.M., L.A.H.); and the College of Health and Human Services, George Mason University, Fairfax, VA (R.D.H.)
| | - Abbey C Hines
- From the University of New Mexico Health Sciences Center, Albuquerque (K.L.W., C.B.-L., J.R.L.); the Department of Pediatrics, Rainbow Babies and Children's Hospital, Case Western Reserve University, Cleveland (M.C.W., A.M.H., D.E.W.-C.), Cincinnati Children's Hospital Medical Center, Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati (B.B.P., S.M.), and the Department of Pediatrics, Nationwide Children's Hospital, Ohio State University College of Medicine, Columbus (M.M., N.L.M.) - all in Ohio; the Social, Statistical, and Environmental Sciences Unit, RTI International, Research Triangle Park (L.L.), the Department of Pediatrics, Duke University, Durham (R.N.G., C.M.C., W.F.M.), and the Division of Neonatal-Perinatal Medicine, Department of Pediatrics, University of North Carolina at Chapel Hill, Chapel Hill (M.M.L.) - all in North Carolina; the Department of Pediatrics, Wayne State University (S.C., G.N.), and the Department of Pediatrics, Central Michigan University (S.C.) - both in Detroit; the University of Rochester School of Medicine and Dentistry, Rochester (C.T.D., P.R.C.), and the Department of Pediatrics, University of Buffalo Women's and Children's Hospital of Buffalo, Buffalo (A.M.R.) - both in New York; the Department of Pediatrics, Division of Neonatal and Developmental Medicine, Stanford University School of Medicine and Lucile Packard Children's Hospital, Palo Alto (S.R.H., K.P.V.M.), and the Department of Pediatrics, University of California, Los Angeles, Los Angeles (M.G., I.B.P.) - both in California; the Department of Pediatrics, Division of Neonatology, University of Utah School of Medicine, Salt Lake City (B.A.Y., S.W.); the Department of Pediatrics, McGovern Medical School at the University of Texas Health Science Center at Houston, Houston (K.A.K., G.E.M., A.M.K., R.A.M.), and the Department of Pediatrics, University of Texas Southwestern Medical Center, Dallas (M.H.W., R.J.H.) - both in Texas; the Social, Statistical, and Environmental Sciences Unit, RTI International, Rockville (A.D., M.M.C.), and the Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, Bethesda (R.D.H.) - both in Maryland; the Department of Pediatrics, Women and Infants Hospital, Brown University, Providence, RI (M.K., E.C.M.); the Department of Pediatrics, Indiana University School of Medicine, Indianapolis (G.M.S., A.C.H.); Emory University School of Medicine, Department of Pediatrics, Children's Healthcare of Atlanta, Atlanta (B.B.P., R.M.P., N.L.M., I.A.-C.); the Division of Neonatology, University of Alabama at Birmingham, Birmingham (N.A., M.P.-C.); the Department of Pediatrics, Children's Mercy Hospital, Kansas City, MO (W.E.T., H.W.K.); the Department of Pediatrics, University of Pennsylvania Perelman School of Medicine, Philadelphia (B.S., S.B.D.); the Department of Pediatrics, University of Iowa, Iowa City (E.F.B., H.M.H.); the Department of Pediatrics, Sanford School of Medicine, University of South Dakota, Sioux Falls (L.R.M., L.A.H.); and the College of Health and Human Services, George Mason University, Fairfax, VA (R.D.H.)
| | - Stephanie Merhar
- From the University of New Mexico Health Sciences Center, Albuquerque (K.L.W., C.B.-L., J.R.L.); the Department of Pediatrics, Rainbow Babies and Children's Hospital, Case Western Reserve University, Cleveland (M.C.W., A.M.H., D.E.W.-C.), Cincinnati Children's Hospital Medical Center, Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati (B.B.P., S.M.), and the Department of Pediatrics, Nationwide Children's Hospital, Ohio State University College of Medicine, Columbus (M.M., N.L.M.) - all in Ohio; the Social, Statistical, and Environmental Sciences Unit, RTI International, Research Triangle Park (L.L.), the Department of Pediatrics, Duke University, Durham (R.N.G., C.M.C., W.F.M.), and the Division of Neonatal-Perinatal Medicine, Department of Pediatrics, University of North Carolina at Chapel Hill, Chapel Hill (M.M.L.) - all in North Carolina; the Department of Pediatrics, Wayne State University (S.C., G.N.), and the Department of Pediatrics, Central Michigan University (S.C.) - both in Detroit; the University of Rochester School of Medicine and Dentistry, Rochester (C.T.D., P.R.C.), and the Department of Pediatrics, University of Buffalo Women's and Children's Hospital of Buffalo, Buffalo (A.M.R.) - both in New York; the Department of Pediatrics, Division of Neonatal and Developmental Medicine, Stanford University School of Medicine and Lucile Packard Children's Hospital, Palo Alto (S.R.H., K.P.V.M.), and the Department of Pediatrics, University of California, Los Angeles, Los Angeles (M.G., I.B.P.) - both in California; the Department of Pediatrics, Division of Neonatology, University of Utah School of Medicine, Salt Lake City (B.A.Y., S.W.); the Department of Pediatrics, McGovern Medical School at the University of Texas Health Science Center at Houston, Houston (K.A.K., G.E.M., A.M.K., R.A.M.), and the Department of Pediatrics, University of Texas Southwestern Medical Center, Dallas (M.H.W., R.J.H.) - both in Texas; the Social, Statistical, and Environmental Sciences Unit, RTI International, Rockville (A.D., M.M.C.), and the Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, Bethesda (R.D.H.) - both in Maryland; the Department of Pediatrics, Women and Infants Hospital, Brown University, Providence, RI (M.K., E.C.M.); the Department of Pediatrics, Indiana University School of Medicine, Indianapolis (G.M.S., A.C.H.); Emory University School of Medicine, Department of Pediatrics, Children's Healthcare of Atlanta, Atlanta (B.B.P., R.M.P., N.L.M., I.A.-C.); the Division of Neonatology, University of Alabama at Birmingham, Birmingham (N.A., M.P.-C.); the Department of Pediatrics, Children's Mercy Hospital, Kansas City, MO (W.E.T., H.W.K.); the Department of Pediatrics, University of Pennsylvania Perelman School of Medicine, Philadelphia (B.S., S.B.D.); the Department of Pediatrics, University of Iowa, Iowa City (E.F.B., H.M.H.); the Department of Pediatrics, Sanford School of Medicine, University of South Dakota, Sioux Falls (L.R.M., L.A.H.); and the College of Health and Human Services, George Mason University, Fairfax, VA (R.D.H.)
| | - Myriam Peralta-Carcelen
- From the University of New Mexico Health Sciences Center, Albuquerque (K.L.W., C.B.-L., J.R.L.); the Department of Pediatrics, Rainbow Babies and Children's Hospital, Case Western Reserve University, Cleveland (M.C.W., A.M.H., D.E.W.-C.), Cincinnati Children's Hospital Medical Center, Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati (B.B.P., S.M.), and the Department of Pediatrics, Nationwide Children's Hospital, Ohio State University College of Medicine, Columbus (M.M., N.L.M.) - all in Ohio; the Social, Statistical, and Environmental Sciences Unit, RTI International, Research Triangle Park (L.L.), the Department of Pediatrics, Duke University, Durham (R.N.G., C.M.C., W.F.M.), and the Division of Neonatal-Perinatal Medicine, Department of Pediatrics, University of North Carolina at Chapel Hill, Chapel Hill (M.M.L.) - all in North Carolina; the Department of Pediatrics, Wayne State University (S.C., G.N.), and the Department of Pediatrics, Central Michigan University (S.C.) - both in Detroit; the University of Rochester School of Medicine and Dentistry, Rochester (C.T.D., P.R.C.), and the Department of Pediatrics, University of Buffalo Women's and Children's Hospital of Buffalo, Buffalo (A.M.R.) - both in New York; the Department of Pediatrics, Division of Neonatal and Developmental Medicine, Stanford University School of Medicine and Lucile Packard Children's Hospital, Palo Alto (S.R.H., K.P.V.M.), and the Department of Pediatrics, University of California, Los Angeles, Los Angeles (M.G., I.B.P.) - both in California; the Department of Pediatrics, Division of Neonatology, University of Utah School of Medicine, Salt Lake City (B.A.Y., S.W.); the Department of Pediatrics, McGovern Medical School at the University of Texas Health Science Center at Houston, Houston (K.A.K., G.E.M., A.M.K., R.A.M.), and the Department of Pediatrics, University of Texas Southwestern Medical Center, Dallas (M.H.W., R.J.H.) - both in Texas; the Social, Statistical, and Environmental Sciences Unit, RTI International, Rockville (A.D., M.M.C.), and the Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, Bethesda (R.D.H.) - both in Maryland; the Department of Pediatrics, Women and Infants Hospital, Brown University, Providence, RI (M.K., E.C.M.); the Department of Pediatrics, Indiana University School of Medicine, Indianapolis (G.M.S., A.C.H.); Emory University School of Medicine, Department of Pediatrics, Children's Healthcare of Atlanta, Atlanta (B.B.P., R.M.P., N.L.M., I.A.-C.); the Division of Neonatology, University of Alabama at Birmingham, Birmingham (N.A., M.P.-C.); the Department of Pediatrics, Children's Mercy Hospital, Kansas City, MO (W.E.T., H.W.K.); the Department of Pediatrics, University of Pennsylvania Perelman School of Medicine, Philadelphia (B.S., S.B.D.); the Department of Pediatrics, University of Iowa, Iowa City (E.F.B., H.M.H.); the Department of Pediatrics, Sanford School of Medicine, University of South Dakota, Sioux Falls (L.R.M., L.A.H.); and the College of Health and Human Services, George Mason University, Fairfax, VA (R.D.H.)
| | - Deanne E Wilson-Costello
- From the University of New Mexico Health Sciences Center, Albuquerque (K.L.W., C.B.-L., J.R.L.); the Department of Pediatrics, Rainbow Babies and Children's Hospital, Case Western Reserve University, Cleveland (M.C.W., A.M.H., D.E.W.-C.), Cincinnati Children's Hospital Medical Center, Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati (B.B.P., S.M.), and the Department of Pediatrics, Nationwide Children's Hospital, Ohio State University College of Medicine, Columbus (M.M., N.L.M.) - all in Ohio; the Social, Statistical, and Environmental Sciences Unit, RTI International, Research Triangle Park (L.L.), the Department of Pediatrics, Duke University, Durham (R.N.G., C.M.C., W.F.M.), and the Division of Neonatal-Perinatal Medicine, Department of Pediatrics, University of North Carolina at Chapel Hill, Chapel Hill (M.M.L.) - all in North Carolina; the Department of Pediatrics, Wayne State University (S.C., G.N.), and the Department of Pediatrics, Central Michigan University (S.C.) - both in Detroit; the University of Rochester School of Medicine and Dentistry, Rochester (C.T.D., P.R.C.), and the Department of Pediatrics, University of Buffalo Women's and Children's Hospital of Buffalo, Buffalo (A.M.R.) - both in New York; the Department of Pediatrics, Division of Neonatal and Developmental Medicine, Stanford University School of Medicine and Lucile Packard Children's Hospital, Palo Alto (S.R.H., K.P.V.M.), and the Department of Pediatrics, University of California, Los Angeles, Los Angeles (M.G., I.B.P.) - both in California; the Department of Pediatrics, Division of Neonatology, University of Utah School of Medicine, Salt Lake City (B.A.Y., S.W.); the Department of Pediatrics, McGovern Medical School at the University of Texas Health Science Center at Houston, Houston (K.A.K., G.E.M., A.M.K., R.A.M.), and the Department of Pediatrics, University of Texas Southwestern Medical Center, Dallas (M.H.W., R.J.H.) - both in Texas; the Social, Statistical, and Environmental Sciences Unit, RTI International, Rockville (A.D., M.M.C.), and the Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, Bethesda (R.D.H.) - both in Maryland; the Department of Pediatrics, Women and Infants Hospital, Brown University, Providence, RI (M.K., E.C.M.); the Department of Pediatrics, Indiana University School of Medicine, Indianapolis (G.M.S., A.C.H.); Emory University School of Medicine, Department of Pediatrics, Children's Healthcare of Atlanta, Atlanta (B.B.P., R.M.P., N.L.M., I.A.-C.); the Division of Neonatology, University of Alabama at Birmingham, Birmingham (N.A., M.P.-C.); the Department of Pediatrics, Children's Mercy Hospital, Kansas City, MO (W.E.T., H.W.K.); the Department of Pediatrics, University of Pennsylvania Perelman School of Medicine, Philadelphia (B.S., S.B.D.); the Department of Pediatrics, University of Iowa, Iowa City (E.F.B., H.M.H.); the Department of Pediatrics, Sanford School of Medicine, University of South Dakota, Sioux Falls (L.R.M., L.A.H.); and the College of Health and Human Services, George Mason University, Fairfax, VA (R.D.H.)
| | - Howard W Kilbride
- From the University of New Mexico Health Sciences Center, Albuquerque (K.L.W., C.B.-L., J.R.L.); the Department of Pediatrics, Rainbow Babies and Children's Hospital, Case Western Reserve University, Cleveland (M.C.W., A.M.H., D.E.W.-C.), Cincinnati Children's Hospital Medical Center, Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati (B.B.P., S.M.), and the Department of Pediatrics, Nationwide Children's Hospital, Ohio State University College of Medicine, Columbus (M.M., N.L.M.) - all in Ohio; the Social, Statistical, and Environmental Sciences Unit, RTI International, Research Triangle Park (L.L.), the Department of Pediatrics, Duke University, Durham (R.N.G., C.M.C., W.F.M.), and the Division of Neonatal-Perinatal Medicine, Department of Pediatrics, University of North Carolina at Chapel Hill, Chapel Hill (M.M.L.) - all in North Carolina; the Department of Pediatrics, Wayne State University (S.C., G.N.), and the Department of Pediatrics, Central Michigan University (S.C.) - both in Detroit; the University of Rochester School of Medicine and Dentistry, Rochester (C.T.D., P.R.C.), and the Department of Pediatrics, University of Buffalo Women's and Children's Hospital of Buffalo, Buffalo (A.M.R.) - both in New York; the Department of Pediatrics, Division of Neonatal and Developmental Medicine, Stanford University School of Medicine and Lucile Packard Children's Hospital, Palo Alto (S.R.H., K.P.V.M.), and the Department of Pediatrics, University of California, Los Angeles, Los Angeles (M.G., I.B.P.) - both in California; the Department of Pediatrics, Division of Neonatology, University of Utah School of Medicine, Salt Lake City (B.A.Y., S.W.); the Department of Pediatrics, McGovern Medical School at the University of Texas Health Science Center at Houston, Houston (K.A.K., G.E.M., A.M.K., R.A.M.), and the Department of Pediatrics, University of Texas Southwestern Medical Center, Dallas (M.H.W., R.J.H.) - both in Texas; the Social, Statistical, and Environmental Sciences Unit, RTI International, Rockville (A.D., M.M.C.), and the Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, Bethesda (R.D.H.) - both in Maryland; the Department of Pediatrics, Women and Infants Hospital, Brown University, Providence, RI (M.K., E.C.M.); the Department of Pediatrics, Indiana University School of Medicine, Indianapolis (G.M.S., A.C.H.); Emory University School of Medicine, Department of Pediatrics, Children's Healthcare of Atlanta, Atlanta (B.B.P., R.M.P., N.L.M., I.A.-C.); the Division of Neonatology, University of Alabama at Birmingham, Birmingham (N.A., M.P.-C.); the Department of Pediatrics, Children's Mercy Hospital, Kansas City, MO (W.E.T., H.W.K.); the Department of Pediatrics, University of Pennsylvania Perelman School of Medicine, Philadelphia (B.S., S.B.D.); the Department of Pediatrics, University of Iowa, Iowa City (E.F.B., H.M.H.); the Department of Pediatrics, Sanford School of Medicine, University of South Dakota, Sioux Falls (L.R.M., L.A.H.); and the College of Health and Human Services, George Mason University, Fairfax, VA (R.D.H.)
| | - Sara B DeMauro
- From the University of New Mexico Health Sciences Center, Albuquerque (K.L.W., C.B.-L., J.R.L.); the Department of Pediatrics, Rainbow Babies and Children's Hospital, Case Western Reserve University, Cleveland (M.C.W., A.M.H., D.E.W.-C.), Cincinnati Children's Hospital Medical Center, Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati (B.B.P., S.M.), and the Department of Pediatrics, Nationwide Children's Hospital, Ohio State University College of Medicine, Columbus (M.M., N.L.M.) - all in Ohio; the Social, Statistical, and Environmental Sciences Unit, RTI International, Research Triangle Park (L.L.), the Department of Pediatrics, Duke University, Durham (R.N.G., C.M.C., W.F.M.), and the Division of Neonatal-Perinatal Medicine, Department of Pediatrics, University of North Carolina at Chapel Hill, Chapel Hill (M.M.L.) - all in North Carolina; the Department of Pediatrics, Wayne State University (S.C., G.N.), and the Department of Pediatrics, Central Michigan University (S.C.) - both in Detroit; the University of Rochester School of Medicine and Dentistry, Rochester (C.T.D., P.R.C.), and the Department of Pediatrics, University of Buffalo Women's and Children's Hospital of Buffalo, Buffalo (A.M.R.) - both in New York; the Department of Pediatrics, Division of Neonatal and Developmental Medicine, Stanford University School of Medicine and Lucile Packard Children's Hospital, Palo Alto (S.R.H., K.P.V.M.), and the Department of Pediatrics, University of California, Los Angeles, Los Angeles (M.G., I.B.P.) - both in California; the Department of Pediatrics, Division of Neonatology, University of Utah School of Medicine, Salt Lake City (B.A.Y., S.W.); the Department of Pediatrics, McGovern Medical School at the University of Texas Health Science Center at Houston, Houston (K.A.K., G.E.M., A.M.K., R.A.M.), and the Department of Pediatrics, University of Texas Southwestern Medical Center, Dallas (M.H.W., R.J.H.) - both in Texas; the Social, Statistical, and Environmental Sciences Unit, RTI International, Rockville (A.D., M.M.C.), and the Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, Bethesda (R.D.H.) - both in Maryland; the Department of Pediatrics, Women and Infants Hospital, Brown University, Providence, RI (M.K., E.C.M.); the Department of Pediatrics, Indiana University School of Medicine, Indianapolis (G.M.S., A.C.H.); Emory University School of Medicine, Department of Pediatrics, Children's Healthcare of Atlanta, Atlanta (B.B.P., R.M.P., N.L.M., I.A.-C.); the Division of Neonatology, University of Alabama at Birmingham, Birmingham (N.A., M.P.-C.); the Department of Pediatrics, Children's Mercy Hospital, Kansas City, MO (W.E.T., H.W.K.); the Department of Pediatrics, University of Pennsylvania Perelman School of Medicine, Philadelphia (B.S., S.B.D.); the Department of Pediatrics, University of Iowa, Iowa City (E.F.B., H.M.H.); the Department of Pediatrics, Sanford School of Medicine, University of South Dakota, Sioux Falls (L.R.M., L.A.H.); and the College of Health and Human Services, George Mason University, Fairfax, VA (R.D.H.)
| | - Roy J Heyne
- From the University of New Mexico Health Sciences Center, Albuquerque (K.L.W., C.B.-L., J.R.L.); the Department of Pediatrics, Rainbow Babies and Children's Hospital, Case Western Reserve University, Cleveland (M.C.W., A.M.H., D.E.W.-C.), Cincinnati Children's Hospital Medical Center, Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati (B.B.P., S.M.), and the Department of Pediatrics, Nationwide Children's Hospital, Ohio State University College of Medicine, Columbus (M.M., N.L.M.) - all in Ohio; the Social, Statistical, and Environmental Sciences Unit, RTI International, Research Triangle Park (L.L.), the Department of Pediatrics, Duke University, Durham (R.N.G., C.M.C., W.F.M.), and the Division of Neonatal-Perinatal Medicine, Department of Pediatrics, University of North Carolina at Chapel Hill, Chapel Hill (M.M.L.) - all in North Carolina; the Department of Pediatrics, Wayne State University (S.C., G.N.), and the Department of Pediatrics, Central Michigan University (S.C.) - both in Detroit; the University of Rochester School of Medicine and Dentistry, Rochester (C.T.D., P.R.C.), and the Department of Pediatrics, University of Buffalo Women's and Children's Hospital of Buffalo, Buffalo (A.M.R.) - both in New York; the Department of Pediatrics, Division of Neonatal and Developmental Medicine, Stanford University School of Medicine and Lucile Packard Children's Hospital, Palo Alto (S.R.H., K.P.V.M.), and the Department of Pediatrics, University of California, Los Angeles, Los Angeles (M.G., I.B.P.) - both in California; the Department of Pediatrics, Division of Neonatology, University of Utah School of Medicine, Salt Lake City (B.A.Y., S.W.); the Department of Pediatrics, McGovern Medical School at the University of Texas Health Science Center at Houston, Houston (K.A.K., G.E.M., A.M.K., R.A.M.), and the Department of Pediatrics, University of Texas Southwestern Medical Center, Dallas (M.H.W., R.J.H.) - both in Texas; the Social, Statistical, and Environmental Sciences Unit, RTI International, Rockville (A.D., M.M.C.), and the Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, Bethesda (R.D.H.) - both in Maryland; the Department of Pediatrics, Women and Infants Hospital, Brown University, Providence, RI (M.K., E.C.M.); the Department of Pediatrics, Indiana University School of Medicine, Indianapolis (G.M.S., A.C.H.); Emory University School of Medicine, Department of Pediatrics, Children's Healthcare of Atlanta, Atlanta (B.B.P., R.M.P., N.L.M., I.A.-C.); the Division of Neonatology, University of Alabama at Birmingham, Birmingham (N.A., M.P.-C.); the Department of Pediatrics, Children's Mercy Hospital, Kansas City, MO (W.E.T., H.W.K.); the Department of Pediatrics, University of Pennsylvania Perelman School of Medicine, Philadelphia (B.S., S.B.D.); the Department of Pediatrics, University of Iowa, Iowa City (E.F.B., H.M.H.); the Department of Pediatrics, Sanford School of Medicine, University of South Dakota, Sioux Falls (L.R.M., L.A.H.); and the College of Health and Human Services, George Mason University, Fairfax, VA (R.D.H.)
| | - Ricardo A Mosquera
- From the University of New Mexico Health Sciences Center, Albuquerque (K.L.W., C.B.-L., J.R.L.); the Department of Pediatrics, Rainbow Babies and Children's Hospital, Case Western Reserve University, Cleveland (M.C.W., A.M.H., D.E.W.-C.), Cincinnati Children's Hospital Medical Center, Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati (B.B.P., S.M.), and the Department of Pediatrics, Nationwide Children's Hospital, Ohio State University College of Medicine, Columbus (M.M., N.L.M.) - all in Ohio; the Social, Statistical, and Environmental Sciences Unit, RTI International, Research Triangle Park (L.L.), the Department of Pediatrics, Duke University, Durham (R.N.G., C.M.C., W.F.M.), and the Division of Neonatal-Perinatal Medicine, Department of Pediatrics, University of North Carolina at Chapel Hill, Chapel Hill (M.M.L.) - all in North Carolina; the Department of Pediatrics, Wayne State University (S.C., G.N.), and the Department of Pediatrics, Central Michigan University (S.C.) - both in Detroit; the University of Rochester School of Medicine and Dentistry, Rochester (C.T.D., P.R.C.), and the Department of Pediatrics, University of Buffalo Women's and Children's Hospital of Buffalo, Buffalo (A.M.R.) - both in New York; the Department of Pediatrics, Division of Neonatal and Developmental Medicine, Stanford University School of Medicine and Lucile Packard Children's Hospital, Palo Alto (S.R.H., K.P.V.M.), and the Department of Pediatrics, University of California, Los Angeles, Los Angeles (M.G., I.B.P.) - both in California; the Department of Pediatrics, Division of Neonatology, University of Utah School of Medicine, Salt Lake City (B.A.Y., S.W.); the Department of Pediatrics, McGovern Medical School at the University of Texas Health Science Center at Houston, Houston (K.A.K., G.E.M., A.M.K., R.A.M.), and the Department of Pediatrics, University of Texas Southwestern Medical Center, Dallas (M.H.W., R.J.H.) - both in Texas; the Social, Statistical, and Environmental Sciences Unit, RTI International, Rockville (A.D., M.M.C.), and the Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, Bethesda (R.D.H.) - both in Maryland; the Department of Pediatrics, Women and Infants Hospital, Brown University, Providence, RI (M.K., E.C.M.); the Department of Pediatrics, Indiana University School of Medicine, Indianapolis (G.M.S., A.C.H.); Emory University School of Medicine, Department of Pediatrics, Children's Healthcare of Atlanta, Atlanta (B.B.P., R.M.P., N.L.M., I.A.-C.); the Division of Neonatology, University of Alabama at Birmingham, Birmingham (N.A., M.P.-C.); the Department of Pediatrics, Children's Mercy Hospital, Kansas City, MO (W.E.T., H.W.K.); the Department of Pediatrics, University of Pennsylvania Perelman School of Medicine, Philadelphia (B.S., S.B.D.); the Department of Pediatrics, University of Iowa, Iowa City (E.F.B., H.M.H.); the Department of Pediatrics, Sanford School of Medicine, University of South Dakota, Sioux Falls (L.R.M., L.A.H.); and the College of Health and Human Services, George Mason University, Fairfax, VA (R.D.H.)
| | - Girija Natarajan
- From the University of New Mexico Health Sciences Center, Albuquerque (K.L.W., C.B.-L., J.R.L.); the Department of Pediatrics, Rainbow Babies and Children's Hospital, Case Western Reserve University, Cleveland (M.C.W., A.M.H., D.E.W.-C.), Cincinnati Children's Hospital Medical Center, Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati (B.B.P., S.M.), and the Department of Pediatrics, Nationwide Children's Hospital, Ohio State University College of Medicine, Columbus (M.M., N.L.M.) - all in Ohio; the Social, Statistical, and Environmental Sciences Unit, RTI International, Research Triangle Park (L.L.), the Department of Pediatrics, Duke University, Durham (R.N.G., C.M.C., W.F.M.), and the Division of Neonatal-Perinatal Medicine, Department of Pediatrics, University of North Carolina at Chapel Hill, Chapel Hill (M.M.L.) - all in North Carolina; the Department of Pediatrics, Wayne State University (S.C., G.N.), and the Department of Pediatrics, Central Michigan University (S.C.) - both in Detroit; the University of Rochester School of Medicine and Dentistry, Rochester (C.T.D., P.R.C.), and the Department of Pediatrics, University of Buffalo Women's and Children's Hospital of Buffalo, Buffalo (A.M.R.) - both in New York; the Department of Pediatrics, Division of Neonatal and Developmental Medicine, Stanford University School of Medicine and Lucile Packard Children's Hospital, Palo Alto (S.R.H., K.P.V.M.), and the Department of Pediatrics, University of California, Los Angeles, Los Angeles (M.G., I.B.P.) - both in California; the Department of Pediatrics, Division of Neonatology, University of Utah School of Medicine, Salt Lake City (B.A.Y., S.W.); the Department of Pediatrics, McGovern Medical School at the University of Texas Health Science Center at Houston, Houston (K.A.K., G.E.M., A.M.K., R.A.M.), and the Department of Pediatrics, University of Texas Southwestern Medical Center, Dallas (M.H.W., R.J.H.) - both in Texas; the Social, Statistical, and Environmental Sciences Unit, RTI International, Rockville (A.D., M.M.C.), and the Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, Bethesda (R.D.H.) - both in Maryland; the Department of Pediatrics, Women and Infants Hospital, Brown University, Providence, RI (M.K., E.C.M.); the Department of Pediatrics, Indiana University School of Medicine, Indianapolis (G.M.S., A.C.H.); Emory University School of Medicine, Department of Pediatrics, Children's Healthcare of Atlanta, Atlanta (B.B.P., R.M.P., N.L.M., I.A.-C.); the Division of Neonatology, University of Alabama at Birmingham, Birmingham (N.A., M.P.-C.); the Department of Pediatrics, Children's Mercy Hospital, Kansas City, MO (W.E.T., H.W.K.); the Department of Pediatrics, University of Pennsylvania Perelman School of Medicine, Philadelphia (B.S., S.B.D.); the Department of Pediatrics, University of Iowa, Iowa City (E.F.B., H.M.H.); the Department of Pediatrics, Sanford School of Medicine, University of South Dakota, Sioux Falls (L.R.M., L.A.H.); and the College of Health and Human Services, George Mason University, Fairfax, VA (R.D.H.)
| | - Isabell B Purdy
- From the University of New Mexico Health Sciences Center, Albuquerque (K.L.W., C.B.-L., J.R.L.); the Department of Pediatrics, Rainbow Babies and Children's Hospital, Case Western Reserve University, Cleveland (M.C.W., A.M.H., D.E.W.-C.), Cincinnati Children's Hospital Medical Center, Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati (B.B.P., S.M.), and the Department of Pediatrics, Nationwide Children's Hospital, Ohio State University College of Medicine, Columbus (M.M., N.L.M.) - all in Ohio; the Social, Statistical, and Environmental Sciences Unit, RTI International, Research Triangle Park (L.L.), the Department of Pediatrics, Duke University, Durham (R.N.G., C.M.C., W.F.M.), and the Division of Neonatal-Perinatal Medicine, Department of Pediatrics, University of North Carolina at Chapel Hill, Chapel Hill (M.M.L.) - all in North Carolina; the Department of Pediatrics, Wayne State University (S.C., G.N.), and the Department of Pediatrics, Central Michigan University (S.C.) - both in Detroit; the University of Rochester School of Medicine and Dentistry, Rochester (C.T.D., P.R.C.), and the Department of Pediatrics, University of Buffalo Women's and Children's Hospital of Buffalo, Buffalo (A.M.R.) - both in New York; the Department of Pediatrics, Division of Neonatal and Developmental Medicine, Stanford University School of Medicine and Lucile Packard Children's Hospital, Palo Alto (S.R.H., K.P.V.M.), and the Department of Pediatrics, University of California, Los Angeles, Los Angeles (M.G., I.B.P.) - both in California; the Department of Pediatrics, Division of Neonatology, University of Utah School of Medicine, Salt Lake City (B.A.Y., S.W.); the Department of Pediatrics, McGovern Medical School at the University of Texas Health Science Center at Houston, Houston (K.A.K., G.E.M., A.M.K., R.A.M.), and the Department of Pediatrics, University of Texas Southwestern Medical Center, Dallas (M.H.W., R.J.H.) - both in Texas; the Social, Statistical, and Environmental Sciences Unit, RTI International, Rockville (A.D., M.M.C.), and the Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, Bethesda (R.D.H.) - both in Maryland; the Department of Pediatrics, Women and Infants Hospital, Brown University, Providence, RI (M.K., E.C.M.); the Department of Pediatrics, Indiana University School of Medicine, Indianapolis (G.M.S., A.C.H.); Emory University School of Medicine, Department of Pediatrics, Children's Healthcare of Atlanta, Atlanta (B.B.P., R.M.P., N.L.M., I.A.-C.); the Division of Neonatology, University of Alabama at Birmingham, Birmingham (N.A., M.P.-C.); the Department of Pediatrics, Children's Mercy Hospital, Kansas City, MO (W.E.T., H.W.K.); the Department of Pediatrics, University of Pennsylvania Perelman School of Medicine, Philadelphia (B.S., S.B.D.); the Department of Pediatrics, University of Iowa, Iowa City (E.F.B., H.M.H.); the Department of Pediatrics, Sanford School of Medicine, University of South Dakota, Sioux Falls (L.R.M., L.A.H.); and the College of Health and Human Services, George Mason University, Fairfax, VA (R.D.H.)
| | - Jean R Lowe
- From the University of New Mexico Health Sciences Center, Albuquerque (K.L.W., C.B.-L., J.R.L.); the Department of Pediatrics, Rainbow Babies and Children's Hospital, Case Western Reserve University, Cleveland (M.C.W., A.M.H., D.E.W.-C.), Cincinnati Children's Hospital Medical Center, Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati (B.B.P., S.M.), and the Department of Pediatrics, Nationwide Children's Hospital, Ohio State University College of Medicine, Columbus (M.M., N.L.M.) - all in Ohio; the Social, Statistical, and Environmental Sciences Unit, RTI International, Research Triangle Park (L.L.), the Department of Pediatrics, Duke University, Durham (R.N.G., C.M.C., W.F.M.), and the Division of Neonatal-Perinatal Medicine, Department of Pediatrics, University of North Carolina at Chapel Hill, Chapel Hill (M.M.L.) - all in North Carolina; the Department of Pediatrics, Wayne State University (S.C., G.N.), and the Department of Pediatrics, Central Michigan University (S.C.) - both in Detroit; the University of Rochester School of Medicine and Dentistry, Rochester (C.T.D., P.R.C.), and the Department of Pediatrics, University of Buffalo Women's and Children's Hospital of Buffalo, Buffalo (A.M.R.) - both in New York; the Department of Pediatrics, Division of Neonatal and Developmental Medicine, Stanford University School of Medicine and Lucile Packard Children's Hospital, Palo Alto (S.R.H., K.P.V.M.), and the Department of Pediatrics, University of California, Los Angeles, Los Angeles (M.G., I.B.P.) - both in California; the Department of Pediatrics, Division of Neonatology, University of Utah School of Medicine, Salt Lake City (B.A.Y., S.W.); the Department of Pediatrics, McGovern Medical School at the University of Texas Health Science Center at Houston, Houston (K.A.K., G.E.M., A.M.K., R.A.M.), and the Department of Pediatrics, University of Texas Southwestern Medical Center, Dallas (M.H.W., R.J.H.) - both in Texas; the Social, Statistical, and Environmental Sciences Unit, RTI International, Rockville (A.D., M.M.C.), and the Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, Bethesda (R.D.H.) - both in Maryland; the Department of Pediatrics, Women and Infants Hospital, Brown University, Providence, RI (M.K., E.C.M.); the Department of Pediatrics, Indiana University School of Medicine, Indianapolis (G.M.S., A.C.H.); Emory University School of Medicine, Department of Pediatrics, Children's Healthcare of Atlanta, Atlanta (B.B.P., R.M.P., N.L.M., I.A.-C.); the Division of Neonatology, University of Alabama at Birmingham, Birmingham (N.A., M.P.-C.); the Department of Pediatrics, Children's Mercy Hospital, Kansas City, MO (W.E.T., H.W.K.); the Department of Pediatrics, University of Pennsylvania Perelman School of Medicine, Philadelphia (B.S., S.B.D.); the Department of Pediatrics, University of Iowa, Iowa City (E.F.B., H.M.H.); the Department of Pediatrics, Sanford School of Medicine, University of South Dakota, Sioux Falls (L.R.M., L.A.H.); and the College of Health and Human Services, George Mason University, Fairfax, VA (R.D.H.)
| | - Nathalie L Maitre
- From the University of New Mexico Health Sciences Center, Albuquerque (K.L.W., C.B.-L., J.R.L.); the Department of Pediatrics, Rainbow Babies and Children's Hospital, Case Western Reserve University, Cleveland (M.C.W., A.M.H., D.E.W.-C.), Cincinnati Children's Hospital Medical Center, Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati (B.B.P., S.M.), and the Department of Pediatrics, Nationwide Children's Hospital, Ohio State University College of Medicine, Columbus (M.M., N.L.M.) - all in Ohio; the Social, Statistical, and Environmental Sciences Unit, RTI International, Research Triangle Park (L.L.), the Department of Pediatrics, Duke University, Durham (R.N.G., C.M.C., W.F.M.), and the Division of Neonatal-Perinatal Medicine, Department of Pediatrics, University of North Carolina at Chapel Hill, Chapel Hill (M.M.L.) - all in North Carolina; the Department of Pediatrics, Wayne State University (S.C., G.N.), and the Department of Pediatrics, Central Michigan University (S.C.) - both in Detroit; the University of Rochester School of Medicine and Dentistry, Rochester (C.T.D., P.R.C.), and the Department of Pediatrics, University of Buffalo Women's and Children's Hospital of Buffalo, Buffalo (A.M.R.) - both in New York; the Department of Pediatrics, Division of Neonatal and Developmental Medicine, Stanford University School of Medicine and Lucile Packard Children's Hospital, Palo Alto (S.R.H., K.P.V.M.), and the Department of Pediatrics, University of California, Los Angeles, Los Angeles (M.G., I.B.P.) - both in California; the Department of Pediatrics, Division of Neonatology, University of Utah School of Medicine, Salt Lake City (B.A.Y., S.W.); the Department of Pediatrics, McGovern Medical School at the University of Texas Health Science Center at Houston, Houston (K.A.K., G.E.M., A.M.K., R.A.M.), and the Department of Pediatrics, University of Texas Southwestern Medical Center, Dallas (M.H.W., R.J.H.) - both in Texas; the Social, Statistical, and Environmental Sciences Unit, RTI International, Rockville (A.D., M.M.C.), and the Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, Bethesda (R.D.H.) - both in Maryland; the Department of Pediatrics, Women and Infants Hospital, Brown University, Providence, RI (M.K., E.C.M.); the Department of Pediatrics, Indiana University School of Medicine, Indianapolis (G.M.S., A.C.H.); Emory University School of Medicine, Department of Pediatrics, Children's Healthcare of Atlanta, Atlanta (B.B.P., R.M.P., N.L.M., I.A.-C.); the Division of Neonatology, University of Alabama at Birmingham, Birmingham (N.A., M.P.-C.); the Department of Pediatrics, Children's Mercy Hospital, Kansas City, MO (W.E.T., H.W.K.); the Department of Pediatrics, University of Pennsylvania Perelman School of Medicine, Philadelphia (B.S., S.B.D.); the Department of Pediatrics, University of Iowa, Iowa City (E.F.B., H.M.H.); the Department of Pediatrics, Sanford School of Medicine, University of South Dakota, Sioux Falls (L.R.M., L.A.H.); and the College of Health and Human Services, George Mason University, Fairfax, VA (R.D.H.)
| | - Heidi M Harmon
- From the University of New Mexico Health Sciences Center, Albuquerque (K.L.W., C.B.-L., J.R.L.); the Department of Pediatrics, Rainbow Babies and Children's Hospital, Case Western Reserve University, Cleveland (M.C.W., A.M.H., D.E.W.-C.), Cincinnati Children's Hospital Medical Center, Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati (B.B.P., S.M.), and the Department of Pediatrics, Nationwide Children's Hospital, Ohio State University College of Medicine, Columbus (M.M., N.L.M.) - all in Ohio; the Social, Statistical, and Environmental Sciences Unit, RTI International, Research Triangle Park (L.L.), the Department of Pediatrics, Duke University, Durham (R.N.G., C.M.C., W.F.M.), and the Division of Neonatal-Perinatal Medicine, Department of Pediatrics, University of North Carolina at Chapel Hill, Chapel Hill (M.M.L.) - all in North Carolina; the Department of Pediatrics, Wayne State University (S.C., G.N.), and the Department of Pediatrics, Central Michigan University (S.C.) - both in Detroit; the University of Rochester School of Medicine and Dentistry, Rochester (C.T.D., P.R.C.), and the Department of Pediatrics, University of Buffalo Women's and Children's Hospital of Buffalo, Buffalo (A.M.R.) - both in New York; the Department of Pediatrics, Division of Neonatal and Developmental Medicine, Stanford University School of Medicine and Lucile Packard Children's Hospital, Palo Alto (S.R.H., K.P.V.M.), and the Department of Pediatrics, University of California, Los Angeles, Los Angeles (M.G., I.B.P.) - both in California; the Department of Pediatrics, Division of Neonatology, University of Utah School of Medicine, Salt Lake City (B.A.Y., S.W.); the Department of Pediatrics, McGovern Medical School at the University of Texas Health Science Center at Houston, Houston (K.A.K., G.E.M., A.M.K., R.A.M.), and the Department of Pediatrics, University of Texas Southwestern Medical Center, Dallas (M.H.W., R.J.H.) - both in Texas; the Social, Statistical, and Environmental Sciences Unit, RTI International, Rockville (A.D., M.M.C.), and the Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, Bethesda (R.D.H.) - both in Maryland; the Department of Pediatrics, Women and Infants Hospital, Brown University, Providence, RI (M.K., E.C.M.); the Department of Pediatrics, Indiana University School of Medicine, Indianapolis (G.M.S., A.C.H.); Emory University School of Medicine, Department of Pediatrics, Children's Healthcare of Atlanta, Atlanta (B.B.P., R.M.P., N.L.M., I.A.-C.); the Division of Neonatology, University of Alabama at Birmingham, Birmingham (N.A., M.P.-C.); the Department of Pediatrics, Children's Mercy Hospital, Kansas City, MO (W.E.T., H.W.K.); the Department of Pediatrics, University of Pennsylvania Perelman School of Medicine, Philadelphia (B.S., S.B.D.); the Department of Pediatrics, University of Iowa, Iowa City (E.F.B., H.M.H.); the Department of Pediatrics, Sanford School of Medicine, University of South Dakota, Sioux Falls (L.R.M., L.A.H.); and the College of Health and Human Services, George Mason University, Fairfax, VA (R.D.H.)
| | - Laurie A Hogden
- From the University of New Mexico Health Sciences Center, Albuquerque (K.L.W., C.B.-L., J.R.L.); the Department of Pediatrics, Rainbow Babies and Children's Hospital, Case Western Reserve University, Cleveland (M.C.W., A.M.H., D.E.W.-C.), Cincinnati Children's Hospital Medical Center, Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati (B.B.P., S.M.), and the Department of Pediatrics, Nationwide Children's Hospital, Ohio State University College of Medicine, Columbus (M.M., N.L.M.) - all in Ohio; the Social, Statistical, and Environmental Sciences Unit, RTI International, Research Triangle Park (L.L.), the Department of Pediatrics, Duke University, Durham (R.N.G., C.M.C., W.F.M.), and the Division of Neonatal-Perinatal Medicine, Department of Pediatrics, University of North Carolina at Chapel Hill, Chapel Hill (M.M.L.) - all in North Carolina; the Department of Pediatrics, Wayne State University (S.C., G.N.), and the Department of Pediatrics, Central Michigan University (S.C.) - both in Detroit; the University of Rochester School of Medicine and Dentistry, Rochester (C.T.D., P.R.C.), and the Department of Pediatrics, University of Buffalo Women's and Children's Hospital of Buffalo, Buffalo (A.M.R.) - both in New York; the Department of Pediatrics, Division of Neonatal and Developmental Medicine, Stanford University School of Medicine and Lucile Packard Children's Hospital, Palo Alto (S.R.H., K.P.V.M.), and the Department of Pediatrics, University of California, Los Angeles, Los Angeles (M.G., I.B.P.) - both in California; the Department of Pediatrics, Division of Neonatology, University of Utah School of Medicine, Salt Lake City (B.A.Y., S.W.); the Department of Pediatrics, McGovern Medical School at the University of Texas Health Science Center at Houston, Houston (K.A.K., G.E.M., A.M.K., R.A.M.), and the Department of Pediatrics, University of Texas Southwestern Medical Center, Dallas (M.H.W., R.J.H.) - both in Texas; the Social, Statistical, and Environmental Sciences Unit, RTI International, Rockville (A.D., M.M.C.), and the Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, Bethesda (R.D.H.) - both in Maryland; the Department of Pediatrics, Women and Infants Hospital, Brown University, Providence, RI (M.K., E.C.M.); the Department of Pediatrics, Indiana University School of Medicine, Indianapolis (G.M.S., A.C.H.); Emory University School of Medicine, Department of Pediatrics, Children's Healthcare of Atlanta, Atlanta (B.B.P., R.M.P., N.L.M., I.A.-C.); the Division of Neonatology, University of Alabama at Birmingham, Birmingham (N.A., M.P.-C.); the Department of Pediatrics, Children's Mercy Hospital, Kansas City, MO (W.E.T., H.W.K.); the Department of Pediatrics, University of Pennsylvania Perelman School of Medicine, Philadelphia (B.S., S.B.D.); the Department of Pediatrics, University of Iowa, Iowa City (E.F.B., H.M.H.); the Department of Pediatrics, Sanford School of Medicine, University of South Dakota, Sioux Falls (L.R.M., L.A.H.); and the College of Health and Human Services, George Mason University, Fairfax, VA (R.D.H.)
| | - Ira Adams-Chapman
- From the University of New Mexico Health Sciences Center, Albuquerque (K.L.W., C.B.-L., J.R.L.); the Department of Pediatrics, Rainbow Babies and Children's Hospital, Case Western Reserve University, Cleveland (M.C.W., A.M.H., D.E.W.-C.), Cincinnati Children's Hospital Medical Center, Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati (B.B.P., S.M.), and the Department of Pediatrics, Nationwide Children's Hospital, Ohio State University College of Medicine, Columbus (M.M., N.L.M.) - all in Ohio; the Social, Statistical, and Environmental Sciences Unit, RTI International, Research Triangle Park (L.L.), the Department of Pediatrics, Duke University, Durham (R.N.G., C.M.C., W.F.M.), and the Division of Neonatal-Perinatal Medicine, Department of Pediatrics, University of North Carolina at Chapel Hill, Chapel Hill (M.M.L.) - all in North Carolina; the Department of Pediatrics, Wayne State University (S.C., G.N.), and the Department of Pediatrics, Central Michigan University (S.C.) - both in Detroit; the University of Rochester School of Medicine and Dentistry, Rochester (C.T.D., P.R.C.), and the Department of Pediatrics, University of Buffalo Women's and Children's Hospital of Buffalo, Buffalo (A.M.R.) - both in New York; the Department of Pediatrics, Division of Neonatal and Developmental Medicine, Stanford University School of Medicine and Lucile Packard Children's Hospital, Palo Alto (S.R.H., K.P.V.M.), and the Department of Pediatrics, University of California, Los Angeles, Los Angeles (M.G., I.B.P.) - both in California; the Department of Pediatrics, Division of Neonatology, University of Utah School of Medicine, Salt Lake City (B.A.Y., S.W.); the Department of Pediatrics, McGovern Medical School at the University of Texas Health Science Center at Houston, Houston (K.A.K., G.E.M., A.M.K., R.A.M.), and the Department of Pediatrics, University of Texas Southwestern Medical Center, Dallas (M.H.W., R.J.H.) - both in Texas; the Social, Statistical, and Environmental Sciences Unit, RTI International, Rockville (A.D., M.M.C.), and the Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, Bethesda (R.D.H.) - both in Maryland; the Department of Pediatrics, Women and Infants Hospital, Brown University, Providence, RI (M.K., E.C.M.); the Department of Pediatrics, Indiana University School of Medicine, Indianapolis (G.M.S., A.C.H.); Emory University School of Medicine, Department of Pediatrics, Children's Healthcare of Atlanta, Atlanta (B.B.P., R.M.P., N.L.M., I.A.-C.); the Division of Neonatology, University of Alabama at Birmingham, Birmingham (N.A., M.P.-C.); the Department of Pediatrics, Children's Mercy Hospital, Kansas City, MO (W.E.T., H.W.K.); the Department of Pediatrics, University of Pennsylvania Perelman School of Medicine, Philadelphia (B.S., S.B.D.); the Department of Pediatrics, University of Iowa, Iowa City (E.F.B., H.M.H.); the Department of Pediatrics, Sanford School of Medicine, University of South Dakota, Sioux Falls (L.R.M., L.A.H.); and the College of Health and Human Services, George Mason University, Fairfax, VA (R.D.H.)
| | - Sarah Winter
- From the University of New Mexico Health Sciences Center, Albuquerque (K.L.W., C.B.-L., J.R.L.); the Department of Pediatrics, Rainbow Babies and Children's Hospital, Case Western Reserve University, Cleveland (M.C.W., A.M.H., D.E.W.-C.), Cincinnati Children's Hospital Medical Center, Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati (B.B.P., S.M.), and the Department of Pediatrics, Nationwide Children's Hospital, Ohio State University College of Medicine, Columbus (M.M., N.L.M.) - all in Ohio; the Social, Statistical, and Environmental Sciences Unit, RTI International, Research Triangle Park (L.L.), the Department of Pediatrics, Duke University, Durham (R.N.G., C.M.C., W.F.M.), and the Division of Neonatal-Perinatal Medicine, Department of Pediatrics, University of North Carolina at Chapel Hill, Chapel Hill (M.M.L.) - all in North Carolina; the Department of Pediatrics, Wayne State University (S.C., G.N.), and the Department of Pediatrics, Central Michigan University (S.C.) - both in Detroit; the University of Rochester School of Medicine and Dentistry, Rochester (C.T.D., P.R.C.), and the Department of Pediatrics, University of Buffalo Women's and Children's Hospital of Buffalo, Buffalo (A.M.R.) - both in New York; the Department of Pediatrics, Division of Neonatal and Developmental Medicine, Stanford University School of Medicine and Lucile Packard Children's Hospital, Palo Alto (S.R.H., K.P.V.M.), and the Department of Pediatrics, University of California, Los Angeles, Los Angeles (M.G., I.B.P.) - both in California; the Department of Pediatrics, Division of Neonatology, University of Utah School of Medicine, Salt Lake City (B.A.Y., S.W.); the Department of Pediatrics, McGovern Medical School at the University of Texas Health Science Center at Houston, Houston (K.A.K., G.E.M., A.M.K., R.A.M.), and the Department of Pediatrics, University of Texas Southwestern Medical Center, Dallas (M.H.W., R.J.H.) - both in Texas; the Social, Statistical, and Environmental Sciences Unit, RTI International, Rockville (A.D., M.M.C.), and the Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, Bethesda (R.D.H.) - both in Maryland; the Department of Pediatrics, Women and Infants Hospital, Brown University, Providence, RI (M.K., E.C.M.); the Department of Pediatrics, Indiana University School of Medicine, Indianapolis (G.M.S., A.C.H.); Emory University School of Medicine, Department of Pediatrics, Children's Healthcare of Atlanta, Atlanta (B.B.P., R.M.P., N.L.M., I.A.-C.); the Division of Neonatology, University of Alabama at Birmingham, Birmingham (N.A., M.P.-C.); the Department of Pediatrics, Children's Mercy Hospital, Kansas City, MO (W.E.T., H.W.K.); the Department of Pediatrics, University of Pennsylvania Perelman School of Medicine, Philadelphia (B.S., S.B.D.); the Department of Pediatrics, University of Iowa, Iowa City (E.F.B., H.M.H.); the Department of Pediatrics, Sanford School of Medicine, University of South Dakota, Sioux Falls (L.R.M., L.A.H.); and the College of Health and Human Services, George Mason University, Fairfax, VA (R.D.H.)
| | - William F Malcolm
- From the University of New Mexico Health Sciences Center, Albuquerque (K.L.W., C.B.-L., J.R.L.); the Department of Pediatrics, Rainbow Babies and Children's Hospital, Case Western Reserve University, Cleveland (M.C.W., A.M.H., D.E.W.-C.), Cincinnati Children's Hospital Medical Center, Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati (B.B.P., S.M.), and the Department of Pediatrics, Nationwide Children's Hospital, Ohio State University College of Medicine, Columbus (M.M., N.L.M.) - all in Ohio; the Social, Statistical, and Environmental Sciences Unit, RTI International, Research Triangle Park (L.L.), the Department of Pediatrics, Duke University, Durham (R.N.G., C.M.C., W.F.M.), and the Division of Neonatal-Perinatal Medicine, Department of Pediatrics, University of North Carolina at Chapel Hill, Chapel Hill (M.M.L.) - all in North Carolina; the Department of Pediatrics, Wayne State University (S.C., G.N.), and the Department of Pediatrics, Central Michigan University (S.C.) - both in Detroit; the University of Rochester School of Medicine and Dentistry, Rochester (C.T.D., P.R.C.), and the Department of Pediatrics, University of Buffalo Women's and Children's Hospital of Buffalo, Buffalo (A.M.R.) - both in New York; the Department of Pediatrics, Division of Neonatal and Developmental Medicine, Stanford University School of Medicine and Lucile Packard Children's Hospital, Palo Alto (S.R.H., K.P.V.M.), and the Department of Pediatrics, University of California, Los Angeles, Los Angeles (M.G., I.B.P.) - both in California; the Department of Pediatrics, Division of Neonatology, University of Utah School of Medicine, Salt Lake City (B.A.Y., S.W.); the Department of Pediatrics, McGovern Medical School at the University of Texas Health Science Center at Houston, Houston (K.A.K., G.E.M., A.M.K., R.A.M.), and the Department of Pediatrics, University of Texas Southwestern Medical Center, Dallas (M.H.W., R.J.H.) - both in Texas; the Social, Statistical, and Environmental Sciences Unit, RTI International, Rockville (A.D., M.M.C.), and the Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, Bethesda (R.D.H.) - both in Maryland; the Department of Pediatrics, Women and Infants Hospital, Brown University, Providence, RI (M.K., E.C.M.); the Department of Pediatrics, Indiana University School of Medicine, Indianapolis (G.M.S., A.C.H.); Emory University School of Medicine, Department of Pediatrics, Children's Healthcare of Atlanta, Atlanta (B.B.P., R.M.P., N.L.M., I.A.-C.); the Division of Neonatology, University of Alabama at Birmingham, Birmingham (N.A., M.P.-C.); the Department of Pediatrics, Children's Mercy Hospital, Kansas City, MO (W.E.T., H.W.K.); the Department of Pediatrics, University of Pennsylvania Perelman School of Medicine, Philadelphia (B.S., S.B.D.); the Department of Pediatrics, University of Iowa, Iowa City (E.F.B., H.M.H.); the Department of Pediatrics, Sanford School of Medicine, University of South Dakota, Sioux Falls (L.R.M., L.A.H.); and the College of Health and Human Services, George Mason University, Fairfax, VA (R.D.H.)
| | - Rosemary D Higgins
- From the University of New Mexico Health Sciences Center, Albuquerque (K.L.W., C.B.-L., J.R.L.); the Department of Pediatrics, Rainbow Babies and Children's Hospital, Case Western Reserve University, Cleveland (M.C.W., A.M.H., D.E.W.-C.), Cincinnati Children's Hospital Medical Center, Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati (B.B.P., S.M.), and the Department of Pediatrics, Nationwide Children's Hospital, Ohio State University College of Medicine, Columbus (M.M., N.L.M.) - all in Ohio; the Social, Statistical, and Environmental Sciences Unit, RTI International, Research Triangle Park (L.L.), the Department of Pediatrics, Duke University, Durham (R.N.G., C.M.C., W.F.M.), and the Division of Neonatal-Perinatal Medicine, Department of Pediatrics, University of North Carolina at Chapel Hill, Chapel Hill (M.M.L.) - all in North Carolina; the Department of Pediatrics, Wayne State University (S.C., G.N.), and the Department of Pediatrics, Central Michigan University (S.C.) - both in Detroit; the University of Rochester School of Medicine and Dentistry, Rochester (C.T.D., P.R.C.), and the Department of Pediatrics, University of Buffalo Women's and Children's Hospital of Buffalo, Buffalo (A.M.R.) - both in New York; the Department of Pediatrics, Division of Neonatal and Developmental Medicine, Stanford University School of Medicine and Lucile Packard Children's Hospital, Palo Alto (S.R.H., K.P.V.M.), and the Department of Pediatrics, University of California, Los Angeles, Los Angeles (M.G., I.B.P.) - both in California; the Department of Pediatrics, Division of Neonatology, University of Utah School of Medicine, Salt Lake City (B.A.Y., S.W.); the Department of Pediatrics, McGovern Medical School at the University of Texas Health Science Center at Houston, Houston (K.A.K., G.E.M., A.M.K., R.A.M.), and the Department of Pediatrics, University of Texas Southwestern Medical Center, Dallas (M.H.W., R.J.H.) - both in Texas; the Social, Statistical, and Environmental Sciences Unit, RTI International, Rockville (A.D., M.M.C.), and the Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, Bethesda (R.D.H.) - both in Maryland; the Department of Pediatrics, Women and Infants Hospital, Brown University, Providence, RI (M.K., E.C.M.); the Department of Pediatrics, Indiana University School of Medicine, Indianapolis (G.M.S., A.C.H.); Emory University School of Medicine, Department of Pediatrics, Children's Healthcare of Atlanta, Atlanta (B.B.P., R.M.P., N.L.M., I.A.-C.); the Division of Neonatology, University of Alabama at Birmingham, Birmingham (N.A., M.P.-C.); the Department of Pediatrics, Children's Mercy Hospital, Kansas City, MO (W.E.T., H.W.K.); the Department of Pediatrics, University of Pennsylvania Perelman School of Medicine, Philadelphia (B.S., S.B.D.); the Department of Pediatrics, University of Iowa, Iowa City (E.F.B., H.M.H.); the Department of Pediatrics, Sanford School of Medicine, University of South Dakota, Sioux Falls (L.R.M., L.A.H.); and the College of Health and Human Services, George Mason University, Fairfax, VA (R.D.H.)
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Jackson W, Gonzalez D, Smith PB, Ambalavanan N, Atz AM, Sokol GM, Hornik CD, Stewart D, Mundakel G, Poindexter BB, Ahlfeld SK, Mills M, Cohen-Wolkowiez M, Martz K, Hornik CP, Laughon MM. Safety of sildenafil in extremely premature infants: a phase I trial. J Perinatol 2022; 42:31-36. [PMID: 34741102 PMCID: PMC8569839 DOI: 10.1038/s41372-021-01261-w] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/03/2021] [Revised: 10/16/2021] [Accepted: 10/20/2021] [Indexed: 11/10/2022]
Abstract
OBJECTIVE To characterize the safety of sildenafil in premature infants. STUDY DESIGN A phase I, open-label trial of sildenafil in premature infants receiving sildenafil per usual clinical care (cohort 1) or receiving a single IV dose of sildenafil (cohort 2). Safety was evaluated based on adverse events (AEs), transaminase levels, and mean arterial pressure monitoring. RESULTS Twenty-four infants in cohort 1 (n = 25) received enteral sildenafil. In cohort 2, infants received a single IV sildenafil dose of 0.25 mg/kg (n = 7) or 0.125 mg/kg (n = 2). In cohort 2, there was one serious AE related to study drug involving hypotension associated with a faster infusion rate than specified by the protocol. There were no AEs related to elevated transaminases. CONCLUSION Sildenafil was well tolerated by the study population. Drug administration times and flush rates require careful attention to prevent infusion-related hypotension associated with faster infusions of IV sildenafil in premature infants. CLINICAL TRIAL ClinicalTrials.gov Identifier: NCT01670136.
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Affiliation(s)
- Wesley Jackson
- Department of Pediatrics, School of Medicine, The University of North Carolina at Chapel Hill, Chapel Hill, NC, USA.
| | - Daniel Gonzalez
- Division of Pharmacotherapy and Experimental Therapeutics, UNC Eshelman School of Pharmacy, The University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - P Brian Smith
- Department of Pediatrics, Duke University School of Medicine, Durham, NC, USA
- Duke Clinical Research Institute, Durham, NC, USA
| | - Namasivayam Ambalavanan
- Division of Neonatology, School of Medicine, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Andrew M Atz
- Department of Pediatrics, Medical University of South Carolina Children's Hospital, Charleston, SC, USA
| | - Gregory M Sokol
- Division of Neonatal-Perinatal Medicine, Indiana University School of Medicine, Indianapolis, IN, USA
| | - Chi D Hornik
- Department of Pediatrics, Duke University School of Medicine, Durham, NC, USA
- Duke Clinical Research Institute, Durham, NC, USA
| | - Dan Stewart
- University of Louisville Norton Children's Hospital, Louisville, KY, USA
| | - Gratias Mundakel
- Kings County Hospital Center/SUNY Downstate Medical Center, Brooklyn, NY, USA
| | - Brenda B Poindexter
- Department of Pediatrics, Emory University and Children's Healthcare of Atlanta, Atlanta, GA, USA
| | - Shawn K Ahlfeld
- Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA
| | - Mary Mills
- Duke Clinical Research Institute, Durham, NC, USA
| | - Michael Cohen-Wolkowiez
- Department of Pediatrics, Duke University School of Medicine, Durham, NC, USA
- Duke Clinical Research Institute, Durham, NC, USA
| | | | - Christoph P Hornik
- Department of Pediatrics, Duke University School of Medicine, Durham, NC, USA
- Duke Clinical Research Institute, Durham, NC, USA
| | - Matthew M Laughon
- Department of Pediatrics, School of Medicine, The University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
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Radhakrishnan R, Vishnubhotla RV, Zhao Y, Yan J, He B, Steinhardt N, Haas DM, Sokol GM, Sadhasivam S. Global Brain Functional Network Connectivity in Infants With Prenatal Opioid Exposure. Front Pediatr 2022; 10:847037. [PMID: 35359894 PMCID: PMC8964084 DOI: 10.3389/fped.2022.847037] [Citation(s) in RCA: 15] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/01/2022] [Accepted: 02/08/2022] [Indexed: 11/22/2022] Open
Abstract
BACKGROUND Infants with prenatal opioid and substance exposure are at higher risk of poor neurobehavioral outcomes in later childhood. Early brain imaging in infancy has the potential to identify early brain developmental alterations that may help predict behavioral outcomes in these children. In this study, using resting-state functional MRI in early infancy, we aim to identify differences in global brain network connectivity in infants with prenatal opioid and substance exposure compared to healthy control infants. METHODS AND MATERIALS In this prospective study, we recruited 23 infants with prenatal opioid exposure and 29 healthy opioid naïve infants. All subjects underwent brain resting-state functional MRI before 3 months postmenstrual age. Covariate Assisted Principal (CAP) regression was performed to identify brain networks within which functional connectivity was associated with opioid exposure after adjusting for sex and gestational age. Associations of these significant networks with maternal comorbidities were also evaluated. Additionally, graph network metrics were assessed in these CAP networks. RESULTS There were four CAP network components that were significantly different between the opioid exposed and healthy control infants. Two of these four networks were associated with maternal psychological factors. Intra-network graph metrics, namely average flow coefficient, clustering coefficient and transitivity were also significantly different in opioid exposed infants compared to healthy controls. CONCLUSION Prenatal opioid exposure is associated with alterations in global brain functional networks compared to non-opioid exposed infants, with intra-network alterations in graph network modeling. These network alterations were also associated with maternal comorbidity, especially mental health. Large-scale longitudinal studies can help in understanding the clinical implications of these early brain functional network alterations in infants with prenatal opioid exposure.
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Affiliation(s)
- Rupa Radhakrishnan
- Department of Radiology and Imaging Sciences, Indiana University School of Medicine, Indianapolis, IN, United States
| | - Ramana V Vishnubhotla
- Department of Radiology and Imaging Sciences, Indiana University School of Medicine, Indianapolis, IN, United States
| | - Yi Zhao
- Department of Biostatistics and Health Data Science, Indiana University School of Medicine, Indianapolis, IN, United States
| | - Jingwen Yan
- Department of Biostatistics and Health Data Science, Indiana University School of Medicine, Indianapolis, IN, United States
| | - Bing He
- Department of Biostatistics and Health Data Science, Indiana University School of Medicine, Indianapolis, IN, United States
| | - Nicole Steinhardt
- Indiana University School of Medicine, Indianapolis, IN, United States
| | - David M Haas
- Department of Obstetrics and Gynecology, Indiana University School of Medicine, Indianapolis, IN, United States
| | - Gregory M Sokol
- Department of Pediatrics, Indiana University School of Medicine, Indianapolis, IN, United States
| | - Senthilkumar Sadhasivam
- Department of Anesthesia, Indiana University School of Medicine, Indianapolis, IN, United States.,Department of Anesthesiology and Perioperative Medicine, University of Pittsburgh Medical Center, University of Pittsburgh School of Medicine, Pittsburgh, PA, United States
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Chalak LF, Pappas A, Tan S, Das A, Sánchez PJ, Laptook AR, Van Meurs KP, Shankaran S, Bell EF, Davis AS, Heyne RJ, Pedroza C, Poindexter BB, Schibler K, Tyson JE, Ball MB, Bara R, Grisby C, Sokol GM, D’Angio CT, Hamrick SEG, Dysart KC, Cotten CM, Truog WE, Watterberg KL, Timan CJ, Garg M, Carlo WA, Higgins RD. Association Between Increased Seizures During Rewarming After Hypothermia for Neonatal Hypoxic Ischemic Encephalopathy and Abnormal Neurodevelopmental Outcomes at 2-Year Follow-up: A Nested Multisite Cohort Study. JAMA Neurol 2021; 78:1484-1493. [PMID: 34882200 PMCID: PMC8524352 DOI: 10.1001/jamaneurol.2021.3723] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2021] [Accepted: 08/17/2021] [Indexed: 01/19/2023]
Abstract
Importance Compared with normothermia, hypothermia has been shown to reduce death or disability in neonatal hypoxic ischemic encephalopathy but data on seizures during rewarming and associated outcomes are scarce. Objective To determine whether electrographic seizures are more likely to occur during rewarming compared with the preceding period and whether they are associated with abnormal outcomes in asphyxiated neonates receiving hypothermia therapy. Design, Setting, and Participants This prespecified nested cohort study of infants enrolled in the Optimizing Cooling (OC) multicenter Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD) Neonatal Research Network trial from December 2011 to December 2013 with 2 years' follow-up randomized infants to either 72 hours of cooling (group A) or 120 hours (group B). The main trial included 364 infants. Of these, 194 were screened, 10 declined consent, and 120 met all predefined inclusion criteria. A total of 112 (90%) had complete data for death or disability. Data were analyzed from January 2018 to January 2020. Interventions Serial amplitude electroencephalography recordings were compared in the 12 hours prior and 12 hours during rewarming for evidence of electrographic seizure activity by 2 central amplitude-integrated electroencephalography readers blinded to treatment arm and rewarming epoch. Odds ratios and 95% CIs were evaluated following adjustment for center, prior seizures, depth of cooling, and encephalopathy severity. Main Outcomes and Measures The primary outcome was the occurrence of electrographic seizures during rewarming initiated at 72 or 120 hours compared with the preceding 12-hour epoch. Secondary outcomes included death or moderate or severe disability at age 18 to 22 months. The hypothesis was that seizures during rewarming were associated with higher odds of abnormal neurodevelopmental outcomes. Results A total of 120 newborns (70 male [58%]) were enrolled (66 in group A and 54 in group B). The mean (SD) gestational age was 39 (1) weeks. There was excellent interrater agreement (κ, 0.99) in detection of seizures. More infants had electrographic seizures during the rewarming epoch compared with the preceding epoch (group A, 27% vs 14%; P = .001; group B, 21% vs 10%; P = .03). Adjusted odd ratios (95% CIs) for seizure frequency during rewarming were 2.7 (1.0-7.5) for group A and 3.2 (0.9-11.6) for group B. The composite death or moderate to severe disability outcome at 2 years was significantly higher in infants with electrographic seizures during rewarming (relative risk [95% CI], 1.7 [1.25-2.37]) after adjusting for baseline clinical encephalopathy and seizures as well as center. Conclusions and Relevance Findings that higher odds of electrographic seizures during rewarming are associated with death or disability at 2 years highlight the necessity of electroencephalography monitoring during rewarming in infants at risk. Trial Registration ClinicalTrials.gov Identifier: NCT01192776.
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Affiliation(s)
- Lina F. Chalak
- Department of Pediatrics, University of Texas Southwestern Medical Center, Dallas
| | - Athina Pappas
- Department of Pediatrics, Wayne State University, Detroit, Michigan
| | - Sylvia Tan
- Social, Statistical and Environmental Sciences Unit, RTI International, Research Triangle Park, North Carolina
| | - Abhik Das
- Social, Statistical and Environmental Sciences Unit, RTI International, Rockville, Maryland
| | - Pablo J. Sánchez
- Department of Pediatrics, Nationwide Children’s Hospital, Ohio State University College of Medicine, Columbus
| | - Abbot R. Laptook
- Department of Pediatrics, Women & Infants Hospital, Brown University, Providence, Rhode Island
| | - Krisa P. Van Meurs
- Department of Pediatrics, Division of Neonatal and Developmental Medicine, Stanford University School of Medicine and Lucile Packard Children’s Hospital, Palo Alto, California
| | - Seetha Shankaran
- Department of Pediatrics, Wayne State University, Detroit, Michigan
| | | | - Alexis S. Davis
- Department of Pediatrics, Division of Neonatal and Developmental Medicine, Stanford University School of Medicine and Lucile Packard Children’s Hospital, Palo Alto, California
| | - Roy J. Heyne
- Department of Pediatrics, University of Texas Southwestern Medical Center, Dallas
| | - Claudia Pedroza
- Department of Pediatrics, University of Texas Medical School at Houston, Houston
| | - Brenda B. Poindexter
- Department of Pediatrics, Indiana University School of Medicine, Indianapolis
- Emory University Hospital Midtown, Department of Pediatrics, Emory University School of Medicine, Atlanta, Georgia
| | - Kurt Schibler
- Cincinnati Children’s Hospital Medical Center, Cincinnati, Ohio
| | - Jon E. Tyson
- Department of Pediatrics, University of Texas Medical School at Houston, Houston
| | - M. Bethany Ball
- Department of Pediatrics, Division of Neonatal and Developmental Medicine, Stanford University School of Medicine and Lucile Packard Children’s Hospital, Palo Alto, California
| | - Rebecca Bara
- Department of Pediatrics, Wayne State University, Detroit, Michigan
| | - Cathy Grisby
- Cincinnati Children’s Hospital Medical Center, Cincinnati, Ohio
| | - Gregory M. Sokol
- Department of Pediatrics, Indiana University School of Medicine, Indianapolis
| | - Carl T. D’Angio
- University of Rochester School of Medicine and Dentistry, Rochester, New York
| | - Shannon E. G. Hamrick
- Emory University Hospital Midtown, Department of Pediatrics, Emory University School of Medicine, Atlanta, Georgia
| | - Kevin C. Dysart
- Department of Pediatrics, University of Pennsylvania, Philadelphia
| | | | - William E. Truog
- Department of Pediatrics, Children’s Mercy Hospital, Kansas City, Missouri
| | | | - Christopher J. Timan
- Department of Pediatrics, Nationwide Children’s Hospital, Ohio State University College of Medicine, Columbus
| | - Meena Garg
- Department of Pediatrics, University of California, Los Angeles
| | - Waldemar A. Carlo
- Division of Neonatology, University of Alabama at Birmingham, Birmingham
| | - Rosemary D. Higgins
- Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, Bethesda, Maryland
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15
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Blakely ML, Tyson JE, Lally KP, Hintz SR, Eggleston B, Stevenson DK, Besner GE, Das A, Ohls RK, Truog WE, Nelin LD, Poindexter BB, Pedroza C, Walsh MC, Stoll BJ, Geller R, Kennedy KA, Dimmitt RA, Carlo WA, Cotten CM, Laptook AR, Van Meurs KP, Calkins KL, Sokol GM, Sanchez PJ, Wyckoff MH, Patel RM, Frantz ID, Shankaran S, D’Angio CT, Yoder BA, Bell EF, Watterberg KL, Martin CA, Harmon CM, Rice H, Kurkchubasche AG, Sylvester K, Dunn JCY, Markel TA, Diesen DL, Bhatia AM, Flake A, Chwals WJ, Brown R, Bass KD, St. Peter SD, Shanti CM, Pegoli W, Skarda D, Shilyansky J, Lemon DG, Mosquera RA, Peralta-Carcelen M, Goldstein RF, Vohr BR, Purdy IB, Hines AC, Maitre NL, Heyne RJ, DeMauro SB, McGowan EC, Yolton K, Kilbride HW, Natarajan G, Yost K, Winter S, Colaizy TT, Laughon MM, Lakshminrusimha S, Higgins RD. Initial Laparotomy Versus Peritoneal Drainage in Extremely Low Birthweight Infants With Surgical Necrotizing Enterocolitis or Isolated Intestinal Perforation: A Multicenter Randomized Clinical Trial. Ann Surg 2021; 274:e370-e380. [PMID: 34506326 PMCID: PMC8439547 DOI: 10.1097/sla.0000000000005099] [Citation(s) in RCA: 33] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
Abstract
OBJECTIVE The aim of this study was to determine which initial surgical treatment results in the lowest rate of death or neurodevelopmental impairment (NDI) in premature infants with necrotizing enterocolitis (NEC) or isolated intestinal perforation (IP). SUMMARY BACKGROUND DATA The impact of initial laparotomy versus peritoneal drainage for NEC or IP on the rate of death or NDI in extremely low birth weight infants is unknown. METHODS We conducted the largest feasible randomized trial in 20 US centers, comparing initial laparotomy versus peritoneal drainage. The primary outcome was a composite of death or NDI at 18 to 22 months corrected age, analyzed using prespecified frequentist and Bayesian approaches. RESULTS Of 992 eligible infants, 310 were randomized and 96% had primary outcome assessed. Death or NDI occurred in 69% of infants in the laparotomy group versus 70% with drainage [adjusted relative risk (aRR) 1.0; 95% confidence interval (CI): 0.87-1.14]. A preplanned analysis identified an interaction between preoperative diagnosis and treatment group (P = 0.03). With a preoperative diagnosis of NEC, death or NDI occurred in 69% after laparotomy versus 85% with drainage (aRR 0.81; 95% CI: 0.64-1.04). The Bayesian posterior probability that laparotomy was beneficial (risk difference <0) for a preoperative diagnosis of NEC was 97%. For preoperative diagnosis of IP, death or NDI occurred in 69% after laparotomy versus 63% with drainage (aRR, 1.11; 95% CI: 0.95-1.31); Bayesian probability of benefit with laparotomy = 18%. CONCLUSIONS There was no overall difference in death or NDI rates at 18 to 22 months corrected age between initial laparotomy versus drainage. However, the preoperative diagnosis of NEC or IP modified the impact of initial treatment.
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MESH Headings
- Drainage
- Enterocolitis, Necrotizing/mortality
- Enterocolitis, Necrotizing/psychology
- Enterocolitis, Necrotizing/surgery
- Feasibility Studies
- Female
- Humans
- Infant, Extremely Low Birth Weight
- Infant, Newborn
- Infant, Premature
- Infant, Premature, Diseases/mortality
- Infant, Premature, Diseases/psychology
- Infant, Premature, Diseases/surgery
- Intestinal Perforation/mortality
- Intestinal Perforation/psychology
- Intestinal Perforation/surgery
- Laparotomy
- Male
- Neurodevelopmental Disorders/diagnosis
- Neurodevelopmental Disorders/epidemiology
- Survival Rate
- Treatment Outcome
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Affiliation(s)
- Martin L. Blakely
- Department of Pediatric Surgery, Vanderbilt University Medical Center, Nashville, TN
| | - Jon E. Tyson
- Department of Pediatrics, McGovern Medical School at The University of Texas Health Science Center at Houston, Houston, TX
| | - Kevin P. Lally
- Department of Pediatric Surgery, McGovern Medical School at The University of Texas Health Science Center at Houston, Houston, TX
| | - Susan R. Hintz
- Department of Pediatrics, Division of Neonatal and Developmental Medicine, Stanford University School of Medicine and Lucile Packard Children’s Hospital, Palo Alto, CA
| | - Barry Eggleston
- Social, Statistical and Environmental Sciences Unit, RTI International, Research Triangle Park, NC
| | - David K. Stevenson
- Department of Pediatrics, Division of Neonatal and Developmental Medicine, Stanford University School of Medicine and Lucile Packard Children’s Hospital, Palo Alto, CA
| | - Gail E. Besner
- Department of Pediatric Surgery, Nationwide Children’s Hospital, The Ohio State University College of Medicine, Columbus, OH
| | - Abhik Das
- Social, Statistical and Environmental Sciences Unit, RTI International, Research Rockville, MD
| | - Robin K. Ohls
- University of New Mexico Health Sciences Center, Albuquerque, NM
- Department of Pediatrics, Division of Neonatology, University of Utah School of Medicine, Salt Lake City, UT
| | - William E. Truog
- Department of Pediatrics, Children’s Mercy Hospital, Kansas City, MO
| | - Leif D. Nelin
- Department of Pediatrics, Nationwide Children’s Hospital, The Ohio State University College of Medicine, Columbus, OH
| | - Brenda B. Poindexter
- Cincinnati Children’s Hospital Medical Center, Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, OH
| | - Claudia Pedroza
- Department of Pediatrics, McGovern Medical School at The University of Texas Health Science Center at Houston, Houston, TX
| | - Michele C. Walsh
- Department of Pediatrics, Rainbow Babies & Children’s Hospital, Case Western Reserve University, Cleveland, OH
| | - Barbara J. Stoll
- Department of Pediatrics, McGovern Medical School at The University of Texas Health Science Center at Houston, Houston, TX
| | - Rachel Geller
- Department of Pediatrics, University of California, Los Angeles, CA
| | - Kathleen A. Kennedy
- Department of Pediatrics, McGovern Medical School at The University of Texas Health Science Center at Houston, Houston, TX
| | - Reed A. Dimmitt
- Division of Neonatology, University of Alabama at Birmingham, Birmingham, AL
| | - Waldemar A. Carlo
- Division of Neonatology, University of Alabama at Birmingham, Birmingham, AL
| | | | - Abbot R. Laptook
- Department of Pediatrics, Women’s & Infants Hospital, Brown University, Providence, RI
| | - Krisa P. Van Meurs
- Department of Pediatrics, Division of Neonatal and Developmental Medicine, Stanford University School of Medicine and Lucile Packard Children’s Hospital, Palo Alto, CA
| | - Kara L. Calkins
- Department of Pediatrics, University of California, Los Angeles, CA
| | - Gregory M. Sokol
- Department of Pediatrics, Indiana University School of Medicine, Indianapolis, IN
| | - Pablo J. Sanchez
- Department of Pediatrics, Nationwide Children’s Hospital, The Ohio State University College of Medicine, Columbus, OH
| | - Myra H. Wyckoff
- Department of Pediatrics, University of Texas Southwestern Medical Center, Dallas, TX
| | - Ravi M. Patel
- Emory University School of Medicine, Department of Pediatrics, Children’s Healthcare of Atlanta, Atlanta, GA
| | - Ivan D. Frantz
- Department of Pediatrics, Division of Newborn Medicine, Floating Hospital for Children, Tufts Medical Center, Boston, MA
- Department of Neonatology, Beth Israel Deaconess Medical Center, Boston, MA
| | | | - Carl T. D’Angio
- University of Rochester School of Medicine and Dentistry, Rochester, NY
| | - Bradley A. Yoder
- Department of Pediatrics, Division of Neonatology, University of Utah School of Medicine, Salt Lake City, UT
| | - Edward F. Bell
- Department of Pediatrics, University of Iowa, Iowa City, IA
| | | | - Colin A. Martin
- Division of Pediatric Surgery, University of Alabama at Birmingham, Birmingham, AL
| | - Carroll M. Harmon
- Division of Pediatric Surgery, University of Alabama at Birmingham, Birmingham, AL
- Division of Pediatric Surgery, University of Buffalo, John R. Oishei Children’s Hospital, Buffalo, NY
| | - Henry Rice
- Division of Pediatric General Surgery, Duke University, Durham, NC
| | - Arlet G. Kurkchubasche
- Department of Pediatric Surgery, Hasbro Children’s Hospital, Brown University, Providence, RI
| | - Karl Sylvester
- Department of Pediatric Surgery, Stanford University School of Medicine, Palo Alto, CA
| | - James C. Y. Dunn
- Department of Pediatric Surgery, Stanford University School of Medicine, Palo Alto, CA
- Department of Pediatric Surgery, University of California, Los Angeles, CA
| | - Troy A. Markel
- Department of Pediatric Surgery, Indiana University School of Medicine, Indianapolis, IN
| | - Diana L. Diesen
- Department of Pediatric Surgery, University of Texas Southwestern Medical Center, Dallas, TX
| | - Amina M. Bhatia
- Department of Pediatric Surgery, Emory University School of Medicine, Children’s Healthcare of Atlanta, Atlanta, GA
| | - Alan Flake
- Department of Pediatric Surgery, University of Pennsylvania, Philadelphia, PA
| | - Walter J. Chwals
- Department of Pediatric Surgery, Floating Hospital for Children, Tufts Medical Center, Boston, MA
| | - Rebeccah Brown
- Department of Pediatric Surgery, Cincinnati Children’s Hospital Medical Center, University of Cincinnati College of Medicine, Cincinnati, OH
| | - Kathryn D. Bass
- Division of Pediatric Surgery, University of Buffalo, John R. Oishei Children’s Hospital, Buffalo, NY
| | - Shawn D. St. Peter
- Department of Pediatric Surgery, Children’s Mercy Hospital, Kansas City, MO
| | | | - Walter Pegoli
- Department of Pediatric Surgery, University of Rochester School of Medicine and Dentistry, Rochester, NY
| | - David Skarda
- Department of Pediatric Surgery, University of Utah School of Medicine, Salt Lake City, UT
| | | | - David G. Lemon
- Department of Pediatric Surgery, University of New Mexico Health Sciences Center, Albuquerque, NM
| | - Ricardo A. Mosquera
- Department of Pediatrics, McGovern Medical School at The University of Texas Health Science Center at Houston, Houston, TX
| | | | | | - Betty R. Vohr
- Department of Pediatrics, Women’s & Infants Hospital, Brown University, Providence, RI
| | - Isabell B. Purdy
- Department of Pediatrics, University of California, Los Angeles, CA
| | - Abbey C. Hines
- Department of Pediatrics, Indiana University School of Medicine, Indianapolis, IN
| | - Nathalie L. Maitre
- Department of Pediatrics, Nationwide Children’s Hospital, The Ohio State University College of Medicine, Columbus, OH
| | - Roy J. Heyne
- Department of Pediatrics, University of Texas Southwestern Medical Center, Dallas, TX
| | - Sara B. DeMauro
- Department of Pediatrics, University of Pennsylvania, Philadelphia, PA
| | - Elisabeth C. McGowan
- Department of Pediatrics, Women’s & Infants Hospital, Brown University, Providence, RI
- Department of Pediatrics, Division of Newborn Medicine, Floating Hospital for Children, Tufts Medical Center, Boston, MA
| | - Kimberly Yolton
- Cincinnati Children’s Hospital Medical Center, Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, OH
| | | | | | - Kelley Yost
- University of Rochester School of Medicine and Dentistry, Rochester, NY
| | - Sarah Winter
- Department of Pediatrics, Division of Neonatology, University of Utah School of Medicine, Salt Lake City, UT
| | | | - Matthew M. Laughon
- Division of Neonatal/Perinatal Medicine, Department of Pediatrics, University of North Carolina, Chapel Hill, NC
| | | | - Rosemary D. Higgins
- Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, Bethesda, MD
- College of Health and Human Services, George Mason University, Fairfax, VA
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16
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Chalak L, Redline RW, Goodman AM, Juul SE, Chang T, Yanowitz TD, Maitre N, Mayock DE, Lampland AL, Bendel-Stenzel E, Riley D, Mathur AM, Rao R, Van Meurs KP, Wu TW, Gonzalez FF, Flibotte J, Mietzsch U, Sokol GM, Ahmad KA, Baserga M, Weitkamp JH, Poindexter BB, Comstock BA, Wu YW. Acute and Chronic Placental Abnormalities in a Multicenter Cohort of Newborn Infants with Hypoxic-Ischemic Encephalopathy. J Pediatr 2021; 237:190-196. [PMID: 34144032 DOI: 10.1016/j.jpeds.2021.06.023] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/29/2021] [Revised: 05/28/2021] [Accepted: 06/14/2021] [Indexed: 12/21/2022]
Abstract
OBJECTIVE To examine the frequency of placental abnormalities in a multicenter cohort of newborn infants with hypoxic-ischemic encephalopathy (HIE) and to determine the association between acuity of placental abnormalities and clinical characteristics of HIE. STUDY DESIGN Infants born at ≥36 weeks of gestation (n = 500) with moderate or severe HIE were enrolled in the High-dose Erythropoietin for Asphyxia and Encephalopathy Trial. A placental pathologist blinded to clinical information reviewed clinical pathology reports to determine the presence of acute and chronic placental abnormalities using a standard classification system. RESULTS Complete placental pathologic examination was available for 321 of 500 (64%) trial participants. Placental abnormalities were identified in 273 of 321 (85%) and were more common in infants ≥40 weeks of gestation (93% vs 81%, P = .01). A combination of acute and chronic placental abnormalities (43%) was more common than either acute (20%) or chronic (21%) abnormalities alone. Acute abnormalities included meconium staining of the placenta (41%) and histologic chorioamnionitis (39%). Chronic abnormalities included maternal vascular malperfusion (25%), villitis of unknown etiology (8%), and fetal vascular malperfusion (6%). Infants with chronic placental abnormalities exhibited a greater mean base deficit at birth (-15.9 vs -14.3, P = .049) than those without such abnormalities. Patients with HIE and acute placental lesions had older mean gestational ages (39.1 vs 38.0, P < .001) and greater rates of clinically diagnosed chorioamnionitis (25% vs 2%, P < .001) than those without acute abnormalities. CONCLUSIONS Combined acute and chronic placental abnormalities were common in this cohort of infants with HIE, underscoring the complex causal pathways of HIE. TRIAL REGISTRATION ClinicalTrials.gov: NCT02811263.
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Affiliation(s)
- Lina Chalak
- Department of Pediatrics, University of Texas Southwestern Medical Center, Dallas, TX.
| | - Raymond W Redline
- Department of Pathology, University Hospitals Cleveland Medical Center, Cleveland, OH
| | - Amy M Goodman
- Department of Neurology, University of California San Francisco, San Francisco, CA
| | - Sandra E Juul
- Division of Neonatology, Department of Pediatrics, University of Washington School of Medicine, Seattle, WA
| | - Taeun Chang
- Department of Neurology, Children's National Hospital, George Washington School of Medicine, Washington, DC
| | - Toby D Yanowitz
- Division of Newborn Medicine, Department of Pediatrics, University of Pittsburgh School of Medicine, Children's Hospital of Pittsburgh of UPMC and Magee Womens Hospital of UPMC, Pittsburgh, PA
| | - Nathalie Maitre
- Department of Pediatrics and Research Institute, Nationwide Children's Hospital, Columbus, OH
| | - Dennis E Mayock
- Division of Neonatology, Department of Pediatrics, University of Washington School of Medicine, Seattle, WA
| | | | - Ellen Bendel-Stenzel
- Division of Neonatal Medicine, Department of Pediatric and Adolescent Medicine, Mayo Clinic, Rochester, MN
| | - David Riley
- Department of Pediatrics, Cook Children's Medical Center, Texas Christian University and University of North Texas Health Science Center School of Medicine, Fort Worth, TX
| | - Amit M Mathur
- Department of Pediatrics/Neonatal-Perinatal Medicine, Saint Louis University School of Medicine, St Louis, MO
| | - Rakesh Rao
- Division of Newborn-Medicine, Department of Pediatrics, Washington University School of Medicine, St Louis, MO
| | - Krisa P Van Meurs
- Division of Neonatal and Developmental Medicine, Stanford University School of Medicine, Palo Alto, CA
| | - Tai-Wei Wu
- Division of Neonatology, Fetal and Neonatal Institute, Children's Hospital Los Angeles, Los Angeles, CA; Department of Pediatrics, Keck School of Medicine, University of Southern California, Los Angeles, CA
| | - Fernando F Gonzalez
- Department of Pediatrics, University of California San Francisco, San Francisco, CA
| | - John Flibotte
- Division of Neonatology, Children's Hospital of Philadelphia, Philadelphia, PA; Department of Pediatrics, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA
| | - Ulrike Mietzsch
- Division of Neonatology, Department of Pediatrics, University of Washington School of Medicine, Seattle, WA; Division of Neonatal-Perinatal Medicine, Department of Pediatrics, Indiana University School of Medicine, Indianapolis, IN
| | - Gregory M Sokol
- Division of Neonatal-Perinatal Medicine, Department of Pediatrics, Indiana University School of Medicine, Indianapolis, IN
| | | | - Mariana Baserga
- Division of Neonatology, Department of Pediatrics, University of Utah, Salt Lake City, UT
| | | | - Brenda B Poindexter
- Division of Neonatology, Department of Pediatrics, Children's Healthcare of Atlanta and Emory University, Atlanta, GA
| | - Bryan A Comstock
- Department of Biostatistics, University of Washington, Seattle, WA
| | - Yvonne W Wu
- Department of Neurology, University of California San Francisco, San Francisco, CA
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17
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Smith MJ, Boutzoukas A, Autmizguine J, Hudak ML, Zinkhan E, Bloom BT, Heresi G, Lavery AP, Courtney SE, Sokol GM, Cotten CM, Bliss JM, Mendley S, Bendel C, Dammann CE, Weitkamp JH, Saxonhouse MA, Mundakel GT, Debski J, Sharma G, Erinjeri J, Gao J, Benjamin DK, Hornik CP, Smith PB, Cohen-Wolkowiez M. Antibiotic Safety and Effectiveness in Premature Infants With Complicated Intraabdominal Infections. Pediatr Infect Dis J 2021; 40:550-555. [PMID: 33902072 PMCID: PMC9844130 DOI: 10.1097/inf.0000000000003034] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
Abstract
BACKGROUND In premature infants, complicated intraabdominal infections (cIAIs) are a leading cause of morbidity and mortality. Although universally prescribed, the safety and effectiveness of commonly used antibiotic regimens have not been established in this population. METHODS Infants ≤33 weeks gestational age and <121 days postnatal age with cIAI were randomized to ≤10 days of ampicillin, gentamicin, and metronidazole (group 1); ampicillin, gentamicin, and clindamycin (group 2); or piperacillin-tazobactam and gentamicin (group 3) at doses stratified by postmenstrual age. Due to slow enrollment, a protocol amendment allowed eligible infants already receiving study regimens to enroll without randomization. The primary outcome was mortality within 30 days of study drug completion. Secondary outcomes included adverse events, outcomes of special interest, and therapeutic success (absence of death, negative cultures, and clinical cure score >4) 30 days after study drug completion. RESULTS One hundred eighty infants [128 randomized (R), 52 nonrandomized (NR)] were enrolled: 63 in group 1 (45 R, 18 NR), 47 in group 2 (41 R, 6 NR), and 70 in group 3 (42 R, 28 NR). Thirty-day mortality was 8%, 7%, and 9% in groups 1, 2, and 3, respectively. There were no differences in safety outcomes between antibiotic regimens. After adjusting for treatment group and gestational age, mortality rates through end of follow-up were 4.22 [95% confidence interval (CI): 1.39-12.13], 4.53 (95% CI: 1.21-15.50), and 4.07 (95% CI: 1.22-12.70) for groups 1, 2, and 3, respectively. CONCLUSIONS Each of the antibiotic regimens are safe in premature infants with cIAI. CLINICAL TRIAL REGISTRATION NCT0199499.
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Affiliation(s)
- Michael J. Smith
- Division of Pediatric Infectious Diseases, Duke University, Durham, NC
| | | | - Julie Autmizguine
- Division of Pediatric Infectious Diseases, Universitaire Sainte-Justine, Montreal, Canada
| | - Mark L. Hudak
- Division of Neonatology, University of Florida College of Medicine, Jacksonville, FL
| | - Erin Zinkhan
- Division of Neonatology, University of Utah, Salt Lake City, UT
| | - Barry T. Bloom
- Division of Neonatology, Wesley Medical Center, Wichita, KS
| | - Gloria Heresi
- Division of Pediatric Infectious Diseases, University of Texas, Houston, TX
| | | | - Sherry E. Courtney
- Division of Neonatology, University of Arkansas for Medical Sciences, Little Rock, AR
| | | | - C. Michael Cotten
- Division of Neonatal-Perinatal Medicine, Duke University, Durham, NC
| | | | - Susan Mendley
- Division of Nephrology, University of Maryland, Baltimore, MD
| | - Catherine Bendel
- Division of Neonatology, University of Minnesota, Minneapolis, MN
| | | | | | | | | | | | | | | | - Jamie Gao
- Duke Clinical Research Institute, Durham, NC
| | - Daniel K. Benjamin
- Division of Pediatric Infectious Diseases, Duke University, Durham, NC
- Duke Clinical Research Institute, Durham, NC
| | | | - P. Brian Smith
- Division of Neonatal-Perinatal Medicine, Duke University, Durham, NC
- Duke Clinical Research Institute, Durham, NC
| | - Michael Cohen-Wolkowiez
- Division of Pediatric Infectious Diseases, Duke University, Durham, NC
- Duke Clinical Research Institute, Durham, NC
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18
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Laptook AR, Shankaran S, Barnes P, Rollins N, Do BT, Parikh NA, Hamrick S, Hintz SR, Tyson JE, Bell EF, Ambalavanan N, Goldberg RN, Pappas A, Huitema C, Pedroza C, Chaudhary AS, Hensman AM, Das A, Wyckoff M, Khan A, Walsh MC, Watterberg KL, Faix R, Truog W, Guillet R, Sokol GM, Poindexter BB, Higgins RD. Limitations of Conventional Magnetic Resonance Imaging as a Predictor of Death or Disability Following Neonatal Hypoxic-Ischemic Encephalopathy in the Late Hypothermia Trial. J Pediatr 2021; 230:106-111.e6. [PMID: 33189747 PMCID: PMC7914162 DOI: 10.1016/j.jpeds.2020.11.015] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/22/2020] [Revised: 11/04/2020] [Accepted: 11/09/2020] [Indexed: 01/20/2023]
Abstract
OBJECTIVE To investigate if magnetic resonance imaging (MRI) is an accurate predictor for death or moderate-severe disability at 18-22 months of age among infants with neonatal encephalopathy in a trial of cooling initiated at 6-24 hours. STUDY DESIGN Subgroup analysis of infants ≥36 weeks of gestation with moderate-severe neonatal encephalopathy randomized at 6-24 postnatal hours to hypothermia or usual care in a multicenter trial of late hypothermia. MRI scans were performed per each center's practice and interpreted by 2 central readers using the Eunice Kennedy Shriver National Institute of Child Health and Human Development injury score (6 levels, normal to hemispheric devastation). Neurodevelopmental outcomes were assessed at 18-22 months of age. RESULTS Of 168 enrollees, 128 had an interpretable MRI and were seen in follow-up (n = 119) or died (n = 9). MRI findings were predominantly acute injury and did not differ by cooling treatment. At 18-22 months, death or severe disability occurred in 20.3%. No infant had moderate disability. Agreement between central readers was moderate (weighted kappa 0.56, 95% CI 0.45-0.67). The adjusted odds of death or severe disability increased 3.7-fold (95% CI 1.8-7.9) for each increment of injury score. The area under the curve for severe MRI patterns to predict death or severe disability was 0.77 and the positive and negative predictive values were 36% and 100%, respectively. CONCLUSIONS MRI injury scores were associated with neurodevelopmental outcome at 18-22 months among infants in the Late Hypothermia Trial. However, the results suggest caution when using qualitative interpretations of MRI images to provide prognostic information to families following perinatal hypoxia-ischemia. TRIAL REGISTRATION Clinicaltrials.gov: NCT00614744.
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Affiliation(s)
- Abbot R. Laptook
- Department of Pediatrics, Women and Infants Hospital, Brown
University, Providence, RI
| | | | - Patrick Barnes
- Department of Radiology and Pediatrics, Stanford University
School of Medicine, Palo Alto, CA
| | - Nancy Rollins
- Department of Radiology, University of Texas Southwestern
Medical Center, Dallas, TX
| | - Barbara T. Do
- Biostatistics and Epidemiology Division, RTI International,
Research Triangle Park, NC
| | - Nehal A. Parikh
- Perinatal Institute, Cincinnati Children’s Hospital
Medical Center, Cincinnati, OH
| | - Shannon Hamrick
- Emory University School of Medicine, Department of
Pediatrics, Children’s Healthcare of Atlanta, Atlanta, GA
| | - Susan R. Hintz
- Department of Pediatrics, Division of Neonatal and
Developmental Medicine, Stanford University School of Medicine and Lucile Packard
Children’s Hospital, Palo Alto, CA
| | - Jon E. Tyson
- Department of Pediatrics, McGovern Medical School at The
University of Texas Health Science Center at Houston, Houston, TX
| | - Edward F. Bell
- Department of Pediatrics, University of Iowa, Iowa City,
IA
| | | | | | - Athina Pappas
- Department of Pediatrics, Wayne State University, Detroit,
MI
| | - Carolyn Huitema
- Social, Statistical and Environmental Sciences Unit, RTI
International, Rockville, MD
| | - Claudia Pedroza
- Department of Pediatrics, McGovern Medical School at The
University of Texas Health Science Center at Houston, Houston, TX
| | | | - Angelita M. Hensman
- Department of Pediatrics, Women and Infants Hospital, Brown
University, Providence, RI
| | - Abhik Das
- Social, Statistical and Environmental Sciences Unit, RTI
International, Rockville, MD
| | - Myra Wyckoff
- Department of Pediatrics, University of Texas
Southwestern Medical Center, Dallas, TX
| | - Amir Khan
- Department of Pediatrics, McGovern Medical School at The
University of Texas Health Science Center at Houston, Houston, TX
| | - Michelle C. Walsh
- Department of Pediatrics, Rainbow Babies &
Children’s Hospital, Case Western Reserve University, Cleveland, OH
| | | | - Roger Faix
- Department of Pediatrics, Division of Neonatology,
University of Utah School of Medicine, Salt Lake City, UT
| | - William Truog
- Department of Pediatrics, Children’s Mercy
Hospital and University of Missouri Kansas City School of Medicine, Kansas City,
MO
| | - Ronnie Guillet
- University of Rochester School of Medicine and Dentistry,
Rochester, NY
| | - Gregory M. Sokol
- Department of Pediatrics, Indiana University School of
Medicine, Indianapolis, IN
| | - Brenda B. Poindexter
- Department of Pediatrics, Indiana University School of
Medicine, Indianapolis, IN,Cincinnati Children’s Hospital Medical Center,
Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati,
OH
| | - Rosemary D. Higgins
- Eunice Kennedy Shriver National Institute of Child Health
and Human Development, Pregnancy and Perinatology Branch,George Mason University, Fairfax, VA
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19
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Salerno SN, Edginton A, Gerhart JG, Laughon MM, Ambalavanan N, Sokol GM, Hornik CD, Stewart D, Mills M, Martz K, Gonzalez D. Physiologically-Based Pharmacokinetic Modeling Characterizes the CYP3A-Mediated Drug-Drug Interaction Between Fluconazole and Sildenafil in Infants. Clin Pharmacol Ther 2021; 109:253-262. [PMID: 32691891 PMCID: PMC8138939 DOI: 10.1002/cpt.1990] [Citation(s) in RCA: 21] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2020] [Accepted: 07/05/2020] [Indexed: 12/12/2022]
Abstract
Physiologically-based pharmacokinetic (PBPK) modeling can potentially predict pediatric drug-drug interactions (DDIs) when clinical DDI data are limited. In infants for whom treatment of pulmonary hypertension and prevention or treatment of invasive candidiasis are indicated, sildenafil with fluconazole may be given concurrently. To account for developmental changes in cytochrome P450 (CYP) 3A, we determined and incorporated fluconazole inhibition constants (KI ) for CYP3A4, CYP3A5, and CYP3A7 into a PBPK model developed for sildenafil and its active metabolite, N-desmethylsildenafil. Pharmacokinetic (PK) data in preterm infants receiving sildenafil with and without fluconazole were used for model development and evaluation. The simulated PK parameters were comparable to observed values. Following fluconazole co-administration, differences in the fold change for simulated steady-state area under the plasma concentration vs. time curve from 0 to 24 hours (AUCss,0-24 ) were observed between virtual adults and infants (2.11-fold vs. 2.82-fold change). When given in combination with treatment doses of fluconazole (12 mg/kg i.v. daily), reducing the sildenafil dose by ~ 60% resulted in a geometric mean ratio of 1.01 for simulated AUCss,0-24 relative to virtual infants receiving sildenafil alone. This study highlights the feasibility of PBPK modeling to predict DDIs in infants and the need to include CYP3A7 parameters.
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Affiliation(s)
- Sara N. Salerno
- Division of Pharmacotherapy and Experimental Therapeutics, UNC Eshelman School of Pharmacy, The University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| | - Andrea Edginton
- School of Pharmacy, University of Waterloo, Kitchener, Ontario, Canada
| | - Jacqueline G. Gerhart
- Division of Pharmacotherapy and Experimental Therapeutics, UNC Eshelman School of Pharmacy, The University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| | - Matthew M. Laughon
- Department of Pediatrics, UNC School of Medicine, The University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| | - Namasivayam Ambalavanan
- Division of Neonatology, School of Medicine, University of Alabama at Birmingham, Birmingham, Alabama, USA
| | - Gregory M. Sokol
- Division of Neonatal-Perinatal Medicine, Indiana University School of Medicine, Indianapolis, Indiana, USA
| | - Chi D. Hornik
- Department of Pediatrics, Duke University School of Medicine, Durham, North Carolina, USA
- Duke Clinical Research Institute, Durham, North Carolina, USA
- Department of Pharmacy, Duke University Medical Center, Durham, North Carolina, USA
| | - Dan Stewart
- University of Louisville Norton Children’s Hospital, Louisville, Kentucky, USA
| | - Mary Mills
- Duke Clinical Research Institute, Durham, North Carolina, USA
| | - Karen Martz
- The Emmes Company, LLC, Rockville, Maryland, USA
| | - Daniel Gonzalez
- Division of Pharmacotherapy and Experimental Therapeutics, UNC Eshelman School of Pharmacy, The University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
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20
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Kirpalani H, Bell EF, Hintz SR, Tan S, Schmidt B, Chaudhary AS, Johnson KJ, Crawford MM, Newman JE, Vohr BR, Carlo WA, D'Angio CT, Kennedy KA, Ohls RK, Poindexter BB, Schibler K, Whyte RK, Widness JA, Zupancic JAF, Wyckoff MH, Truog WE, Walsh MC, Chock VY, Laptook AR, Sokol GM, Yoder BA, Patel RM, Cotten CM, Carmen MF, Devaskar U, Chawla S, Seabrook R, Higgins RD, Das A. Higher or Lower Hemoglobin Transfusion Thresholds for Preterm Infants. N Engl J Med 2020; 383:2639-2651. [PMID: 33382931 PMCID: PMC8487591 DOI: 10.1056/nejmoa2020248] [Citation(s) in RCA: 102] [Impact Index Per Article: 25.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
BACKGROUND Limited data suggest that higher hemoglobin thresholds for red-cell transfusions may reduce the risk of cognitive delay among extremely-low-birth-weight infants with anemia. METHODS We performed an open, multicenter trial in which infants with a birth weight of 1000 g or less and a gestational age between 22 weeks 0 days and 28 weeks 6 days were randomly assigned within 48 hours after delivery to receive red-cell transfusions at higher or lower hemoglobin thresholds until 36 weeks of postmenstrual age or discharge, whichever occurred first. The primary outcome was a composite of death or neurodevelopmental impairment (cognitive delay, cerebral palsy, or hearing or vision loss) at 22 to 26 months of age, corrected for prematurity. RESULTS A total of 1824 infants (mean birth weight, 756 g; mean gestational age, 25.9 weeks) underwent randomization. There was a between-group difference of 1.9 g per deciliter (19 g per liter) in the pretransfusion mean hemoglobin levels throughout the treatment period. Primary outcome data were available for 1692 infants (92.8%). Of 845 infants in the higher-threshold group, 423 (50.1%) died or survived with neurodevelopmental impairment, as compared with 422 of 847 infants (49.8%) in the lower-threshold group (relative risk adjusted for birth-weight stratum and center, 1.00; 95% confidence interval [CI], 0.92 to 1.10; P = 0.93). At 2 years, the higher- and lower-threshold groups had similar incidences of death (16.2% and 15.0%, respectively) and neurodevelopmental impairment (39.6% and 40.3%, respectively). At discharge from the hospital, the incidences of survival without severe complications were 28.5% and 30.9%, respectively. Serious adverse events occurred in 22.7% and 21.7%, respectively. CONCLUSIONS In extremely-low-birth-weight infants, a higher hemoglobin threshold for red-cell transfusion did not improve survival without neurodevelopmental impairment at 22 to 26 months of age, corrected for prematurity. (Funded by the National Heart, Lung, and Blood Institute and others; TOP ClinicalTrials.gov number, NCT01702805.).
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MESH Headings
- Algorithms
- Anemia/blood
- Anemia/mortality
- Anemia/therapy
- Cerebral Palsy/prevention & control
- Cognition Disorders/prevention & control
- Erythrocyte Transfusion/adverse effects
- Hearing Loss/prevention & control
- Hemoglobins/analysis
- Humans
- Infant, Extremely Low Birth Weight/blood
- Infant, Extremely Premature/blood
- Infant, Newborn/blood
- Infant, Premature/blood
- Infant, Premature, Diseases/blood
- Infant, Premature, Diseases/mortality
- Infant, Premature, Diseases/therapy
- Neurodevelopmental Disorders/prevention & control
- Survival Rate
- Vision Disorders/prevention & control
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Affiliation(s)
- Haresh Kirpalani
- From the Department of Pediatrics, University of Pennsylvania, and Children's Hospital of Philadelphia, Philadelphia (H.K., B.S., A.S.C.); the Department of Pediatrics, University of Iowa, Iowa City (E.F.B., K.J.J., J.A.W.); the Department of Pediatrics, Division of Neonatal and Developmental Medicine, Stanford University School of Medicine and Lucile Packard Children's Hospital, Palo Alto (S.R.H., V.Y.C.), and the Department of Pediatrics, University of California, Los Angeles, Los Angeles (U.D.) - both in California; the Biostatistics and Epidemiology Division, RTI International, Research Triangle Park (S.T., M.M.C.), and the Department of Pediatrics, Duke University School of Medicine, Durham (C.M.C.) - both in North Carolina; the Biostatistics and Epidemiology Division, RTI International, Rockville (J.E.N., A.D.), and the Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, Bethesda (R.D.H.) - both in Maryland; the Department of Pediatrics, Women and Infants Hospital, Brown University, Providence, RI (B.R.V., A.R.L.); the Division of Neonatology, University of Alabama at Birmingham, Birmingham (W.A.C.); the University of Rochester School of Medicine and Dentistry, Rochester, NY (C.T.D., M.F.C.); the Department of Pediatrics, McGovern Medical School at the University of Texas Health Science Center at Houston, Houston (K.A.K.), and the Department of Pediatrics, University of Texas Southwestern Medical Center, Dallas (M.H.W.); the University of New Mexico Health Sciences Center, Albuquerque (R.K.O.); the Department of Pediatrics, Division of Neonatology, University of Utah School of Medicine, Salt Lake City (R.K.O., B.A.Y.); the Department of Pediatrics, Indiana University School of Medicine, Indianapolis (B.B.P., G.M.S.); Cincinnati Children's Hospital Medical Center, Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati (B.B.P., K.S.), the Department of Pediatrics, Rainbow Babies and Children's Hospital, Case Western Reserve University, Cleveland (M.C.W.), and Nationwide Children's Hospital and the Department of Pediatrics, Ohio State University College of Medicine, Columbus (R.S.); the Department of Pediatrics, Dalhousie University, Halifax, NS, Canada (R.K.W.); the Department of Neonatology, Harvard Medical School, Beth Israel Deaconess Medical Center, Boston (J.A.F.Z.); the Department of Pediatrics, Children's Mercy Hospital, Kansas City, MO (W.E.T.); Emory University School of Medicine, Department of Pediatrics, Children's Healthcare of Atlanta, Atlanta (R.M.P.); the Department of Pediatrics, Wayne State University, Detroit (S.C.); and the College of Health and Human Services, George Mason University, Fairfax, VA (R.D.H.)
| | - Edward F Bell
- From the Department of Pediatrics, University of Pennsylvania, and Children's Hospital of Philadelphia, Philadelphia (H.K., B.S., A.S.C.); the Department of Pediatrics, University of Iowa, Iowa City (E.F.B., K.J.J., J.A.W.); the Department of Pediatrics, Division of Neonatal and Developmental Medicine, Stanford University School of Medicine and Lucile Packard Children's Hospital, Palo Alto (S.R.H., V.Y.C.), and the Department of Pediatrics, University of California, Los Angeles, Los Angeles (U.D.) - both in California; the Biostatistics and Epidemiology Division, RTI International, Research Triangle Park (S.T., M.M.C.), and the Department of Pediatrics, Duke University School of Medicine, Durham (C.M.C.) - both in North Carolina; the Biostatistics and Epidemiology Division, RTI International, Rockville (J.E.N., A.D.), and the Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, Bethesda (R.D.H.) - both in Maryland; the Department of Pediatrics, Women and Infants Hospital, Brown University, Providence, RI (B.R.V., A.R.L.); the Division of Neonatology, University of Alabama at Birmingham, Birmingham (W.A.C.); the University of Rochester School of Medicine and Dentistry, Rochester, NY (C.T.D., M.F.C.); the Department of Pediatrics, McGovern Medical School at the University of Texas Health Science Center at Houston, Houston (K.A.K.), and the Department of Pediatrics, University of Texas Southwestern Medical Center, Dallas (M.H.W.); the University of New Mexico Health Sciences Center, Albuquerque (R.K.O.); the Department of Pediatrics, Division of Neonatology, University of Utah School of Medicine, Salt Lake City (R.K.O., B.A.Y.); the Department of Pediatrics, Indiana University School of Medicine, Indianapolis (B.B.P., G.M.S.); Cincinnati Children's Hospital Medical Center, Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati (B.B.P., K.S.), the Department of Pediatrics, Rainbow Babies and Children's Hospital, Case Western Reserve University, Cleveland (M.C.W.), and Nationwide Children's Hospital and the Department of Pediatrics, Ohio State University College of Medicine, Columbus (R.S.); the Department of Pediatrics, Dalhousie University, Halifax, NS, Canada (R.K.W.); the Department of Neonatology, Harvard Medical School, Beth Israel Deaconess Medical Center, Boston (J.A.F.Z.); the Department of Pediatrics, Children's Mercy Hospital, Kansas City, MO (W.E.T.); Emory University School of Medicine, Department of Pediatrics, Children's Healthcare of Atlanta, Atlanta (R.M.P.); the Department of Pediatrics, Wayne State University, Detroit (S.C.); and the College of Health and Human Services, George Mason University, Fairfax, VA (R.D.H.)
| | - Susan R Hintz
- From the Department of Pediatrics, University of Pennsylvania, and Children's Hospital of Philadelphia, Philadelphia (H.K., B.S., A.S.C.); the Department of Pediatrics, University of Iowa, Iowa City (E.F.B., K.J.J., J.A.W.); the Department of Pediatrics, Division of Neonatal and Developmental Medicine, Stanford University School of Medicine and Lucile Packard Children's Hospital, Palo Alto (S.R.H., V.Y.C.), and the Department of Pediatrics, University of California, Los Angeles, Los Angeles (U.D.) - both in California; the Biostatistics and Epidemiology Division, RTI International, Research Triangle Park (S.T., M.M.C.), and the Department of Pediatrics, Duke University School of Medicine, Durham (C.M.C.) - both in North Carolina; the Biostatistics and Epidemiology Division, RTI International, Rockville (J.E.N., A.D.), and the Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, Bethesda (R.D.H.) - both in Maryland; the Department of Pediatrics, Women and Infants Hospital, Brown University, Providence, RI (B.R.V., A.R.L.); the Division of Neonatology, University of Alabama at Birmingham, Birmingham (W.A.C.); the University of Rochester School of Medicine and Dentistry, Rochester, NY (C.T.D., M.F.C.); the Department of Pediatrics, McGovern Medical School at the University of Texas Health Science Center at Houston, Houston (K.A.K.), and the Department of Pediatrics, University of Texas Southwestern Medical Center, Dallas (M.H.W.); the University of New Mexico Health Sciences Center, Albuquerque (R.K.O.); the Department of Pediatrics, Division of Neonatology, University of Utah School of Medicine, Salt Lake City (R.K.O., B.A.Y.); the Department of Pediatrics, Indiana University School of Medicine, Indianapolis (B.B.P., G.M.S.); Cincinnati Children's Hospital Medical Center, Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati (B.B.P., K.S.), the Department of Pediatrics, Rainbow Babies and Children's Hospital, Case Western Reserve University, Cleveland (M.C.W.), and Nationwide Children's Hospital and the Department of Pediatrics, Ohio State University College of Medicine, Columbus (R.S.); the Department of Pediatrics, Dalhousie University, Halifax, NS, Canada (R.K.W.); the Department of Neonatology, Harvard Medical School, Beth Israel Deaconess Medical Center, Boston (J.A.F.Z.); the Department of Pediatrics, Children's Mercy Hospital, Kansas City, MO (W.E.T.); Emory University School of Medicine, Department of Pediatrics, Children's Healthcare of Atlanta, Atlanta (R.M.P.); the Department of Pediatrics, Wayne State University, Detroit (S.C.); and the College of Health and Human Services, George Mason University, Fairfax, VA (R.D.H.)
| | - Sylvia Tan
- From the Department of Pediatrics, University of Pennsylvania, and Children's Hospital of Philadelphia, Philadelphia (H.K., B.S., A.S.C.); the Department of Pediatrics, University of Iowa, Iowa City (E.F.B., K.J.J., J.A.W.); the Department of Pediatrics, Division of Neonatal and Developmental Medicine, Stanford University School of Medicine and Lucile Packard Children's Hospital, Palo Alto (S.R.H., V.Y.C.), and the Department of Pediatrics, University of California, Los Angeles, Los Angeles (U.D.) - both in California; the Biostatistics and Epidemiology Division, RTI International, Research Triangle Park (S.T., M.M.C.), and the Department of Pediatrics, Duke University School of Medicine, Durham (C.M.C.) - both in North Carolina; the Biostatistics and Epidemiology Division, RTI International, Rockville (J.E.N., A.D.), and the Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, Bethesda (R.D.H.) - both in Maryland; the Department of Pediatrics, Women and Infants Hospital, Brown University, Providence, RI (B.R.V., A.R.L.); the Division of Neonatology, University of Alabama at Birmingham, Birmingham (W.A.C.); the University of Rochester School of Medicine and Dentistry, Rochester, NY (C.T.D., M.F.C.); the Department of Pediatrics, McGovern Medical School at the University of Texas Health Science Center at Houston, Houston (K.A.K.), and the Department of Pediatrics, University of Texas Southwestern Medical Center, Dallas (M.H.W.); the University of New Mexico Health Sciences Center, Albuquerque (R.K.O.); the Department of Pediatrics, Division of Neonatology, University of Utah School of Medicine, Salt Lake City (R.K.O., B.A.Y.); the Department of Pediatrics, Indiana University School of Medicine, Indianapolis (B.B.P., G.M.S.); Cincinnati Children's Hospital Medical Center, Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati (B.B.P., K.S.), the Department of Pediatrics, Rainbow Babies and Children's Hospital, Case Western Reserve University, Cleveland (M.C.W.), and Nationwide Children's Hospital and the Department of Pediatrics, Ohio State University College of Medicine, Columbus (R.S.); the Department of Pediatrics, Dalhousie University, Halifax, NS, Canada (R.K.W.); the Department of Neonatology, Harvard Medical School, Beth Israel Deaconess Medical Center, Boston (J.A.F.Z.); the Department of Pediatrics, Children's Mercy Hospital, Kansas City, MO (W.E.T.); Emory University School of Medicine, Department of Pediatrics, Children's Healthcare of Atlanta, Atlanta (R.M.P.); the Department of Pediatrics, Wayne State University, Detroit (S.C.); and the College of Health and Human Services, George Mason University, Fairfax, VA (R.D.H.)
| | - Barbara Schmidt
- From the Department of Pediatrics, University of Pennsylvania, and Children's Hospital of Philadelphia, Philadelphia (H.K., B.S., A.S.C.); the Department of Pediatrics, University of Iowa, Iowa City (E.F.B., K.J.J., J.A.W.); the Department of Pediatrics, Division of Neonatal and Developmental Medicine, Stanford University School of Medicine and Lucile Packard Children's Hospital, Palo Alto (S.R.H., V.Y.C.), and the Department of Pediatrics, University of California, Los Angeles, Los Angeles (U.D.) - both in California; the Biostatistics and Epidemiology Division, RTI International, Research Triangle Park (S.T., M.M.C.), and the Department of Pediatrics, Duke University School of Medicine, Durham (C.M.C.) - both in North Carolina; the Biostatistics and Epidemiology Division, RTI International, Rockville (J.E.N., A.D.), and the Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, Bethesda (R.D.H.) - both in Maryland; the Department of Pediatrics, Women and Infants Hospital, Brown University, Providence, RI (B.R.V., A.R.L.); the Division of Neonatology, University of Alabama at Birmingham, Birmingham (W.A.C.); the University of Rochester School of Medicine and Dentistry, Rochester, NY (C.T.D., M.F.C.); the Department of Pediatrics, McGovern Medical School at the University of Texas Health Science Center at Houston, Houston (K.A.K.), and the Department of Pediatrics, University of Texas Southwestern Medical Center, Dallas (M.H.W.); the University of New Mexico Health Sciences Center, Albuquerque (R.K.O.); the Department of Pediatrics, Division of Neonatology, University of Utah School of Medicine, Salt Lake City (R.K.O., B.A.Y.); the Department of Pediatrics, Indiana University School of Medicine, Indianapolis (B.B.P., G.M.S.); Cincinnati Children's Hospital Medical Center, Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati (B.B.P., K.S.), the Department of Pediatrics, Rainbow Babies and Children's Hospital, Case Western Reserve University, Cleveland (M.C.W.), and Nationwide Children's Hospital and the Department of Pediatrics, Ohio State University College of Medicine, Columbus (R.S.); the Department of Pediatrics, Dalhousie University, Halifax, NS, Canada (R.K.W.); the Department of Neonatology, Harvard Medical School, Beth Israel Deaconess Medical Center, Boston (J.A.F.Z.); the Department of Pediatrics, Children's Mercy Hospital, Kansas City, MO (W.E.T.); Emory University School of Medicine, Department of Pediatrics, Children's Healthcare of Atlanta, Atlanta (R.M.P.); the Department of Pediatrics, Wayne State University, Detroit (S.C.); and the College of Health and Human Services, George Mason University, Fairfax, VA (R.D.H.)
| | - Aasma S Chaudhary
- From the Department of Pediatrics, University of Pennsylvania, and Children's Hospital of Philadelphia, Philadelphia (H.K., B.S., A.S.C.); the Department of Pediatrics, University of Iowa, Iowa City (E.F.B., K.J.J., J.A.W.); the Department of Pediatrics, Division of Neonatal and Developmental Medicine, Stanford University School of Medicine and Lucile Packard Children's Hospital, Palo Alto (S.R.H., V.Y.C.), and the Department of Pediatrics, University of California, Los Angeles, Los Angeles (U.D.) - both in California; the Biostatistics and Epidemiology Division, RTI International, Research Triangle Park (S.T., M.M.C.), and the Department of Pediatrics, Duke University School of Medicine, Durham (C.M.C.) - both in North Carolina; the Biostatistics and Epidemiology Division, RTI International, Rockville (J.E.N., A.D.), and the Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, Bethesda (R.D.H.) - both in Maryland; the Department of Pediatrics, Women and Infants Hospital, Brown University, Providence, RI (B.R.V., A.R.L.); the Division of Neonatology, University of Alabama at Birmingham, Birmingham (W.A.C.); the University of Rochester School of Medicine and Dentistry, Rochester, NY (C.T.D., M.F.C.); the Department of Pediatrics, McGovern Medical School at the University of Texas Health Science Center at Houston, Houston (K.A.K.), and the Department of Pediatrics, University of Texas Southwestern Medical Center, Dallas (M.H.W.); the University of New Mexico Health Sciences Center, Albuquerque (R.K.O.); the Department of Pediatrics, Division of Neonatology, University of Utah School of Medicine, Salt Lake City (R.K.O., B.A.Y.); the Department of Pediatrics, Indiana University School of Medicine, Indianapolis (B.B.P., G.M.S.); Cincinnati Children's Hospital Medical Center, Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati (B.B.P., K.S.), the Department of Pediatrics, Rainbow Babies and Children's Hospital, Case Western Reserve University, Cleveland (M.C.W.), and Nationwide Children's Hospital and the Department of Pediatrics, Ohio State University College of Medicine, Columbus (R.S.); the Department of Pediatrics, Dalhousie University, Halifax, NS, Canada (R.K.W.); the Department of Neonatology, Harvard Medical School, Beth Israel Deaconess Medical Center, Boston (J.A.F.Z.); the Department of Pediatrics, Children's Mercy Hospital, Kansas City, MO (W.E.T.); Emory University School of Medicine, Department of Pediatrics, Children's Healthcare of Atlanta, Atlanta (R.M.P.); the Department of Pediatrics, Wayne State University, Detroit (S.C.); and the College of Health and Human Services, George Mason University, Fairfax, VA (R.D.H.)
| | - Karen J Johnson
- From the Department of Pediatrics, University of Pennsylvania, and Children's Hospital of Philadelphia, Philadelphia (H.K., B.S., A.S.C.); the Department of Pediatrics, University of Iowa, Iowa City (E.F.B., K.J.J., J.A.W.); the Department of Pediatrics, Division of Neonatal and Developmental Medicine, Stanford University School of Medicine and Lucile Packard Children's Hospital, Palo Alto (S.R.H., V.Y.C.), and the Department of Pediatrics, University of California, Los Angeles, Los Angeles (U.D.) - both in California; the Biostatistics and Epidemiology Division, RTI International, Research Triangle Park (S.T., M.M.C.), and the Department of Pediatrics, Duke University School of Medicine, Durham (C.M.C.) - both in North Carolina; the Biostatistics and Epidemiology Division, RTI International, Rockville (J.E.N., A.D.), and the Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, Bethesda (R.D.H.) - both in Maryland; the Department of Pediatrics, Women and Infants Hospital, Brown University, Providence, RI (B.R.V., A.R.L.); the Division of Neonatology, University of Alabama at Birmingham, Birmingham (W.A.C.); the University of Rochester School of Medicine and Dentistry, Rochester, NY (C.T.D., M.F.C.); the Department of Pediatrics, McGovern Medical School at the University of Texas Health Science Center at Houston, Houston (K.A.K.), and the Department of Pediatrics, University of Texas Southwestern Medical Center, Dallas (M.H.W.); the University of New Mexico Health Sciences Center, Albuquerque (R.K.O.); the Department of Pediatrics, Division of Neonatology, University of Utah School of Medicine, Salt Lake City (R.K.O., B.A.Y.); the Department of Pediatrics, Indiana University School of Medicine, Indianapolis (B.B.P., G.M.S.); Cincinnati Children's Hospital Medical Center, Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati (B.B.P., K.S.), the Department of Pediatrics, Rainbow Babies and Children's Hospital, Case Western Reserve University, Cleveland (M.C.W.), and Nationwide Children's Hospital and the Department of Pediatrics, Ohio State University College of Medicine, Columbus (R.S.); the Department of Pediatrics, Dalhousie University, Halifax, NS, Canada (R.K.W.); the Department of Neonatology, Harvard Medical School, Beth Israel Deaconess Medical Center, Boston (J.A.F.Z.); the Department of Pediatrics, Children's Mercy Hospital, Kansas City, MO (W.E.T.); Emory University School of Medicine, Department of Pediatrics, Children's Healthcare of Atlanta, Atlanta (R.M.P.); the Department of Pediatrics, Wayne State University, Detroit (S.C.); and the College of Health and Human Services, George Mason University, Fairfax, VA (R.D.H.)
| | - Margaret M Crawford
- From the Department of Pediatrics, University of Pennsylvania, and Children's Hospital of Philadelphia, Philadelphia (H.K., B.S., A.S.C.); the Department of Pediatrics, University of Iowa, Iowa City (E.F.B., K.J.J., J.A.W.); the Department of Pediatrics, Division of Neonatal and Developmental Medicine, Stanford University School of Medicine and Lucile Packard Children's Hospital, Palo Alto (S.R.H., V.Y.C.), and the Department of Pediatrics, University of California, Los Angeles, Los Angeles (U.D.) - both in California; the Biostatistics and Epidemiology Division, RTI International, Research Triangle Park (S.T., M.M.C.), and the Department of Pediatrics, Duke University School of Medicine, Durham (C.M.C.) - both in North Carolina; the Biostatistics and Epidemiology Division, RTI International, Rockville (J.E.N., A.D.), and the Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, Bethesda (R.D.H.) - both in Maryland; the Department of Pediatrics, Women and Infants Hospital, Brown University, Providence, RI (B.R.V., A.R.L.); the Division of Neonatology, University of Alabama at Birmingham, Birmingham (W.A.C.); the University of Rochester School of Medicine and Dentistry, Rochester, NY (C.T.D., M.F.C.); the Department of Pediatrics, McGovern Medical School at the University of Texas Health Science Center at Houston, Houston (K.A.K.), and the Department of Pediatrics, University of Texas Southwestern Medical Center, Dallas (M.H.W.); the University of New Mexico Health Sciences Center, Albuquerque (R.K.O.); the Department of Pediatrics, Division of Neonatology, University of Utah School of Medicine, Salt Lake City (R.K.O., B.A.Y.); the Department of Pediatrics, Indiana University School of Medicine, Indianapolis (B.B.P., G.M.S.); Cincinnati Children's Hospital Medical Center, Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati (B.B.P., K.S.), the Department of Pediatrics, Rainbow Babies and Children's Hospital, Case Western Reserve University, Cleveland (M.C.W.), and Nationwide Children's Hospital and the Department of Pediatrics, Ohio State University College of Medicine, Columbus (R.S.); the Department of Pediatrics, Dalhousie University, Halifax, NS, Canada (R.K.W.); the Department of Neonatology, Harvard Medical School, Beth Israel Deaconess Medical Center, Boston (J.A.F.Z.); the Department of Pediatrics, Children's Mercy Hospital, Kansas City, MO (W.E.T.); Emory University School of Medicine, Department of Pediatrics, Children's Healthcare of Atlanta, Atlanta (R.M.P.); the Department of Pediatrics, Wayne State University, Detroit (S.C.); and the College of Health and Human Services, George Mason University, Fairfax, VA (R.D.H.)
| | - Jamie E Newman
- From the Department of Pediatrics, University of Pennsylvania, and Children's Hospital of Philadelphia, Philadelphia (H.K., B.S., A.S.C.); the Department of Pediatrics, University of Iowa, Iowa City (E.F.B., K.J.J., J.A.W.); the Department of Pediatrics, Division of Neonatal and Developmental Medicine, Stanford University School of Medicine and Lucile Packard Children's Hospital, Palo Alto (S.R.H., V.Y.C.), and the Department of Pediatrics, University of California, Los Angeles, Los Angeles (U.D.) - both in California; the Biostatistics and Epidemiology Division, RTI International, Research Triangle Park (S.T., M.M.C.), and the Department of Pediatrics, Duke University School of Medicine, Durham (C.M.C.) - both in North Carolina; the Biostatistics and Epidemiology Division, RTI International, Rockville (J.E.N., A.D.), and the Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, Bethesda (R.D.H.) - both in Maryland; the Department of Pediatrics, Women and Infants Hospital, Brown University, Providence, RI (B.R.V., A.R.L.); the Division of Neonatology, University of Alabama at Birmingham, Birmingham (W.A.C.); the University of Rochester School of Medicine and Dentistry, Rochester, NY (C.T.D., M.F.C.); the Department of Pediatrics, McGovern Medical School at the University of Texas Health Science Center at Houston, Houston (K.A.K.), and the Department of Pediatrics, University of Texas Southwestern Medical Center, Dallas (M.H.W.); the University of New Mexico Health Sciences Center, Albuquerque (R.K.O.); the Department of Pediatrics, Division of Neonatology, University of Utah School of Medicine, Salt Lake City (R.K.O., B.A.Y.); the Department of Pediatrics, Indiana University School of Medicine, Indianapolis (B.B.P., G.M.S.); Cincinnati Children's Hospital Medical Center, Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati (B.B.P., K.S.), the Department of Pediatrics, Rainbow Babies and Children's Hospital, Case Western Reserve University, Cleveland (M.C.W.), and Nationwide Children's Hospital and the Department of Pediatrics, Ohio State University College of Medicine, Columbus (R.S.); the Department of Pediatrics, Dalhousie University, Halifax, NS, Canada (R.K.W.); the Department of Neonatology, Harvard Medical School, Beth Israel Deaconess Medical Center, Boston (J.A.F.Z.); the Department of Pediatrics, Children's Mercy Hospital, Kansas City, MO (W.E.T.); Emory University School of Medicine, Department of Pediatrics, Children's Healthcare of Atlanta, Atlanta (R.M.P.); the Department of Pediatrics, Wayne State University, Detroit (S.C.); and the College of Health and Human Services, George Mason University, Fairfax, VA (R.D.H.)
| | - Betty R Vohr
- From the Department of Pediatrics, University of Pennsylvania, and Children's Hospital of Philadelphia, Philadelphia (H.K., B.S., A.S.C.); the Department of Pediatrics, University of Iowa, Iowa City (E.F.B., K.J.J., J.A.W.); the Department of Pediatrics, Division of Neonatal and Developmental Medicine, Stanford University School of Medicine and Lucile Packard Children's Hospital, Palo Alto (S.R.H., V.Y.C.), and the Department of Pediatrics, University of California, Los Angeles, Los Angeles (U.D.) - both in California; the Biostatistics and Epidemiology Division, RTI International, Research Triangle Park (S.T., M.M.C.), and the Department of Pediatrics, Duke University School of Medicine, Durham (C.M.C.) - both in North Carolina; the Biostatistics and Epidemiology Division, RTI International, Rockville (J.E.N., A.D.), and the Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, Bethesda (R.D.H.) - both in Maryland; the Department of Pediatrics, Women and Infants Hospital, Brown University, Providence, RI (B.R.V., A.R.L.); the Division of Neonatology, University of Alabama at Birmingham, Birmingham (W.A.C.); the University of Rochester School of Medicine and Dentistry, Rochester, NY (C.T.D., M.F.C.); the Department of Pediatrics, McGovern Medical School at the University of Texas Health Science Center at Houston, Houston (K.A.K.), and the Department of Pediatrics, University of Texas Southwestern Medical Center, Dallas (M.H.W.); the University of New Mexico Health Sciences Center, Albuquerque (R.K.O.); the Department of Pediatrics, Division of Neonatology, University of Utah School of Medicine, Salt Lake City (R.K.O., B.A.Y.); the Department of Pediatrics, Indiana University School of Medicine, Indianapolis (B.B.P., G.M.S.); Cincinnati Children's Hospital Medical Center, Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati (B.B.P., K.S.), the Department of Pediatrics, Rainbow Babies and Children's Hospital, Case Western Reserve University, Cleveland (M.C.W.), and Nationwide Children's Hospital and the Department of Pediatrics, Ohio State University College of Medicine, Columbus (R.S.); the Department of Pediatrics, Dalhousie University, Halifax, NS, Canada (R.K.W.); the Department of Neonatology, Harvard Medical School, Beth Israel Deaconess Medical Center, Boston (J.A.F.Z.); the Department of Pediatrics, Children's Mercy Hospital, Kansas City, MO (W.E.T.); Emory University School of Medicine, Department of Pediatrics, Children's Healthcare of Atlanta, Atlanta (R.M.P.); the Department of Pediatrics, Wayne State University, Detroit (S.C.); and the College of Health and Human Services, George Mason University, Fairfax, VA (R.D.H.)
| | - Waldemar A Carlo
- From the Department of Pediatrics, University of Pennsylvania, and Children's Hospital of Philadelphia, Philadelphia (H.K., B.S., A.S.C.); the Department of Pediatrics, University of Iowa, Iowa City (E.F.B., K.J.J., J.A.W.); the Department of Pediatrics, Division of Neonatal and Developmental Medicine, Stanford University School of Medicine and Lucile Packard Children's Hospital, Palo Alto (S.R.H., V.Y.C.), and the Department of Pediatrics, University of California, Los Angeles, Los Angeles (U.D.) - both in California; the Biostatistics and Epidemiology Division, RTI International, Research Triangle Park (S.T., M.M.C.), and the Department of Pediatrics, Duke University School of Medicine, Durham (C.M.C.) - both in North Carolina; the Biostatistics and Epidemiology Division, RTI International, Rockville (J.E.N., A.D.), and the Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, Bethesda (R.D.H.) - both in Maryland; the Department of Pediatrics, Women and Infants Hospital, Brown University, Providence, RI (B.R.V., A.R.L.); the Division of Neonatology, University of Alabama at Birmingham, Birmingham (W.A.C.); the University of Rochester School of Medicine and Dentistry, Rochester, NY (C.T.D., M.F.C.); the Department of Pediatrics, McGovern Medical School at the University of Texas Health Science Center at Houston, Houston (K.A.K.), and the Department of Pediatrics, University of Texas Southwestern Medical Center, Dallas (M.H.W.); the University of New Mexico Health Sciences Center, Albuquerque (R.K.O.); the Department of Pediatrics, Division of Neonatology, University of Utah School of Medicine, Salt Lake City (R.K.O., B.A.Y.); the Department of Pediatrics, Indiana University School of Medicine, Indianapolis (B.B.P., G.M.S.); Cincinnati Children's Hospital Medical Center, Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati (B.B.P., K.S.), the Department of Pediatrics, Rainbow Babies and Children's Hospital, Case Western Reserve University, Cleveland (M.C.W.), and Nationwide Children's Hospital and the Department of Pediatrics, Ohio State University College of Medicine, Columbus (R.S.); the Department of Pediatrics, Dalhousie University, Halifax, NS, Canada (R.K.W.); the Department of Neonatology, Harvard Medical School, Beth Israel Deaconess Medical Center, Boston (J.A.F.Z.); the Department of Pediatrics, Children's Mercy Hospital, Kansas City, MO (W.E.T.); Emory University School of Medicine, Department of Pediatrics, Children's Healthcare of Atlanta, Atlanta (R.M.P.); the Department of Pediatrics, Wayne State University, Detroit (S.C.); and the College of Health and Human Services, George Mason University, Fairfax, VA (R.D.H.)
| | - Carl T D'Angio
- From the Department of Pediatrics, University of Pennsylvania, and Children's Hospital of Philadelphia, Philadelphia (H.K., B.S., A.S.C.); the Department of Pediatrics, University of Iowa, Iowa City (E.F.B., K.J.J., J.A.W.); the Department of Pediatrics, Division of Neonatal and Developmental Medicine, Stanford University School of Medicine and Lucile Packard Children's Hospital, Palo Alto (S.R.H., V.Y.C.), and the Department of Pediatrics, University of California, Los Angeles, Los Angeles (U.D.) - both in California; the Biostatistics and Epidemiology Division, RTI International, Research Triangle Park (S.T., M.M.C.), and the Department of Pediatrics, Duke University School of Medicine, Durham (C.M.C.) - both in North Carolina; the Biostatistics and Epidemiology Division, RTI International, Rockville (J.E.N., A.D.), and the Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, Bethesda (R.D.H.) - both in Maryland; the Department of Pediatrics, Women and Infants Hospital, Brown University, Providence, RI (B.R.V., A.R.L.); the Division of Neonatology, University of Alabama at Birmingham, Birmingham (W.A.C.); the University of Rochester School of Medicine and Dentistry, Rochester, NY (C.T.D., M.F.C.); the Department of Pediatrics, McGovern Medical School at the University of Texas Health Science Center at Houston, Houston (K.A.K.), and the Department of Pediatrics, University of Texas Southwestern Medical Center, Dallas (M.H.W.); the University of New Mexico Health Sciences Center, Albuquerque (R.K.O.); the Department of Pediatrics, Division of Neonatology, University of Utah School of Medicine, Salt Lake City (R.K.O., B.A.Y.); the Department of Pediatrics, Indiana University School of Medicine, Indianapolis (B.B.P., G.M.S.); Cincinnati Children's Hospital Medical Center, Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati (B.B.P., K.S.), the Department of Pediatrics, Rainbow Babies and Children's Hospital, Case Western Reserve University, Cleveland (M.C.W.), and Nationwide Children's Hospital and the Department of Pediatrics, Ohio State University College of Medicine, Columbus (R.S.); the Department of Pediatrics, Dalhousie University, Halifax, NS, Canada (R.K.W.); the Department of Neonatology, Harvard Medical School, Beth Israel Deaconess Medical Center, Boston (J.A.F.Z.); the Department of Pediatrics, Children's Mercy Hospital, Kansas City, MO (W.E.T.); Emory University School of Medicine, Department of Pediatrics, Children's Healthcare of Atlanta, Atlanta (R.M.P.); the Department of Pediatrics, Wayne State University, Detroit (S.C.); and the College of Health and Human Services, George Mason University, Fairfax, VA (R.D.H.)
| | - Kathleen A Kennedy
- From the Department of Pediatrics, University of Pennsylvania, and Children's Hospital of Philadelphia, Philadelphia (H.K., B.S., A.S.C.); the Department of Pediatrics, University of Iowa, Iowa City (E.F.B., K.J.J., J.A.W.); the Department of Pediatrics, Division of Neonatal and Developmental Medicine, Stanford University School of Medicine and Lucile Packard Children's Hospital, Palo Alto (S.R.H., V.Y.C.), and the Department of Pediatrics, University of California, Los Angeles, Los Angeles (U.D.) - both in California; the Biostatistics and Epidemiology Division, RTI International, Research Triangle Park (S.T., M.M.C.), and the Department of Pediatrics, Duke University School of Medicine, Durham (C.M.C.) - both in North Carolina; the Biostatistics and Epidemiology Division, RTI International, Rockville (J.E.N., A.D.), and the Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, Bethesda (R.D.H.) - both in Maryland; the Department of Pediatrics, Women and Infants Hospital, Brown University, Providence, RI (B.R.V., A.R.L.); the Division of Neonatology, University of Alabama at Birmingham, Birmingham (W.A.C.); the University of Rochester School of Medicine and Dentistry, Rochester, NY (C.T.D., M.F.C.); the Department of Pediatrics, McGovern Medical School at the University of Texas Health Science Center at Houston, Houston (K.A.K.), and the Department of Pediatrics, University of Texas Southwestern Medical Center, Dallas (M.H.W.); the University of New Mexico Health Sciences Center, Albuquerque (R.K.O.); the Department of Pediatrics, Division of Neonatology, University of Utah School of Medicine, Salt Lake City (R.K.O., B.A.Y.); the Department of Pediatrics, Indiana University School of Medicine, Indianapolis (B.B.P., G.M.S.); Cincinnati Children's Hospital Medical Center, Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati (B.B.P., K.S.), the Department of Pediatrics, Rainbow Babies and Children's Hospital, Case Western Reserve University, Cleveland (M.C.W.), and Nationwide Children's Hospital and the Department of Pediatrics, Ohio State University College of Medicine, Columbus (R.S.); the Department of Pediatrics, Dalhousie University, Halifax, NS, Canada (R.K.W.); the Department of Neonatology, Harvard Medical School, Beth Israel Deaconess Medical Center, Boston (J.A.F.Z.); the Department of Pediatrics, Children's Mercy Hospital, Kansas City, MO (W.E.T.); Emory University School of Medicine, Department of Pediatrics, Children's Healthcare of Atlanta, Atlanta (R.M.P.); the Department of Pediatrics, Wayne State University, Detroit (S.C.); and the College of Health and Human Services, George Mason University, Fairfax, VA (R.D.H.)
| | - Robin K Ohls
- From the Department of Pediatrics, University of Pennsylvania, and Children's Hospital of Philadelphia, Philadelphia (H.K., B.S., A.S.C.); the Department of Pediatrics, University of Iowa, Iowa City (E.F.B., K.J.J., J.A.W.); the Department of Pediatrics, Division of Neonatal and Developmental Medicine, Stanford University School of Medicine and Lucile Packard Children's Hospital, Palo Alto (S.R.H., V.Y.C.), and the Department of Pediatrics, University of California, Los Angeles, Los Angeles (U.D.) - both in California; the Biostatistics and Epidemiology Division, RTI International, Research Triangle Park (S.T., M.M.C.), and the Department of Pediatrics, Duke University School of Medicine, Durham (C.M.C.) - both in North Carolina; the Biostatistics and Epidemiology Division, RTI International, Rockville (J.E.N., A.D.), and the Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, Bethesda (R.D.H.) - both in Maryland; the Department of Pediatrics, Women and Infants Hospital, Brown University, Providence, RI (B.R.V., A.R.L.); the Division of Neonatology, University of Alabama at Birmingham, Birmingham (W.A.C.); the University of Rochester School of Medicine and Dentistry, Rochester, NY (C.T.D., M.F.C.); the Department of Pediatrics, McGovern Medical School at the University of Texas Health Science Center at Houston, Houston (K.A.K.), and the Department of Pediatrics, University of Texas Southwestern Medical Center, Dallas (M.H.W.); the University of New Mexico Health Sciences Center, Albuquerque (R.K.O.); the Department of Pediatrics, Division of Neonatology, University of Utah School of Medicine, Salt Lake City (R.K.O., B.A.Y.); the Department of Pediatrics, Indiana University School of Medicine, Indianapolis (B.B.P., G.M.S.); Cincinnati Children's Hospital Medical Center, Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati (B.B.P., K.S.), the Department of Pediatrics, Rainbow Babies and Children's Hospital, Case Western Reserve University, Cleveland (M.C.W.), and Nationwide Children's Hospital and the Department of Pediatrics, Ohio State University College of Medicine, Columbus (R.S.); the Department of Pediatrics, Dalhousie University, Halifax, NS, Canada (R.K.W.); the Department of Neonatology, Harvard Medical School, Beth Israel Deaconess Medical Center, Boston (J.A.F.Z.); the Department of Pediatrics, Children's Mercy Hospital, Kansas City, MO (W.E.T.); Emory University School of Medicine, Department of Pediatrics, Children's Healthcare of Atlanta, Atlanta (R.M.P.); the Department of Pediatrics, Wayne State University, Detroit (S.C.); and the College of Health and Human Services, George Mason University, Fairfax, VA (R.D.H.)
| | - Brenda B Poindexter
- From the Department of Pediatrics, University of Pennsylvania, and Children's Hospital of Philadelphia, Philadelphia (H.K., B.S., A.S.C.); the Department of Pediatrics, University of Iowa, Iowa City (E.F.B., K.J.J., J.A.W.); the Department of Pediatrics, Division of Neonatal and Developmental Medicine, Stanford University School of Medicine and Lucile Packard Children's Hospital, Palo Alto (S.R.H., V.Y.C.), and the Department of Pediatrics, University of California, Los Angeles, Los Angeles (U.D.) - both in California; the Biostatistics and Epidemiology Division, RTI International, Research Triangle Park (S.T., M.M.C.), and the Department of Pediatrics, Duke University School of Medicine, Durham (C.M.C.) - both in North Carolina; the Biostatistics and Epidemiology Division, RTI International, Rockville (J.E.N., A.D.), and the Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, Bethesda (R.D.H.) - both in Maryland; the Department of Pediatrics, Women and Infants Hospital, Brown University, Providence, RI (B.R.V., A.R.L.); the Division of Neonatology, University of Alabama at Birmingham, Birmingham (W.A.C.); the University of Rochester School of Medicine and Dentistry, Rochester, NY (C.T.D., M.F.C.); the Department of Pediatrics, McGovern Medical School at the University of Texas Health Science Center at Houston, Houston (K.A.K.), and the Department of Pediatrics, University of Texas Southwestern Medical Center, Dallas (M.H.W.); the University of New Mexico Health Sciences Center, Albuquerque (R.K.O.); the Department of Pediatrics, Division of Neonatology, University of Utah School of Medicine, Salt Lake City (R.K.O., B.A.Y.); the Department of Pediatrics, Indiana University School of Medicine, Indianapolis (B.B.P., G.M.S.); Cincinnati Children's Hospital Medical Center, Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati (B.B.P., K.S.), the Department of Pediatrics, Rainbow Babies and Children's Hospital, Case Western Reserve University, Cleveland (M.C.W.), and Nationwide Children's Hospital and the Department of Pediatrics, Ohio State University College of Medicine, Columbus (R.S.); the Department of Pediatrics, Dalhousie University, Halifax, NS, Canada (R.K.W.); the Department of Neonatology, Harvard Medical School, Beth Israel Deaconess Medical Center, Boston (J.A.F.Z.); the Department of Pediatrics, Children's Mercy Hospital, Kansas City, MO (W.E.T.); Emory University School of Medicine, Department of Pediatrics, Children's Healthcare of Atlanta, Atlanta (R.M.P.); the Department of Pediatrics, Wayne State University, Detroit (S.C.); and the College of Health and Human Services, George Mason University, Fairfax, VA (R.D.H.)
| | - Kurt Schibler
- From the Department of Pediatrics, University of Pennsylvania, and Children's Hospital of Philadelphia, Philadelphia (H.K., B.S., A.S.C.); the Department of Pediatrics, University of Iowa, Iowa City (E.F.B., K.J.J., J.A.W.); the Department of Pediatrics, Division of Neonatal and Developmental Medicine, Stanford University School of Medicine and Lucile Packard Children's Hospital, Palo Alto (S.R.H., V.Y.C.), and the Department of Pediatrics, University of California, Los Angeles, Los Angeles (U.D.) - both in California; the Biostatistics and Epidemiology Division, RTI International, Research Triangle Park (S.T., M.M.C.), and the Department of Pediatrics, Duke University School of Medicine, Durham (C.M.C.) - both in North Carolina; the Biostatistics and Epidemiology Division, RTI International, Rockville (J.E.N., A.D.), and the Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, Bethesda (R.D.H.) - both in Maryland; the Department of Pediatrics, Women and Infants Hospital, Brown University, Providence, RI (B.R.V., A.R.L.); the Division of Neonatology, University of Alabama at Birmingham, Birmingham (W.A.C.); the University of Rochester School of Medicine and Dentistry, Rochester, NY (C.T.D., M.F.C.); the Department of Pediatrics, McGovern Medical School at the University of Texas Health Science Center at Houston, Houston (K.A.K.), and the Department of Pediatrics, University of Texas Southwestern Medical Center, Dallas (M.H.W.); the University of New Mexico Health Sciences Center, Albuquerque (R.K.O.); the Department of Pediatrics, Division of Neonatology, University of Utah School of Medicine, Salt Lake City (R.K.O., B.A.Y.); the Department of Pediatrics, Indiana University School of Medicine, Indianapolis (B.B.P., G.M.S.); Cincinnati Children's Hospital Medical Center, Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati (B.B.P., K.S.), the Department of Pediatrics, Rainbow Babies and Children's Hospital, Case Western Reserve University, Cleveland (M.C.W.), and Nationwide Children's Hospital and the Department of Pediatrics, Ohio State University College of Medicine, Columbus (R.S.); the Department of Pediatrics, Dalhousie University, Halifax, NS, Canada (R.K.W.); the Department of Neonatology, Harvard Medical School, Beth Israel Deaconess Medical Center, Boston (J.A.F.Z.); the Department of Pediatrics, Children's Mercy Hospital, Kansas City, MO (W.E.T.); Emory University School of Medicine, Department of Pediatrics, Children's Healthcare of Atlanta, Atlanta (R.M.P.); the Department of Pediatrics, Wayne State University, Detroit (S.C.); and the College of Health and Human Services, George Mason University, Fairfax, VA (R.D.H.)
| | - Robin K Whyte
- From the Department of Pediatrics, University of Pennsylvania, and Children's Hospital of Philadelphia, Philadelphia (H.K., B.S., A.S.C.); the Department of Pediatrics, University of Iowa, Iowa City (E.F.B., K.J.J., J.A.W.); the Department of Pediatrics, Division of Neonatal and Developmental Medicine, Stanford University School of Medicine and Lucile Packard Children's Hospital, Palo Alto (S.R.H., V.Y.C.), and the Department of Pediatrics, University of California, Los Angeles, Los Angeles (U.D.) - both in California; the Biostatistics and Epidemiology Division, RTI International, Research Triangle Park (S.T., M.M.C.), and the Department of Pediatrics, Duke University School of Medicine, Durham (C.M.C.) - both in North Carolina; the Biostatistics and Epidemiology Division, RTI International, Rockville (J.E.N., A.D.), and the Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, Bethesda (R.D.H.) - both in Maryland; the Department of Pediatrics, Women and Infants Hospital, Brown University, Providence, RI (B.R.V., A.R.L.); the Division of Neonatology, University of Alabama at Birmingham, Birmingham (W.A.C.); the University of Rochester School of Medicine and Dentistry, Rochester, NY (C.T.D., M.F.C.); the Department of Pediatrics, McGovern Medical School at the University of Texas Health Science Center at Houston, Houston (K.A.K.), and the Department of Pediatrics, University of Texas Southwestern Medical Center, Dallas (M.H.W.); the University of New Mexico Health Sciences Center, Albuquerque (R.K.O.); the Department of Pediatrics, Division of Neonatology, University of Utah School of Medicine, Salt Lake City (R.K.O., B.A.Y.); the Department of Pediatrics, Indiana University School of Medicine, Indianapolis (B.B.P., G.M.S.); Cincinnati Children's Hospital Medical Center, Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati (B.B.P., K.S.), the Department of Pediatrics, Rainbow Babies and Children's Hospital, Case Western Reserve University, Cleveland (M.C.W.), and Nationwide Children's Hospital and the Department of Pediatrics, Ohio State University College of Medicine, Columbus (R.S.); the Department of Pediatrics, Dalhousie University, Halifax, NS, Canada (R.K.W.); the Department of Neonatology, Harvard Medical School, Beth Israel Deaconess Medical Center, Boston (J.A.F.Z.); the Department of Pediatrics, Children's Mercy Hospital, Kansas City, MO (W.E.T.); Emory University School of Medicine, Department of Pediatrics, Children's Healthcare of Atlanta, Atlanta (R.M.P.); the Department of Pediatrics, Wayne State University, Detroit (S.C.); and the College of Health and Human Services, George Mason University, Fairfax, VA (R.D.H.)
| | - John A Widness
- From the Department of Pediatrics, University of Pennsylvania, and Children's Hospital of Philadelphia, Philadelphia (H.K., B.S., A.S.C.); the Department of Pediatrics, University of Iowa, Iowa City (E.F.B., K.J.J., J.A.W.); the Department of Pediatrics, Division of Neonatal and Developmental Medicine, Stanford University School of Medicine and Lucile Packard Children's Hospital, Palo Alto (S.R.H., V.Y.C.), and the Department of Pediatrics, University of California, Los Angeles, Los Angeles (U.D.) - both in California; the Biostatistics and Epidemiology Division, RTI International, Research Triangle Park (S.T., M.M.C.), and the Department of Pediatrics, Duke University School of Medicine, Durham (C.M.C.) - both in North Carolina; the Biostatistics and Epidemiology Division, RTI International, Rockville (J.E.N., A.D.), and the Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, Bethesda (R.D.H.) - both in Maryland; the Department of Pediatrics, Women and Infants Hospital, Brown University, Providence, RI (B.R.V., A.R.L.); the Division of Neonatology, University of Alabama at Birmingham, Birmingham (W.A.C.); the University of Rochester School of Medicine and Dentistry, Rochester, NY (C.T.D., M.F.C.); the Department of Pediatrics, McGovern Medical School at the University of Texas Health Science Center at Houston, Houston (K.A.K.), and the Department of Pediatrics, University of Texas Southwestern Medical Center, Dallas (M.H.W.); the University of New Mexico Health Sciences Center, Albuquerque (R.K.O.); the Department of Pediatrics, Division of Neonatology, University of Utah School of Medicine, Salt Lake City (R.K.O., B.A.Y.); the Department of Pediatrics, Indiana University School of Medicine, Indianapolis (B.B.P., G.M.S.); Cincinnati Children's Hospital Medical Center, Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati (B.B.P., K.S.), the Department of Pediatrics, Rainbow Babies and Children's Hospital, Case Western Reserve University, Cleveland (M.C.W.), and Nationwide Children's Hospital and the Department of Pediatrics, Ohio State University College of Medicine, Columbus (R.S.); the Department of Pediatrics, Dalhousie University, Halifax, NS, Canada (R.K.W.); the Department of Neonatology, Harvard Medical School, Beth Israel Deaconess Medical Center, Boston (J.A.F.Z.); the Department of Pediatrics, Children's Mercy Hospital, Kansas City, MO (W.E.T.); Emory University School of Medicine, Department of Pediatrics, Children's Healthcare of Atlanta, Atlanta (R.M.P.); the Department of Pediatrics, Wayne State University, Detroit (S.C.); and the College of Health and Human Services, George Mason University, Fairfax, VA (R.D.H.)
| | - John A F Zupancic
- From the Department of Pediatrics, University of Pennsylvania, and Children's Hospital of Philadelphia, Philadelphia (H.K., B.S., A.S.C.); the Department of Pediatrics, University of Iowa, Iowa City (E.F.B., K.J.J., J.A.W.); the Department of Pediatrics, Division of Neonatal and Developmental Medicine, Stanford University School of Medicine and Lucile Packard Children's Hospital, Palo Alto (S.R.H., V.Y.C.), and the Department of Pediatrics, University of California, Los Angeles, Los Angeles (U.D.) - both in California; the Biostatistics and Epidemiology Division, RTI International, Research Triangle Park (S.T., M.M.C.), and the Department of Pediatrics, Duke University School of Medicine, Durham (C.M.C.) - both in North Carolina; the Biostatistics and Epidemiology Division, RTI International, Rockville (J.E.N., A.D.), and the Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, Bethesda (R.D.H.) - both in Maryland; the Department of Pediatrics, Women and Infants Hospital, Brown University, Providence, RI (B.R.V., A.R.L.); the Division of Neonatology, University of Alabama at Birmingham, Birmingham (W.A.C.); the University of Rochester School of Medicine and Dentistry, Rochester, NY (C.T.D., M.F.C.); the Department of Pediatrics, McGovern Medical School at the University of Texas Health Science Center at Houston, Houston (K.A.K.), and the Department of Pediatrics, University of Texas Southwestern Medical Center, Dallas (M.H.W.); the University of New Mexico Health Sciences Center, Albuquerque (R.K.O.); the Department of Pediatrics, Division of Neonatology, University of Utah School of Medicine, Salt Lake City (R.K.O., B.A.Y.); the Department of Pediatrics, Indiana University School of Medicine, Indianapolis (B.B.P., G.M.S.); Cincinnati Children's Hospital Medical Center, Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati (B.B.P., K.S.), the Department of Pediatrics, Rainbow Babies and Children's Hospital, Case Western Reserve University, Cleveland (M.C.W.), and Nationwide Children's Hospital and the Department of Pediatrics, Ohio State University College of Medicine, Columbus (R.S.); the Department of Pediatrics, Dalhousie University, Halifax, NS, Canada (R.K.W.); the Department of Neonatology, Harvard Medical School, Beth Israel Deaconess Medical Center, Boston (J.A.F.Z.); the Department of Pediatrics, Children's Mercy Hospital, Kansas City, MO (W.E.T.); Emory University School of Medicine, Department of Pediatrics, Children's Healthcare of Atlanta, Atlanta (R.M.P.); the Department of Pediatrics, Wayne State University, Detroit (S.C.); and the College of Health and Human Services, George Mason University, Fairfax, VA (R.D.H.)
| | - Myra H Wyckoff
- From the Department of Pediatrics, University of Pennsylvania, and Children's Hospital of Philadelphia, Philadelphia (H.K., B.S., A.S.C.); the Department of Pediatrics, University of Iowa, Iowa City (E.F.B., K.J.J., J.A.W.); the Department of Pediatrics, Division of Neonatal and Developmental Medicine, Stanford University School of Medicine and Lucile Packard Children's Hospital, Palo Alto (S.R.H., V.Y.C.), and the Department of Pediatrics, University of California, Los Angeles, Los Angeles (U.D.) - both in California; the Biostatistics and Epidemiology Division, RTI International, Research Triangle Park (S.T., M.M.C.), and the Department of Pediatrics, Duke University School of Medicine, Durham (C.M.C.) - both in North Carolina; the Biostatistics and Epidemiology Division, RTI International, Rockville (J.E.N., A.D.), and the Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, Bethesda (R.D.H.) - both in Maryland; the Department of Pediatrics, Women and Infants Hospital, Brown University, Providence, RI (B.R.V., A.R.L.); the Division of Neonatology, University of Alabama at Birmingham, Birmingham (W.A.C.); the University of Rochester School of Medicine and Dentistry, Rochester, NY (C.T.D., M.F.C.); the Department of Pediatrics, McGovern Medical School at the University of Texas Health Science Center at Houston, Houston (K.A.K.), and the Department of Pediatrics, University of Texas Southwestern Medical Center, Dallas (M.H.W.); the University of New Mexico Health Sciences Center, Albuquerque (R.K.O.); the Department of Pediatrics, Division of Neonatology, University of Utah School of Medicine, Salt Lake City (R.K.O., B.A.Y.); the Department of Pediatrics, Indiana University School of Medicine, Indianapolis (B.B.P., G.M.S.); Cincinnati Children's Hospital Medical Center, Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati (B.B.P., K.S.), the Department of Pediatrics, Rainbow Babies and Children's Hospital, Case Western Reserve University, Cleveland (M.C.W.), and Nationwide Children's Hospital and the Department of Pediatrics, Ohio State University College of Medicine, Columbus (R.S.); the Department of Pediatrics, Dalhousie University, Halifax, NS, Canada (R.K.W.); the Department of Neonatology, Harvard Medical School, Beth Israel Deaconess Medical Center, Boston (J.A.F.Z.); the Department of Pediatrics, Children's Mercy Hospital, Kansas City, MO (W.E.T.); Emory University School of Medicine, Department of Pediatrics, Children's Healthcare of Atlanta, Atlanta (R.M.P.); the Department of Pediatrics, Wayne State University, Detroit (S.C.); and the College of Health and Human Services, George Mason University, Fairfax, VA (R.D.H.)
| | - William E Truog
- From the Department of Pediatrics, University of Pennsylvania, and Children's Hospital of Philadelphia, Philadelphia (H.K., B.S., A.S.C.); the Department of Pediatrics, University of Iowa, Iowa City (E.F.B., K.J.J., J.A.W.); the Department of Pediatrics, Division of Neonatal and Developmental Medicine, Stanford University School of Medicine and Lucile Packard Children's Hospital, Palo Alto (S.R.H., V.Y.C.), and the Department of Pediatrics, University of California, Los Angeles, Los Angeles (U.D.) - both in California; the Biostatistics and Epidemiology Division, RTI International, Research Triangle Park (S.T., M.M.C.), and the Department of Pediatrics, Duke University School of Medicine, Durham (C.M.C.) - both in North Carolina; the Biostatistics and Epidemiology Division, RTI International, Rockville (J.E.N., A.D.), and the Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, Bethesda (R.D.H.) - both in Maryland; the Department of Pediatrics, Women and Infants Hospital, Brown University, Providence, RI (B.R.V., A.R.L.); the Division of Neonatology, University of Alabama at Birmingham, Birmingham (W.A.C.); the University of Rochester School of Medicine and Dentistry, Rochester, NY (C.T.D., M.F.C.); the Department of Pediatrics, McGovern Medical School at the University of Texas Health Science Center at Houston, Houston (K.A.K.), and the Department of Pediatrics, University of Texas Southwestern Medical Center, Dallas (M.H.W.); the University of New Mexico Health Sciences Center, Albuquerque (R.K.O.); the Department of Pediatrics, Division of Neonatology, University of Utah School of Medicine, Salt Lake City (R.K.O., B.A.Y.); the Department of Pediatrics, Indiana University School of Medicine, Indianapolis (B.B.P., G.M.S.); Cincinnati Children's Hospital Medical Center, Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati (B.B.P., K.S.), the Department of Pediatrics, Rainbow Babies and Children's Hospital, Case Western Reserve University, Cleveland (M.C.W.), and Nationwide Children's Hospital and the Department of Pediatrics, Ohio State University College of Medicine, Columbus (R.S.); the Department of Pediatrics, Dalhousie University, Halifax, NS, Canada (R.K.W.); the Department of Neonatology, Harvard Medical School, Beth Israel Deaconess Medical Center, Boston (J.A.F.Z.); the Department of Pediatrics, Children's Mercy Hospital, Kansas City, MO (W.E.T.); Emory University School of Medicine, Department of Pediatrics, Children's Healthcare of Atlanta, Atlanta (R.M.P.); the Department of Pediatrics, Wayne State University, Detroit (S.C.); and the College of Health and Human Services, George Mason University, Fairfax, VA (R.D.H.)
| | - Michele C Walsh
- From the Department of Pediatrics, University of Pennsylvania, and Children's Hospital of Philadelphia, Philadelphia (H.K., B.S., A.S.C.); the Department of Pediatrics, University of Iowa, Iowa City (E.F.B., K.J.J., J.A.W.); the Department of Pediatrics, Division of Neonatal and Developmental Medicine, Stanford University School of Medicine and Lucile Packard Children's Hospital, Palo Alto (S.R.H., V.Y.C.), and the Department of Pediatrics, University of California, Los Angeles, Los Angeles (U.D.) - both in California; the Biostatistics and Epidemiology Division, RTI International, Research Triangle Park (S.T., M.M.C.), and the Department of Pediatrics, Duke University School of Medicine, Durham (C.M.C.) - both in North Carolina; the Biostatistics and Epidemiology Division, RTI International, Rockville (J.E.N., A.D.), and the Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, Bethesda (R.D.H.) - both in Maryland; the Department of Pediatrics, Women and Infants Hospital, Brown University, Providence, RI (B.R.V., A.R.L.); the Division of Neonatology, University of Alabama at Birmingham, Birmingham (W.A.C.); the University of Rochester School of Medicine and Dentistry, Rochester, NY (C.T.D., M.F.C.); the Department of Pediatrics, McGovern Medical School at the University of Texas Health Science Center at Houston, Houston (K.A.K.), and the Department of Pediatrics, University of Texas Southwestern Medical Center, Dallas (M.H.W.); the University of New Mexico Health Sciences Center, Albuquerque (R.K.O.); the Department of Pediatrics, Division of Neonatology, University of Utah School of Medicine, Salt Lake City (R.K.O., B.A.Y.); the Department of Pediatrics, Indiana University School of Medicine, Indianapolis (B.B.P., G.M.S.); Cincinnati Children's Hospital Medical Center, Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati (B.B.P., K.S.), the Department of Pediatrics, Rainbow Babies and Children's Hospital, Case Western Reserve University, Cleveland (M.C.W.), and Nationwide Children's Hospital and the Department of Pediatrics, Ohio State University College of Medicine, Columbus (R.S.); the Department of Pediatrics, Dalhousie University, Halifax, NS, Canada (R.K.W.); the Department of Neonatology, Harvard Medical School, Beth Israel Deaconess Medical Center, Boston (J.A.F.Z.); the Department of Pediatrics, Children's Mercy Hospital, Kansas City, MO (W.E.T.); Emory University School of Medicine, Department of Pediatrics, Children's Healthcare of Atlanta, Atlanta (R.M.P.); the Department of Pediatrics, Wayne State University, Detroit (S.C.); and the College of Health and Human Services, George Mason University, Fairfax, VA (R.D.H.)
| | - Valerie Y Chock
- From the Department of Pediatrics, University of Pennsylvania, and Children's Hospital of Philadelphia, Philadelphia (H.K., B.S., A.S.C.); the Department of Pediatrics, University of Iowa, Iowa City (E.F.B., K.J.J., J.A.W.); the Department of Pediatrics, Division of Neonatal and Developmental Medicine, Stanford University School of Medicine and Lucile Packard Children's Hospital, Palo Alto (S.R.H., V.Y.C.), and the Department of Pediatrics, University of California, Los Angeles, Los Angeles (U.D.) - both in California; the Biostatistics and Epidemiology Division, RTI International, Research Triangle Park (S.T., M.M.C.), and the Department of Pediatrics, Duke University School of Medicine, Durham (C.M.C.) - both in North Carolina; the Biostatistics and Epidemiology Division, RTI International, Rockville (J.E.N., A.D.), and the Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, Bethesda (R.D.H.) - both in Maryland; the Department of Pediatrics, Women and Infants Hospital, Brown University, Providence, RI (B.R.V., A.R.L.); the Division of Neonatology, University of Alabama at Birmingham, Birmingham (W.A.C.); the University of Rochester School of Medicine and Dentistry, Rochester, NY (C.T.D., M.F.C.); the Department of Pediatrics, McGovern Medical School at the University of Texas Health Science Center at Houston, Houston (K.A.K.), and the Department of Pediatrics, University of Texas Southwestern Medical Center, Dallas (M.H.W.); the University of New Mexico Health Sciences Center, Albuquerque (R.K.O.); the Department of Pediatrics, Division of Neonatology, University of Utah School of Medicine, Salt Lake City (R.K.O., B.A.Y.); the Department of Pediatrics, Indiana University School of Medicine, Indianapolis (B.B.P., G.M.S.); Cincinnati Children's Hospital Medical Center, Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati (B.B.P., K.S.), the Department of Pediatrics, Rainbow Babies and Children's Hospital, Case Western Reserve University, Cleveland (M.C.W.), and Nationwide Children's Hospital and the Department of Pediatrics, Ohio State University College of Medicine, Columbus (R.S.); the Department of Pediatrics, Dalhousie University, Halifax, NS, Canada (R.K.W.); the Department of Neonatology, Harvard Medical School, Beth Israel Deaconess Medical Center, Boston (J.A.F.Z.); the Department of Pediatrics, Children's Mercy Hospital, Kansas City, MO (W.E.T.); Emory University School of Medicine, Department of Pediatrics, Children's Healthcare of Atlanta, Atlanta (R.M.P.); the Department of Pediatrics, Wayne State University, Detroit (S.C.); and the College of Health and Human Services, George Mason University, Fairfax, VA (R.D.H.)
| | - Abbot R Laptook
- From the Department of Pediatrics, University of Pennsylvania, and Children's Hospital of Philadelphia, Philadelphia (H.K., B.S., A.S.C.); the Department of Pediatrics, University of Iowa, Iowa City (E.F.B., K.J.J., J.A.W.); the Department of Pediatrics, Division of Neonatal and Developmental Medicine, Stanford University School of Medicine and Lucile Packard Children's Hospital, Palo Alto (S.R.H., V.Y.C.), and the Department of Pediatrics, University of California, Los Angeles, Los Angeles (U.D.) - both in California; the Biostatistics and Epidemiology Division, RTI International, Research Triangle Park (S.T., M.M.C.), and the Department of Pediatrics, Duke University School of Medicine, Durham (C.M.C.) - both in North Carolina; the Biostatistics and Epidemiology Division, RTI International, Rockville (J.E.N., A.D.), and the Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, Bethesda (R.D.H.) - both in Maryland; the Department of Pediatrics, Women and Infants Hospital, Brown University, Providence, RI (B.R.V., A.R.L.); the Division of Neonatology, University of Alabama at Birmingham, Birmingham (W.A.C.); the University of Rochester School of Medicine and Dentistry, Rochester, NY (C.T.D., M.F.C.); the Department of Pediatrics, McGovern Medical School at the University of Texas Health Science Center at Houston, Houston (K.A.K.), and the Department of Pediatrics, University of Texas Southwestern Medical Center, Dallas (M.H.W.); the University of New Mexico Health Sciences Center, Albuquerque (R.K.O.); the Department of Pediatrics, Division of Neonatology, University of Utah School of Medicine, Salt Lake City (R.K.O., B.A.Y.); the Department of Pediatrics, Indiana University School of Medicine, Indianapolis (B.B.P., G.M.S.); Cincinnati Children's Hospital Medical Center, Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati (B.B.P., K.S.), the Department of Pediatrics, Rainbow Babies and Children's Hospital, Case Western Reserve University, Cleveland (M.C.W.), and Nationwide Children's Hospital and the Department of Pediatrics, Ohio State University College of Medicine, Columbus (R.S.); the Department of Pediatrics, Dalhousie University, Halifax, NS, Canada (R.K.W.); the Department of Neonatology, Harvard Medical School, Beth Israel Deaconess Medical Center, Boston (J.A.F.Z.); the Department of Pediatrics, Children's Mercy Hospital, Kansas City, MO (W.E.T.); Emory University School of Medicine, Department of Pediatrics, Children's Healthcare of Atlanta, Atlanta (R.M.P.); the Department of Pediatrics, Wayne State University, Detroit (S.C.); and the College of Health and Human Services, George Mason University, Fairfax, VA (R.D.H.)
| | - Gregory M Sokol
- From the Department of Pediatrics, University of Pennsylvania, and Children's Hospital of Philadelphia, Philadelphia (H.K., B.S., A.S.C.); the Department of Pediatrics, University of Iowa, Iowa City (E.F.B., K.J.J., J.A.W.); the Department of Pediatrics, Division of Neonatal and Developmental Medicine, Stanford University School of Medicine and Lucile Packard Children's Hospital, Palo Alto (S.R.H., V.Y.C.), and the Department of Pediatrics, University of California, Los Angeles, Los Angeles (U.D.) - both in California; the Biostatistics and Epidemiology Division, RTI International, Research Triangle Park (S.T., M.M.C.), and the Department of Pediatrics, Duke University School of Medicine, Durham (C.M.C.) - both in North Carolina; the Biostatistics and Epidemiology Division, RTI International, Rockville (J.E.N., A.D.), and the Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, Bethesda (R.D.H.) - both in Maryland; the Department of Pediatrics, Women and Infants Hospital, Brown University, Providence, RI (B.R.V., A.R.L.); the Division of Neonatology, University of Alabama at Birmingham, Birmingham (W.A.C.); the University of Rochester School of Medicine and Dentistry, Rochester, NY (C.T.D., M.F.C.); the Department of Pediatrics, McGovern Medical School at the University of Texas Health Science Center at Houston, Houston (K.A.K.), and the Department of Pediatrics, University of Texas Southwestern Medical Center, Dallas (M.H.W.); the University of New Mexico Health Sciences Center, Albuquerque (R.K.O.); the Department of Pediatrics, Division of Neonatology, University of Utah School of Medicine, Salt Lake City (R.K.O., B.A.Y.); the Department of Pediatrics, Indiana University School of Medicine, Indianapolis (B.B.P., G.M.S.); Cincinnati Children's Hospital Medical Center, Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati (B.B.P., K.S.), the Department of Pediatrics, Rainbow Babies and Children's Hospital, Case Western Reserve University, Cleveland (M.C.W.), and Nationwide Children's Hospital and the Department of Pediatrics, Ohio State University College of Medicine, Columbus (R.S.); the Department of Pediatrics, Dalhousie University, Halifax, NS, Canada (R.K.W.); the Department of Neonatology, Harvard Medical School, Beth Israel Deaconess Medical Center, Boston (J.A.F.Z.); the Department of Pediatrics, Children's Mercy Hospital, Kansas City, MO (W.E.T.); Emory University School of Medicine, Department of Pediatrics, Children's Healthcare of Atlanta, Atlanta (R.M.P.); the Department of Pediatrics, Wayne State University, Detroit (S.C.); and the College of Health and Human Services, George Mason University, Fairfax, VA (R.D.H.)
| | - Bradley A Yoder
- From the Department of Pediatrics, University of Pennsylvania, and Children's Hospital of Philadelphia, Philadelphia (H.K., B.S., A.S.C.); the Department of Pediatrics, University of Iowa, Iowa City (E.F.B., K.J.J., J.A.W.); the Department of Pediatrics, Division of Neonatal and Developmental Medicine, Stanford University School of Medicine and Lucile Packard Children's Hospital, Palo Alto (S.R.H., V.Y.C.), and the Department of Pediatrics, University of California, Los Angeles, Los Angeles (U.D.) - both in California; the Biostatistics and Epidemiology Division, RTI International, Research Triangle Park (S.T., M.M.C.), and the Department of Pediatrics, Duke University School of Medicine, Durham (C.M.C.) - both in North Carolina; the Biostatistics and Epidemiology Division, RTI International, Rockville (J.E.N., A.D.), and the Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, Bethesda (R.D.H.) - both in Maryland; the Department of Pediatrics, Women and Infants Hospital, Brown University, Providence, RI (B.R.V., A.R.L.); the Division of Neonatology, University of Alabama at Birmingham, Birmingham (W.A.C.); the University of Rochester School of Medicine and Dentistry, Rochester, NY (C.T.D., M.F.C.); the Department of Pediatrics, McGovern Medical School at the University of Texas Health Science Center at Houston, Houston (K.A.K.), and the Department of Pediatrics, University of Texas Southwestern Medical Center, Dallas (M.H.W.); the University of New Mexico Health Sciences Center, Albuquerque (R.K.O.); the Department of Pediatrics, Division of Neonatology, University of Utah School of Medicine, Salt Lake City (R.K.O., B.A.Y.); the Department of Pediatrics, Indiana University School of Medicine, Indianapolis (B.B.P., G.M.S.); Cincinnati Children's Hospital Medical Center, Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati (B.B.P., K.S.), the Department of Pediatrics, Rainbow Babies and Children's Hospital, Case Western Reserve University, Cleveland (M.C.W.), and Nationwide Children's Hospital and the Department of Pediatrics, Ohio State University College of Medicine, Columbus (R.S.); the Department of Pediatrics, Dalhousie University, Halifax, NS, Canada (R.K.W.); the Department of Neonatology, Harvard Medical School, Beth Israel Deaconess Medical Center, Boston (J.A.F.Z.); the Department of Pediatrics, Children's Mercy Hospital, Kansas City, MO (W.E.T.); Emory University School of Medicine, Department of Pediatrics, Children's Healthcare of Atlanta, Atlanta (R.M.P.); the Department of Pediatrics, Wayne State University, Detroit (S.C.); and the College of Health and Human Services, George Mason University, Fairfax, VA (R.D.H.)
| | - Ravi M Patel
- From the Department of Pediatrics, University of Pennsylvania, and Children's Hospital of Philadelphia, Philadelphia (H.K., B.S., A.S.C.); the Department of Pediatrics, University of Iowa, Iowa City (E.F.B., K.J.J., J.A.W.); the Department of Pediatrics, Division of Neonatal and Developmental Medicine, Stanford University School of Medicine and Lucile Packard Children's Hospital, Palo Alto (S.R.H., V.Y.C.), and the Department of Pediatrics, University of California, Los Angeles, Los Angeles (U.D.) - both in California; the Biostatistics and Epidemiology Division, RTI International, Research Triangle Park (S.T., M.M.C.), and the Department of Pediatrics, Duke University School of Medicine, Durham (C.M.C.) - both in North Carolina; the Biostatistics and Epidemiology Division, RTI International, Rockville (J.E.N., A.D.), and the Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, Bethesda (R.D.H.) - both in Maryland; the Department of Pediatrics, Women and Infants Hospital, Brown University, Providence, RI (B.R.V., A.R.L.); the Division of Neonatology, University of Alabama at Birmingham, Birmingham (W.A.C.); the University of Rochester School of Medicine and Dentistry, Rochester, NY (C.T.D., M.F.C.); the Department of Pediatrics, McGovern Medical School at the University of Texas Health Science Center at Houston, Houston (K.A.K.), and the Department of Pediatrics, University of Texas Southwestern Medical Center, Dallas (M.H.W.); the University of New Mexico Health Sciences Center, Albuquerque (R.K.O.); the Department of Pediatrics, Division of Neonatology, University of Utah School of Medicine, Salt Lake City (R.K.O., B.A.Y.); the Department of Pediatrics, Indiana University School of Medicine, Indianapolis (B.B.P., G.M.S.); Cincinnati Children's Hospital Medical Center, Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati (B.B.P., K.S.), the Department of Pediatrics, Rainbow Babies and Children's Hospital, Case Western Reserve University, Cleveland (M.C.W.), and Nationwide Children's Hospital and the Department of Pediatrics, Ohio State University College of Medicine, Columbus (R.S.); the Department of Pediatrics, Dalhousie University, Halifax, NS, Canada (R.K.W.); the Department of Neonatology, Harvard Medical School, Beth Israel Deaconess Medical Center, Boston (J.A.F.Z.); the Department of Pediatrics, Children's Mercy Hospital, Kansas City, MO (W.E.T.); Emory University School of Medicine, Department of Pediatrics, Children's Healthcare of Atlanta, Atlanta (R.M.P.); the Department of Pediatrics, Wayne State University, Detroit (S.C.); and the College of Health and Human Services, George Mason University, Fairfax, VA (R.D.H.)
| | - C Michael Cotten
- From the Department of Pediatrics, University of Pennsylvania, and Children's Hospital of Philadelphia, Philadelphia (H.K., B.S., A.S.C.); the Department of Pediatrics, University of Iowa, Iowa City (E.F.B., K.J.J., J.A.W.); the Department of Pediatrics, Division of Neonatal and Developmental Medicine, Stanford University School of Medicine and Lucile Packard Children's Hospital, Palo Alto (S.R.H., V.Y.C.), and the Department of Pediatrics, University of California, Los Angeles, Los Angeles (U.D.) - both in California; the Biostatistics and Epidemiology Division, RTI International, Research Triangle Park (S.T., M.M.C.), and the Department of Pediatrics, Duke University School of Medicine, Durham (C.M.C.) - both in North Carolina; the Biostatistics and Epidemiology Division, RTI International, Rockville (J.E.N., A.D.), and the Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, Bethesda (R.D.H.) - both in Maryland; the Department of Pediatrics, Women and Infants Hospital, Brown University, Providence, RI (B.R.V., A.R.L.); the Division of Neonatology, University of Alabama at Birmingham, Birmingham (W.A.C.); the University of Rochester School of Medicine and Dentistry, Rochester, NY (C.T.D., M.F.C.); the Department of Pediatrics, McGovern Medical School at the University of Texas Health Science Center at Houston, Houston (K.A.K.), and the Department of Pediatrics, University of Texas Southwestern Medical Center, Dallas (M.H.W.); the University of New Mexico Health Sciences Center, Albuquerque (R.K.O.); the Department of Pediatrics, Division of Neonatology, University of Utah School of Medicine, Salt Lake City (R.K.O., B.A.Y.); the Department of Pediatrics, Indiana University School of Medicine, Indianapolis (B.B.P., G.M.S.); Cincinnati Children's Hospital Medical Center, Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati (B.B.P., K.S.), the Department of Pediatrics, Rainbow Babies and Children's Hospital, Case Western Reserve University, Cleveland (M.C.W.), and Nationwide Children's Hospital and the Department of Pediatrics, Ohio State University College of Medicine, Columbus (R.S.); the Department of Pediatrics, Dalhousie University, Halifax, NS, Canada (R.K.W.); the Department of Neonatology, Harvard Medical School, Beth Israel Deaconess Medical Center, Boston (J.A.F.Z.); the Department of Pediatrics, Children's Mercy Hospital, Kansas City, MO (W.E.T.); Emory University School of Medicine, Department of Pediatrics, Children's Healthcare of Atlanta, Atlanta (R.M.P.); the Department of Pediatrics, Wayne State University, Detroit (S.C.); and the College of Health and Human Services, George Mason University, Fairfax, VA (R.D.H.)
| | - Melissa F Carmen
- From the Department of Pediatrics, University of Pennsylvania, and Children's Hospital of Philadelphia, Philadelphia (H.K., B.S., A.S.C.); the Department of Pediatrics, University of Iowa, Iowa City (E.F.B., K.J.J., J.A.W.); the Department of Pediatrics, Division of Neonatal and Developmental Medicine, Stanford University School of Medicine and Lucile Packard Children's Hospital, Palo Alto (S.R.H., V.Y.C.), and the Department of Pediatrics, University of California, Los Angeles, Los Angeles (U.D.) - both in California; the Biostatistics and Epidemiology Division, RTI International, Research Triangle Park (S.T., M.M.C.), and the Department of Pediatrics, Duke University School of Medicine, Durham (C.M.C.) - both in North Carolina; the Biostatistics and Epidemiology Division, RTI International, Rockville (J.E.N., A.D.), and the Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, Bethesda (R.D.H.) - both in Maryland; the Department of Pediatrics, Women and Infants Hospital, Brown University, Providence, RI (B.R.V., A.R.L.); the Division of Neonatology, University of Alabama at Birmingham, Birmingham (W.A.C.); the University of Rochester School of Medicine and Dentistry, Rochester, NY (C.T.D., M.F.C.); the Department of Pediatrics, McGovern Medical School at the University of Texas Health Science Center at Houston, Houston (K.A.K.), and the Department of Pediatrics, University of Texas Southwestern Medical Center, Dallas (M.H.W.); the University of New Mexico Health Sciences Center, Albuquerque (R.K.O.); the Department of Pediatrics, Division of Neonatology, University of Utah School of Medicine, Salt Lake City (R.K.O., B.A.Y.); the Department of Pediatrics, Indiana University School of Medicine, Indianapolis (B.B.P., G.M.S.); Cincinnati Children's Hospital Medical Center, Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati (B.B.P., K.S.), the Department of Pediatrics, Rainbow Babies and Children's Hospital, Case Western Reserve University, Cleveland (M.C.W.), and Nationwide Children's Hospital and the Department of Pediatrics, Ohio State University College of Medicine, Columbus (R.S.); the Department of Pediatrics, Dalhousie University, Halifax, NS, Canada (R.K.W.); the Department of Neonatology, Harvard Medical School, Beth Israel Deaconess Medical Center, Boston (J.A.F.Z.); the Department of Pediatrics, Children's Mercy Hospital, Kansas City, MO (W.E.T.); Emory University School of Medicine, Department of Pediatrics, Children's Healthcare of Atlanta, Atlanta (R.M.P.); the Department of Pediatrics, Wayne State University, Detroit (S.C.); and the College of Health and Human Services, George Mason University, Fairfax, VA (R.D.H.)
| | - Uday Devaskar
- From the Department of Pediatrics, University of Pennsylvania, and Children's Hospital of Philadelphia, Philadelphia (H.K., B.S., A.S.C.); the Department of Pediatrics, University of Iowa, Iowa City (E.F.B., K.J.J., J.A.W.); the Department of Pediatrics, Division of Neonatal and Developmental Medicine, Stanford University School of Medicine and Lucile Packard Children's Hospital, Palo Alto (S.R.H., V.Y.C.), and the Department of Pediatrics, University of California, Los Angeles, Los Angeles (U.D.) - both in California; the Biostatistics and Epidemiology Division, RTI International, Research Triangle Park (S.T., M.M.C.), and the Department of Pediatrics, Duke University School of Medicine, Durham (C.M.C.) - both in North Carolina; the Biostatistics and Epidemiology Division, RTI International, Rockville (J.E.N., A.D.), and the Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, Bethesda (R.D.H.) - both in Maryland; the Department of Pediatrics, Women and Infants Hospital, Brown University, Providence, RI (B.R.V., A.R.L.); the Division of Neonatology, University of Alabama at Birmingham, Birmingham (W.A.C.); the University of Rochester School of Medicine and Dentistry, Rochester, NY (C.T.D., M.F.C.); the Department of Pediatrics, McGovern Medical School at the University of Texas Health Science Center at Houston, Houston (K.A.K.), and the Department of Pediatrics, University of Texas Southwestern Medical Center, Dallas (M.H.W.); the University of New Mexico Health Sciences Center, Albuquerque (R.K.O.); the Department of Pediatrics, Division of Neonatology, University of Utah School of Medicine, Salt Lake City (R.K.O., B.A.Y.); the Department of Pediatrics, Indiana University School of Medicine, Indianapolis (B.B.P., G.M.S.); Cincinnati Children's Hospital Medical Center, Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati (B.B.P., K.S.), the Department of Pediatrics, Rainbow Babies and Children's Hospital, Case Western Reserve University, Cleveland (M.C.W.), and Nationwide Children's Hospital and the Department of Pediatrics, Ohio State University College of Medicine, Columbus (R.S.); the Department of Pediatrics, Dalhousie University, Halifax, NS, Canada (R.K.W.); the Department of Neonatology, Harvard Medical School, Beth Israel Deaconess Medical Center, Boston (J.A.F.Z.); the Department of Pediatrics, Children's Mercy Hospital, Kansas City, MO (W.E.T.); Emory University School of Medicine, Department of Pediatrics, Children's Healthcare of Atlanta, Atlanta (R.M.P.); the Department of Pediatrics, Wayne State University, Detroit (S.C.); and the College of Health and Human Services, George Mason University, Fairfax, VA (R.D.H.)
| | - Sanjay Chawla
- From the Department of Pediatrics, University of Pennsylvania, and Children's Hospital of Philadelphia, Philadelphia (H.K., B.S., A.S.C.); the Department of Pediatrics, University of Iowa, Iowa City (E.F.B., K.J.J., J.A.W.); the Department of Pediatrics, Division of Neonatal and Developmental Medicine, Stanford University School of Medicine and Lucile Packard Children's Hospital, Palo Alto (S.R.H., V.Y.C.), and the Department of Pediatrics, University of California, Los Angeles, Los Angeles (U.D.) - both in California; the Biostatistics and Epidemiology Division, RTI International, Research Triangle Park (S.T., M.M.C.), and the Department of Pediatrics, Duke University School of Medicine, Durham (C.M.C.) - both in North Carolina; the Biostatistics and Epidemiology Division, RTI International, Rockville (J.E.N., A.D.), and the Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, Bethesda (R.D.H.) - both in Maryland; the Department of Pediatrics, Women and Infants Hospital, Brown University, Providence, RI (B.R.V., A.R.L.); the Division of Neonatology, University of Alabama at Birmingham, Birmingham (W.A.C.); the University of Rochester School of Medicine and Dentistry, Rochester, NY (C.T.D., M.F.C.); the Department of Pediatrics, McGovern Medical School at the University of Texas Health Science Center at Houston, Houston (K.A.K.), and the Department of Pediatrics, University of Texas Southwestern Medical Center, Dallas (M.H.W.); the University of New Mexico Health Sciences Center, Albuquerque (R.K.O.); the Department of Pediatrics, Division of Neonatology, University of Utah School of Medicine, Salt Lake City (R.K.O., B.A.Y.); the Department of Pediatrics, Indiana University School of Medicine, Indianapolis (B.B.P., G.M.S.); Cincinnati Children's Hospital Medical Center, Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati (B.B.P., K.S.), the Department of Pediatrics, Rainbow Babies and Children's Hospital, Case Western Reserve University, Cleveland (M.C.W.), and Nationwide Children's Hospital and the Department of Pediatrics, Ohio State University College of Medicine, Columbus (R.S.); the Department of Pediatrics, Dalhousie University, Halifax, NS, Canada (R.K.W.); the Department of Neonatology, Harvard Medical School, Beth Israel Deaconess Medical Center, Boston (J.A.F.Z.); the Department of Pediatrics, Children's Mercy Hospital, Kansas City, MO (W.E.T.); Emory University School of Medicine, Department of Pediatrics, Children's Healthcare of Atlanta, Atlanta (R.M.P.); the Department of Pediatrics, Wayne State University, Detroit (S.C.); and the College of Health and Human Services, George Mason University, Fairfax, VA (R.D.H.)
| | - Ruth Seabrook
- From the Department of Pediatrics, University of Pennsylvania, and Children's Hospital of Philadelphia, Philadelphia (H.K., B.S., A.S.C.); the Department of Pediatrics, University of Iowa, Iowa City (E.F.B., K.J.J., J.A.W.); the Department of Pediatrics, Division of Neonatal and Developmental Medicine, Stanford University School of Medicine and Lucile Packard Children's Hospital, Palo Alto (S.R.H., V.Y.C.), and the Department of Pediatrics, University of California, Los Angeles, Los Angeles (U.D.) - both in California; the Biostatistics and Epidemiology Division, RTI International, Research Triangle Park (S.T., M.M.C.), and the Department of Pediatrics, Duke University School of Medicine, Durham (C.M.C.) - both in North Carolina; the Biostatistics and Epidemiology Division, RTI International, Rockville (J.E.N., A.D.), and the Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, Bethesda (R.D.H.) - both in Maryland; the Department of Pediatrics, Women and Infants Hospital, Brown University, Providence, RI (B.R.V., A.R.L.); the Division of Neonatology, University of Alabama at Birmingham, Birmingham (W.A.C.); the University of Rochester School of Medicine and Dentistry, Rochester, NY (C.T.D., M.F.C.); the Department of Pediatrics, McGovern Medical School at the University of Texas Health Science Center at Houston, Houston (K.A.K.), and the Department of Pediatrics, University of Texas Southwestern Medical Center, Dallas (M.H.W.); the University of New Mexico Health Sciences Center, Albuquerque (R.K.O.); the Department of Pediatrics, Division of Neonatology, University of Utah School of Medicine, Salt Lake City (R.K.O., B.A.Y.); the Department of Pediatrics, Indiana University School of Medicine, Indianapolis (B.B.P., G.M.S.); Cincinnati Children's Hospital Medical Center, Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati (B.B.P., K.S.), the Department of Pediatrics, Rainbow Babies and Children's Hospital, Case Western Reserve University, Cleveland (M.C.W.), and Nationwide Children's Hospital and the Department of Pediatrics, Ohio State University College of Medicine, Columbus (R.S.); the Department of Pediatrics, Dalhousie University, Halifax, NS, Canada (R.K.W.); the Department of Neonatology, Harvard Medical School, Beth Israel Deaconess Medical Center, Boston (J.A.F.Z.); the Department of Pediatrics, Children's Mercy Hospital, Kansas City, MO (W.E.T.); Emory University School of Medicine, Department of Pediatrics, Children's Healthcare of Atlanta, Atlanta (R.M.P.); the Department of Pediatrics, Wayne State University, Detroit (S.C.); and the College of Health and Human Services, George Mason University, Fairfax, VA (R.D.H.)
| | - Rosemary D Higgins
- From the Department of Pediatrics, University of Pennsylvania, and Children's Hospital of Philadelphia, Philadelphia (H.K., B.S., A.S.C.); the Department of Pediatrics, University of Iowa, Iowa City (E.F.B., K.J.J., J.A.W.); the Department of Pediatrics, Division of Neonatal and Developmental Medicine, Stanford University School of Medicine and Lucile Packard Children's Hospital, Palo Alto (S.R.H., V.Y.C.), and the Department of Pediatrics, University of California, Los Angeles, Los Angeles (U.D.) - both in California; the Biostatistics and Epidemiology Division, RTI International, Research Triangle Park (S.T., M.M.C.), and the Department of Pediatrics, Duke University School of Medicine, Durham (C.M.C.) - both in North Carolina; the Biostatistics and Epidemiology Division, RTI International, Rockville (J.E.N., A.D.), and the Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, Bethesda (R.D.H.) - both in Maryland; the Department of Pediatrics, Women and Infants Hospital, Brown University, Providence, RI (B.R.V., A.R.L.); the Division of Neonatology, University of Alabama at Birmingham, Birmingham (W.A.C.); the University of Rochester School of Medicine and Dentistry, Rochester, NY (C.T.D., M.F.C.); the Department of Pediatrics, McGovern Medical School at the University of Texas Health Science Center at Houston, Houston (K.A.K.), and the Department of Pediatrics, University of Texas Southwestern Medical Center, Dallas (M.H.W.); the University of New Mexico Health Sciences Center, Albuquerque (R.K.O.); the Department of Pediatrics, Division of Neonatology, University of Utah School of Medicine, Salt Lake City (R.K.O., B.A.Y.); the Department of Pediatrics, Indiana University School of Medicine, Indianapolis (B.B.P., G.M.S.); Cincinnati Children's Hospital Medical Center, Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati (B.B.P., K.S.), the Department of Pediatrics, Rainbow Babies and Children's Hospital, Case Western Reserve University, Cleveland (M.C.W.), and Nationwide Children's Hospital and the Department of Pediatrics, Ohio State University College of Medicine, Columbus (R.S.); the Department of Pediatrics, Dalhousie University, Halifax, NS, Canada (R.K.W.); the Department of Neonatology, Harvard Medical School, Beth Israel Deaconess Medical Center, Boston (J.A.F.Z.); the Department of Pediatrics, Children's Mercy Hospital, Kansas City, MO (W.E.T.); Emory University School of Medicine, Department of Pediatrics, Children's Healthcare of Atlanta, Atlanta (R.M.P.); the Department of Pediatrics, Wayne State University, Detroit (S.C.); and the College of Health and Human Services, George Mason University, Fairfax, VA (R.D.H.)
| | - Abhik Das
- From the Department of Pediatrics, University of Pennsylvania, and Children's Hospital of Philadelphia, Philadelphia (H.K., B.S., A.S.C.); the Department of Pediatrics, University of Iowa, Iowa City (E.F.B., K.J.J., J.A.W.); the Department of Pediatrics, Division of Neonatal and Developmental Medicine, Stanford University School of Medicine and Lucile Packard Children's Hospital, Palo Alto (S.R.H., V.Y.C.), and the Department of Pediatrics, University of California, Los Angeles, Los Angeles (U.D.) - both in California; the Biostatistics and Epidemiology Division, RTI International, Research Triangle Park (S.T., M.M.C.), and the Department of Pediatrics, Duke University School of Medicine, Durham (C.M.C.) - both in North Carolina; the Biostatistics and Epidemiology Division, RTI International, Rockville (J.E.N., A.D.), and the Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, Bethesda (R.D.H.) - both in Maryland; the Department of Pediatrics, Women and Infants Hospital, Brown University, Providence, RI (B.R.V., A.R.L.); the Division of Neonatology, University of Alabama at Birmingham, Birmingham (W.A.C.); the University of Rochester School of Medicine and Dentistry, Rochester, NY (C.T.D., M.F.C.); the Department of Pediatrics, McGovern Medical School at the University of Texas Health Science Center at Houston, Houston (K.A.K.), and the Department of Pediatrics, University of Texas Southwestern Medical Center, Dallas (M.H.W.); the University of New Mexico Health Sciences Center, Albuquerque (R.K.O.); the Department of Pediatrics, Division of Neonatology, University of Utah School of Medicine, Salt Lake City (R.K.O., B.A.Y.); the Department of Pediatrics, Indiana University School of Medicine, Indianapolis (B.B.P., G.M.S.); Cincinnati Children's Hospital Medical Center, Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati (B.B.P., K.S.), the Department of Pediatrics, Rainbow Babies and Children's Hospital, Case Western Reserve University, Cleveland (M.C.W.), and Nationwide Children's Hospital and the Department of Pediatrics, Ohio State University College of Medicine, Columbus (R.S.); the Department of Pediatrics, Dalhousie University, Halifax, NS, Canada (R.K.W.); the Department of Neonatology, Harvard Medical School, Beth Israel Deaconess Medical Center, Boston (J.A.F.Z.); the Department of Pediatrics, Children's Mercy Hospital, Kansas City, MO (W.E.T.); Emory University School of Medicine, Department of Pediatrics, Children's Healthcare of Atlanta, Atlanta (R.M.P.); the Department of Pediatrics, Wayne State University, Detroit (S.C.); and the College of Health and Human Services, George Mason University, Fairfax, VA (R.D.H.)
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Commander SJ, Gao J, Zinkhan EK, Heresi G, Courtney SE, Lavery AP, Delmore P, Sokol GM, Moya F, Benjamin D, Bumpass TG, Debski J, Erinjeri J, Sharma G, Tracy ET, Smith PB, Cohen-Wolkowiez M, Hornik CP. Safety of Metronidazole in Late Pre-term and Term Infants with Complicated Intra-abdominal Infections. Pediatr Infect Dis J 2020; 39:e245-e248. [PMID: 32453198 PMCID: PMC10060863 DOI: 10.1097/inf.0000000000002698] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
BACKGROUND Metronidazole is frequently used off-label in infants with complicated intra-abdominal infections (cIAI) to provide coverage against anaerobic organisms, but its safety and efficacy in this indication are unknown. METHODS In the Antibiotic Safety in Infants with Complicated Intra-Abdominal Infections open-label multicenter trial infants ≥34 weeks gestation at birth and <121 days postnatal age with cIAIs were administered metronidazole as part of multimodal therapy. Metronidazole safety was evaluated by reporting of adverse events (AEs) and safety events of special interest. Cure from disease was determined by blood cultures and a clinical cure score >4. A blinded adjudication committee reviewed all safety events of special interest. RESULTS Fifty-five infants were included, median gestational age was 36 weeks (range: 34-41) and postnatal age was 7 days (0-63). The most common additional antibiotics received included gentamicin, piperacillin-tazobactam, ampicillin and vancomycin. Only one AE, a candidal rash, was identified to be potentially caused by metronidazole administration. One infant died of cardiopulmonary failure, which was deemed unrelated to metronidazole. The most common events of special interest included feeding intolerance in 18 (33%) infants, and exploratory laparotomy in 10 (18%) requiring intestinal anastomosis in 7 (13%) infants. There was 1 (2%) intestinal stricture. Fifty-three infants (96%) achieved overall therapeutic success, 54 (98%) were alive through 30 days post-study therapy, and 54 (98%) had 30-day clinical cure score >4. CONCLUSIONS In a cohort of late pre-term and term infants with cIAIs, combination antibiotic therapy that included metronidazole was safe, and therapeutic success was high.
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Affiliation(s)
- Sarah Jane Commander
- Department of Surgery, Duke University Medical Center, Durham, North Carolina
- Department of Pediatrics, Division of Pediatric Research, Duke Clinical Research Institute, Duke University Medical Center, Durham, North Carolina
| | - Jamie Gao
- Department of Pediatrics, Division of Pediatric Research, Duke Clinical Research Institute, Duke University Medical Center, Durham, North Carolina
| | - Erin K Zinkhan
- Department of Pediatrics, Division of Neonatology, Intermountain Medical Center, University of Utah, Salt Lake City, Utah
| | - Gloria Heresi
- Department of Pediatrics, Division of Pediatric Infectious Diseases, University of Texas, Houston, Texas
| | - Sherry E Courtney
- Department of Pediatrics, Division of Neonatology, University of Arkansas for Medical Sciences, Little Rock, Arkansas
| | - Adrian P Lavery
- Department of Pediatrics, Division of Neonatology, Loma Linda University, Loma Linda, California
| | - Paula Delmore
- Department of Pediatrics, Wichita Medical Research and Education Foundation, Wichita, Kansas
| | - Gregory M Sokol
- Department of Pediatrics, Division of Pediatric Research, Duke Clinical Research Institute, Duke University Medical Center, Durham, North Carolina
| | - Fernando Moya
- Department of Pediatrics, Coastal Carolina Neonatology, Wilmington, North Carolina
| | - Danny Benjamin
- Department of Pediatrics, Division of Pediatric Research, Duke Clinical Research Institute, Duke University Medical Center, Durham, North Carolina
| | - Tedryl G Bumpass
- Department of Pediatrics, Division of Pediatric Research, Duke Clinical Research Institute, Duke University Medical Center, Durham, North Carolina
| | | | | | | | - Elisabeth T Tracy
- Department of Surgery, Duke University Medical Center, Durham, North Carolina
| | - P Brian Smith
- Department of Pediatrics, Division of Pediatric Research, Duke Clinical Research Institute, Duke University Medical Center, Durham, North Carolina
| | - Michael Cohen-Wolkowiez
- Department of Pediatrics, Division of Pediatric Research, Duke Clinical Research Institute, Duke University Medical Center, Durham, North Carolina
| | - Christoph P Hornik
- Department of Pediatrics, Division of Pediatric Research, Duke Clinical Research Institute, Duke University Medical Center, Durham, North Carolina
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Stoll BJ, Puopolo KM, Hansen NI, Sánchez PJ, Bell EF, Carlo WA, Cotten CM, D’Angio CT, Kazzi SNJ, Poindexter BB, Van Meurs KP, Hale EC, Collins MV, Das A, Baker CJ, Wyckoff MH, Yoder BA, Watterberg KL, Walsh MC, Devaskar U, Laptook AR, Sokol GM, Schrag SJ, Higgins RD. Early-Onset Neonatal Sepsis 2015 to 2017, the Rise of Escherichia coli, and the Need for Novel Prevention Strategies. JAMA Pediatr 2020; 174:e200593. [PMID: 32364598 PMCID: PMC7199167 DOI: 10.1001/jamapediatrics.2020.0593] [Citation(s) in RCA: 148] [Impact Index Per Article: 37.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
IMPORTANCE Early-onset sepsis (EOS) remains a potentially fatal newborn condition. Ongoing surveillance is critical to optimize prevention and treatment strategies. OBJECTIVE To describe the current incidence, microbiology, morbidity, and mortality of EOS among a cohort of term and preterm infants. DESIGN, SETTING, AND PARTICIPANTS This prospective surveillance study included a cohort of infants born at a gestational age (GA) of at least 22 weeks and birth weight of greater than 400 g from 18 centers of the Eunice Kennedy Shriver National Institute of Child Health and Human Development Neonatal Research Network from April 1, 2015, to March 31, 2017. Data were analyzed from June 14, 2019, to January 28, 2020. MAIN OUTCOMES AND MEASURES Early-onset sepsis defined by isolation of pathogenic species from blood or cerebrospinal fluid culture within 72 hours of birth and antibiotic treatment for at least 5 days or until death. RESULTS A total of 235 EOS cases (127 male [54.0%]) were identified among 217 480 newborns (1.08 [95% CI, 0.95-1.23] cases per 1000 live births). Incidence varied significantly by GA and was highest among infants with a GA of 22 to 28 weeks (18.47 [95% CI, 14.57-23.38] cases per 1000). No significant differences in EOS incidence were observed by sex, race, or ethnicity. The most frequent pathogens were Escherichia coli (86 [36.6%]) and group B streptococcus (GBS; 71 [30.2%]). E coli disease primarily occurred among preterm infants (68 of 131 [51.9%]); GBS disease primarily occurred among term infants (54 of 104 [51.9%]), with 24 of 45 GBS cases (53.3%) seen in infants born to mothers with negative GBS screening test results. Intrapartum antibiotics were administered to 162 mothers (68.9%; 110 of 131 [84.0%] preterm and 52 of 104 [50.0%] term), most commonly for suspected chorioamnionitis. Neonatal empirical antibiotic treatment most frequently included ampicillin and gentamicin. All GBS isolates were tested, but only 18 of 81 (22.2%) E coli isolates tested were susceptible to ampicillin; 6 of 77 E coli isolates (7.8%) were resistant to both ampicillin and gentamicin. Nearly all newborns with EOS (220 of 235 [93.6%]) displayed signs of illness within 72 hours of birth. Death occurred in 38 of 131 infected infants with GA of less than 37 weeks (29.0%); no term infants died. Compared with earlier surveillance (2006-2009), the rate of E coli infection increased among very low-birth-weight (401-1500 g) infants (8.68 [95% CI, 6.50-11.60] vs 5.07 [95% CI, 3.93-6.53] per 1000 live births; P = .008). CONCLUSIONS AND RELEVANCE In this study, EOS incidence and associated mortality disproportionately occurred in preterm infants. Contemporary cases have demonstrated the limitations of current GBS prevention strategies. The increase in E coli infections among very low-birth-weight infants warrants continued study. Ampicillin and gentamicin remained effective antibiotics in most cases, but ongoing surveillance should monitor antibiotic susceptibilities of EOS pathogens.
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Affiliation(s)
- Barbara J. Stoll
- Department of Pediatrics, McGovern Medical School, University of Texas Health Science Center, Houston and Children’s Memorial Hermann Hospital, Houston
| | - Karen M. Puopolo
- Department of Pediatrics, Children’s Hospital of Philadelphia, University of Pennsylvania, Philadelphia
| | - Nellie I. Hansen
- Social, Statistical, and Environmental Sciences Unit, RTI International, Research Triangle Park, North Carolina
| | - Pablo J. Sánchez
- Department of Pediatrics, Nationwide Children’s Hospital, The Ohio State University College of Medicine, Columbus
| | | | | | | | - Carl T. D’Angio
- Department of Pediatrics, University of Rochester School of Medicine and Dentistry, Rochester, New York
| | | | - Brenda B. Poindexter
- Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, Ohio,Department of Pediatrics, Cincinnati Children’s Hospital Medical Center, University of Cincinnati College of Medicine, Cincinnati, Ohio
| | - Krisa P. Van Meurs
- Division of Neonatal and Developmental Medicine, Department of Pediatrics, Lucile Packard Children’s Hospital, Stanford University School of Medicine, Palo Alto, California
| | - Ellen C. Hale
- Department of Pediatrics, Emory University School of Medicine, Children’s Healthcare of Atlanta, Atlanta, Georgia
| | | | - Abhik Das
- Social, Statistical and Environmental Sciences Unit, RTI International, Rockville, Maryland
| | - Carol J. Baker
- Department of Pediatrics, McGovern Medical School, University of Texas Health Science Center, Houston and Children’s Memorial Hermann Hospital, Houston
| | - Myra H. Wyckoff
- Department of Pediatrics, University of Texas Southwestern Medical Center, Dallas
| | - Bradley A. Yoder
- Division of Neonatology, Department of Pediatrics, University of Utah School of Medicine, Salt Lake City
| | - Kristi L. Watterberg
- Department of Pediatrics, University of New Mexico Health Sciences Center, Albuquerque
| | - Michele C. Walsh
- Department of Pediatrics, Rainbow Babies & Children’s Hospital, Case Western Reserve University, Cleveland, Ohio
| | - Uday Devaskar
- Department of Pediatrics, UCLA (University of California, Los Angeles)
| | - Abbot R. Laptook
- Department of Pediatrics, Women & Infants Hospital, Brown University, Providence, Rhode Island
| | - Gregory M. Sokol
- Department of Pediatrics, Indiana University School of Medicine, Indianapolis
| | | | - Rosemary D. Higgins
- Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD), National Institutes of Health (NIH), Bethesda, Maryland,Office of Research, George Mason University College of Health and Human Services, Fairfax, Virginia
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23
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Gonzalez D, Laughon MM, Smith PB, Ge S, Ambalavanan N, Atz A, Sokol GM, Hornik CD, Stewart D, Mundakel G, Poindexter BB, Gaedigk R, Mills M, Cohen‐Wolkowiez M, Martz K, Hornik CP. Population pharmacokinetics of sildenafil in extremely premature infants. Br J Clin Pharmacol 2019; 85:2824-2837. [PMID: 31475367 PMCID: PMC6955411 DOI: 10.1111/bcp.14111] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2019] [Revised: 08/06/2019] [Accepted: 08/22/2019] [Indexed: 11/30/2022] Open
Abstract
AIMS To characterize the population pharmacokinetics (PK) of sildenafil and its active metabolite, N-desmethyl sildenafil (DMS), in premature infants. METHODS We performed a multicentre, open-label trial to characterize the PK of sildenafil in infants ≤28 weeks gestation and < 365 postnatal days (cohort 1) or < 32 weeks gestation and 3-42 postnatal days (cohort 2). In cohort 1, we obtained PK samples from infants receiving sildenafil as ordered per the local standard of care (intravenous [IV] or enteral). In cohort 2, we administered a single IV dose of sildenafil and performed PK sampling. We performed a population PK analysis and dose-exposure simulations using the software NONMEM®. RESULTS We enrolled 34 infants (cohort 1 n = 25; cohort 2 n = 9) and collected 109 plasma PK samples. Sildenafil was given enterally (0.42-2.09 mg/kg) in 24 infants in cohort 1 and via IV (0.125 or 0.25 mg/kg) in all infants in cohort 2. A 2-compartment PK model for sildenafil and 1-compartment model for DMS, with presystemic conversion of sildenafil to DMS, characterized the data well. Coadministration of fluconazole (n = 4), a CYP3A inhibitor, resulted in an estimated 59% decrease in sildenafil clearance. IV doses of 0.125, 0.5 and 1 mg/kg every 8 hours (in the absence of fluconazole) resulted in steady-state maximum sildenafil concentrations that were generally within the range of those reported to inhibit phosphodiesterase type 5 activity in vitro. CONCLUSIONS We successfully characterized the PK of sildenafil and DMS in premature infants and applied the model to inform dosing for a follow-up, phase II study.
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MESH Headings
- Administration, Oral
- Cohort Studies
- Cytochrome P-450 CYP3A/blood
- Cytochrome P-450 CYP3A/genetics
- Fluconazole/administration & dosage
- Fluconazole/pharmacokinetics
- Gestational Age
- Humans
- Hypertension, Pulmonary/blood
- Hypertension, Pulmonary/drug therapy
- Infant
- Infant, Newborn
- Infant, Premature/blood
- Infant, Premature, Diseases/blood
- Infant, Premature, Diseases/drug therapy
- Injections, Intravenous
- Models, Biological
- Phosphodiesterase 5 Inhibitors/administration & dosage
- Phosphodiesterase 5 Inhibitors/blood
- Phosphodiesterase 5 Inhibitors/pharmacokinetics
- Phosphodiesterase 5 Inhibitors/therapeutic use
- Sildenafil Citrate/administration & dosage
- Sildenafil Citrate/blood
- Sildenafil Citrate/pharmacokinetics
- Sildenafil Citrate/therapeutic use
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Affiliation(s)
- Daniel Gonzalez
- Division of Pharmacotherapy and Experimental Therapeutics, UNC Eshelman School of PharmacyThe University of North Carolina at Chapel HillChapel HillNCUSA
| | - Matthew M. Laughon
- Department of Pediatrics, School of MedicineThe University of North Carolina at Chapel HillChapel HillNCUSA
| | - P. Brian Smith
- Department of PediatricsDuke University School of MedicineDurhamNCUSA
- Duke Clinical Research InstituteDurhamNCUSA
| | - Shufan Ge
- Division of Pharmacotherapy and Experimental Therapeutics, UNC Eshelman School of PharmacyThe University of North Carolina at Chapel HillChapel HillNCUSA
| | - Namasivayam Ambalavanan
- Division of Neonatology, School of MedicineUniversity of Alabama at BirminghamBirminghamALUSA
| | - Andrew Atz
- Department of PediatricsMedical University of South Carolina Children's HospitalCharlestonSCUSA
| | - Gregory M. Sokol
- Section of Neonatal‐Perinatal MedicineIndiana University School of MedicineIndianapolisINUSA
| | - Chi D. Hornik
- Department of PediatricsDuke University School of MedicineDurhamNCUSA
- Duke Clinical Research InstituteDurhamNCUSA
- Department of PharmacyDuke University Medical CenterDurhamNCUSA
| | - Dan Stewart
- University of Louisville Norton Children's HospitalLouisvilleKYUSA
| | - Gratias Mundakel
- Kings County Hospital Center/SUNY Downstate Medical CenterBrooklynNYUSA
| | | | - Roger Gaedigk
- Department of Clinical Pharmacology, Toxicology & Therapeutic Innovation, Children's Mercy‐Kansas CityUniversity of Missouri‐Kansas City School of MedicineKansas CityMOUSA
| | - Mary Mills
- Duke Clinical Research InstituteDurhamNCUSA
| | - Michael Cohen‐Wolkowiez
- Department of PediatricsDuke University School of MedicineDurhamNCUSA
- Duke Clinical Research InstituteDurhamNCUSA
| | | | - Christoph P. Hornik
- Department of PediatricsDuke University School of MedicineDurhamNCUSA
- Duke Clinical Research InstituteDurhamNCUSA
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24
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Wong S, Wang H, Tepper R, Sokol GM, Rose R. Expired Tidal Volume Variation in Extremely Low Birth Weight and Very Low Birth Weight Infants on Volume-Targeted Ventilation. J Pediatr 2019; 207:248-251.e1. [PMID: 30770195 DOI: 10.1016/j.jpeds.2018.12.053] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/13/2018] [Revised: 10/12/2018] [Accepted: 12/21/2018] [Indexed: 10/27/2022]
Abstract
In a prospective study we describe the delivery of small tidal volumes to extremely low birth weight (ELBW) and very low birth weight (VLBW) infants using a volume-targeted ventilation mode (VTV). Tidal volume delivery was consistent for both ELBW and VLBW infants independent of gestational age, birth weight, and the target volume.
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Affiliation(s)
- Samuel Wong
- Section of Neonatology, Indiana University, Indianapolis, Indiana.
| | - Honglang Wang
- Department of Mathematical Sciences, Indiana University-Purdue University, Indianapolis, Indiana
| | - Robert Tepper
- Wells Center for Pediatric Research, Indiana University, Indianapolis, Indiana
| | - Gregory M Sokol
- Section of Neonatology, Indiana University, Indianapolis, Indiana
| | - Rebecca Rose
- Section of Neonatology, Indiana University, Indianapolis, Indiana
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25
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Shankaran S, Bell EF, Laptook AR, Saha S, Newman NS, Kazzi SNJ, Barks J, Stoll BJ, Bara R, Gabrio J, Childs K, Das A, Higgins RD, Carlo WA, Sánchez PJ, Carlton DP, Pavageau L, Malcolm WF, D’Angio CT, Ohls RK, Poindexter BB, Sokol GM, Van Meurs KP, Colaizy TT, Khmour A, Puopolo KM, Garg M, Walsh MC. Weaning of Moderately Preterm Infants from the Incubator to the Crib: A Randomized Clinical Trial. J Pediatr 2019; 204:96-102.e4. [PMID: 30337189 PMCID: PMC6326364 DOI: 10.1016/j.jpeds.2018.08.079] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/24/2018] [Revised: 08/03/2018] [Accepted: 08/30/2018] [Indexed: 11/28/2022]
Abstract
OBJECTIVE To assess whether length of hospital stay is decreased among moderately preterm infants weaned from incubator to crib at a lower vs higher weight. STUDY DESIGN This trial was conducted in the Eunice Kennedy Shriver National Institute of Child Health and Human Development Neonatal Research Network. Infants with gestational ages 29-33 weeks, birthweight <1600 g, and in an incubator were randomly assigned to a weaning weight of 1600 or 1800 g. Within 60 to 100 g of weaning weight, the incubator temperature was decreased by 1.0°C to 1.5°C every 24 hours until 28.0°C. The infants were weaned to the crib following stable temperature at 36.5°C to 37.4°C for 8 to 12 hours. Clothing and bedcoverings were standardized. The primary outcome was length of hospital stay from birth to discharge; secondary outcomes included length of stay and growth velocity from weaning to discharge. Adverse events were monitored. RESULTS Of 1565 infants screened, 885 were eligible, and 366 enrolled-187 to the 1600-g and 179 to the 1800-g group. Maternal and neonatal characteristics did not differ among weight groups. Length of hospital stay was a median of 43 days in the lower and 41 days in the higher weight group (P = .12). Growth velocity from completion of weaning to discharge was higher in the lower weight group, 13.7 g/kg/day vs 12.8 g/kg/day (P = .005). Groups did not differ in adverse events. CONCLUSIONS Among moderately preterm neonates, weaning from incubator to crib at a lower weight did not decrease length of stay, but was safe and was accompanied by higher weight gain after weaning. TRIAL REGISTRATION ClinicalTrials.gov: NCT02160002.
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Affiliation(s)
| | - Edward F. Bell
- Department of Pediatrics, University of Iowa, Iowa City, IA
| | - Abbot R. Laptook
- Department of Pediatrics, Women & Infants Hospital, Brown University, Providence, RI
| | - Shampa Saha
- Social, Statistical and Environmental Sciences Unit, RTI International, Research Triangle Park, NC
| | - Nancy S. Newman
- Department of Pediatrics, Rainbow Babies & Children’s Hospital, Case Western Reserve University, Cleveland, OH
| | | | - John Barks
- Department of Pediatrics, University of Michigan, Ann Arbor, MI
| | - Barbara J. Stoll
- Department of Pediatrics, University of Texas Medical School at Houston, Houston, TX
| | - Rebecca Bara
- Department of Pediatrics, Wayne State University, Detroit, MI
| | - Jenna Gabrio
- Social, Statistical and Environmental Sciences Unit, RTI International, Research Triangle Park, NC
| | - Kirsten Childs
- Department of Pediatrics, Wayne State University, Detroit, MI
| | - Abhik Das
- Social, Statistical and Environmental Sciences Unit, RTI International, Rockville
| | - Rosemary D. Higgins
- Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, Bethesda, MD
| | - Waldemar A. Carlo
- Division of Neonatology, University of Alabama at Birmingham, Birmingham, AL
| | - Pablo J. Sánchez
- Department of Pediatrics, Nationwide Children’s Hospital, Ohio State University College of Medicine, Columbus, OH
| | - David P. Carlton
- Department of Pediatrics, Children’s Healthcare of Atlanta, Emory University School of Medicine, Atlanta, GA
| | - Lara Pavageau
- Department of Pediatrics, University of Texas Southwestern Medical Center, Dallas, TX
| | | | - Carl T. D’Angio
- Department of Pediatrics, University of Rochester School of Medicine and Dentistry, Rochester, NY
| | - Robin K. Ohls
- Department of Pediatrics, University of New Mexico Health Sciences Center, Albuquerque, NM
| | - Brenda B. Poindexter
- Department of Pediatrics, Perinatal Institute, Cincinnati Children’s Hospital, Cincinnati, OH
| | - Gregory M. Sokol
- Department of Pediatrics, Indiana University School of Medicine, Indianapolis, IN
| | - Krisa P. Van Meurs
- Department of Pediatrics, Division of Neonatal and Developmental Medicine, Stanford University School of Medicine and Lucile Packard Children’s Hospital, Palo Alto, CA
| | | | - Ayman Khmour
- Department of Pediatrics, Children’s Mercy Hospital, Kansas City, MO
| | - Karen M. Puopolo
- Department of Pediatrics, The Children’s Hospital of Philadelphia and The University of Pennsylvania, Philadelphia, PA
| | - Meena Garg
- Department of Pediatrics, University of California, Los Angeles, CA
| | - Michele C. Walsh
- Department of Pediatrics, Rainbow Babies & Children’s Hospital, Case Western Reserve University, Cleveland, OH
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26
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Phelps DL, Watterberg KL, Nolen TL, Cole CA, Cotten CM, Oh W, Poindexter BB, Zaterka-Baxter KM, Das A, Lacy CB, Scorsone AM, Walsh MC, Bell EF, Kennedy KA, Schibler K, Sokol GM, Laughon MM, Lakshminrusimha S, Truog WE, Garg M, Carlo WA, Laptook AR, Van Meurs KP, Carlton DP, Graf A, DeMauro SB, Brion LP, Shankaran S, Orge FH, Olson RJ, Mintz-Hittner H, Yang MB, Haider KM, Wallace DK, Chung M, Hug D, Tsui I, Cogen MS, Donahue JP, Gaynon M, Hutchinson AK, Bremer DL, Quinn G, He YG, Lucas WR, Winter TW, Kicklighter SD, Kumar K, Chess PR, Colaizy TT, Hibbs AM, Ambalavanan N, Harmon HM, McGowan EC, Higgins RD. Effects of Myo-inositol on Type 1 Retinopathy of Prematurity Among Preterm Infants <28 Weeks' Gestational Age: A Randomized Clinical Trial. JAMA 2018; 320:1649-1658. [PMID: 30357297 PMCID: PMC6233812 DOI: 10.1001/jama.2018.14996] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
IMPORTANCE Previous studies of myo-inositol in preterm infants with respiratory distress found reduced severity of retinopathy of prematurity (ROP) and less frequent ROP, death, and intraventricular hemorrhage. However, no large trials have tested its efficacy or safety. OBJECTIVE To test the adverse events and efficacy of myo-inositol to reduce type 1 ROP among infants younger than 28 weeks' gestational age. DESIGN, SETTING, AND PARTICIPANTS Randomized clinical trial included 638 infants younger than 28 weeks' gestational age enrolled from 18 neonatal intensive care centers throughout the United States from April 17, 2014, to September 4, 2015; final date of follow-up was February 12, 2016. The planned enrollment of 1760 participants would permit detection of an absolute reduction in death or type 1 ROP of 7% with 90% power. The trial was terminated early due to a statistically significantly higher mortality rate in the myo-inositol group. INTERVENTIONS A 40-mg/kg dose of myo-inositol was given every 12 hours (initially intravenously, then enterally when feeding; n = 317) or placebo (n = 321) for up to 10 weeks. MAIN OUTCOMES AND MEASURES Type 1 ROP or death before determination of ROP outcome was designated as unfavorable. The designated favorable outcome was survival without type 1 ROP. RESULTS Among 638 infants (mean, 26 weeks' gestational age; 50% male), 632 (99%) received the trial drug or placebo and 589 (92%) had a study outcome. Death or type 1 ROP occurred more often in the myo-inositol group vs the placebo group (29% vs 21%, respectively; adjusted risk difference, 7% [95% CI, 0%-13%]; adjusted relative risk, 1.41 [95% CI, 1.08-1.83], P = .01). All-cause death before 55 weeks' postmenstrual age occurred in 18% of the myo-inositol group and in 11% of the placebo group (adjusted risk difference, 6% [95% CI, 0%-11%]; adjusted relative risk, 1.66 [95% CI, 1.14-2.43], P = .007). The most common serious adverse events up to 7 days of receiving the ending dose were necrotizing enterocolitis (6% for myo-inositol vs 4% for placebo), poor perfusion or hypotension (7% vs 4%, respectively), intraventricular hemorrhage (10% vs 9%), systemic infection (16% vs 11%), and respiratory distress (15% vs 13%). CONCLUSIONS AND RELEVANCE Among premature infants younger than 28 weeks' gestational age, treatment with myo-inositol for up to 10 weeks did not reduce the risk of type 1 ROP or death vs placebo. These findings do not support the use of myo-inositol among premature infants; however, the early termination of the trial limits definitive conclusions.
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Affiliation(s)
- Dale L. Phelps
- School of Medicine and Dentistry, University of Rochester, Rochester, New York
| | | | - Tracy L. Nolen
- Social, Statistical, and Environmental Sciences Unit, RTI International, Research Triangle Park, North Carolina
| | - Carol A. Cole
- School of Medicine and Dentistry, University of Rochester, Rochester, New York
| | | | - William Oh
- Department of Pediatrics, Women & Infants’ Hospital, Brown University, Providence, Rhode Island
| | - Brenda B. Poindexter
- Department of Pediatrics, Cincinnati Children’s Hospital Medical Center and University of Cincinnati College of Medicine, Cincinnati, Ohio
- Department of Pediatrics, School of Medicine, Indiana University, Indianapolis
| | - Kristin M. Zaterka-Baxter
- Social, Statistical, and Environmental Sciences Unit, RTI International, Research Triangle Park, North Carolina
| | - Abhik Das
- Social, Statistical, and Environmental Sciences Unit, RTI International, Rockville, Maryland
| | | | - Ann Marie Scorsone
- School of Medicine and Dentistry, University of Rochester, Rochester, New York
| | - Michele C. Walsh
- Department of Pediatrics, Rainbow Babies & Children’s Hospital, Case Western Reserve University, Cleveland, Ohio
| | | | - Kathleen A. Kennedy
- Department of Pediatrics, McGovern Medical School, University of Texas Health Science Center, Houston
| | - Kurt Schibler
- Department of Pediatrics, Cincinnati Children’s Hospital Medical Center and University of Cincinnati College of Medicine, Cincinnati, Ohio
| | - Gregory M. Sokol
- Department of Pediatrics, School of Medicine, Indiana University, Indianapolis
| | - Matthew M. Laughon
- Division of Neonatal/Perinatal Medicine, Department of Pediatrics, University of North Carolina, Chapel Hill
| | | | - William E. Truog
- Department of Pediatrics, Children’s Mercy Hospital and University of Missouri School of Medicine, Kansas City
| | - Meena Garg
- Department of Pediatrics, University of California, Los Angeles
| | | | - Abbot R. Laptook
- Department of Pediatrics, Women & Infants’ Hospital, Brown University, Providence, Rhode Island
| | - Krisa P. Van Meurs
- Department of Pediatrics, Division of Neonatal and Developmental Medicine, Stanford University School of Medicine and Lucile Packard Children's Hospital, Palo Alto, California
| | - David P. Carlton
- Department of Pediatrics, Emory University School of Medicine and Children’s Healthcare of Atlanta, Atlanta, Georgia
| | - Amanda Graf
- Department of Pediatrics, Nationwide Children’s Hospital, Columbus, Ohio
| | - Sara B. DeMauro
- Department of Pediatrics, Children’s Hospital of Philadelphia and University of Pennsylvania, Philadelphia
| | - Luc P. Brion
- Department of Pediatrics, University of Texas Southwestern Medical Center, Dallas
| | - Seetha Shankaran
- Department of Pediatrics, Wayne State University, Detroit, Michigan
| | - Faruk H. Orge
- Department of Ophthalmology, Rainbow Babies & Children’s Hospital, Case Western Reserve University, Cleveland, Ohio
| | - Richard J. Olson
- Department of Ophthalmology and Visual Sciences, University of Iowa, Iowa City
| | - Helen Mintz-Hittner
- Department of Ophthalmology and Visual Science, McGovern Medical School, University of Texas Health Science Center, Houston
| | - Michael B. Yang
- Department of Ophthalmology, Cincinnati Children’s Hospital Medical Center and University of Cincinnati College of Medicine, Cincinnati, Ohio
| | - Kathryn M. Haider
- Department of Ophthalmology, School of Medicine, Indiana University, Indianapolis
| | - David K. Wallace
- Department of Pediatrics, Duke University, Durham, North Carolina
| | - Mina Chung
- Department of Ophthalmology, School of Medicine and Dentistry, University of Rochester, Rochester, New York
| | - Denise Hug
- Department of Ophthalmology, Children’s Mercy Hospital and University of Missouri School of Medicine, Kansas City
| | - Irena Tsui
- Department of Ophthalmology, University of California, Los Angeles
| | - Martin S. Cogen
- Department of Ophthalmology, University of Alabama at Birmingham
| | - John P. Donahue
- Alpert Medical School, Women & Infants’ Hospital, Brown University, Providence, Rhode Island
| | - Michael Gaynon
- Department of Ophthalmology, Division of Neonatal and Developmental Medicine, Stanford University School of Medicine and Lucile Packard Children’s Hospital, Palo Alto, California
| | - Amy K. Hutchinson
- Department of Ophthalmology, Emory University School of Medicine and Children’s Healthcare of Atlanta, Atlanta, Georgia
| | - Don L. Bremer
- Department of Ophthalmology, Nationwide Children’s Hospital, Columbus, Ohio
| | - Graham Quinn
- Department of Ophthalmology, Children’s Hospital of Philadelphia and University of Pennsylvania, Philadelphia
| | - Yu-Guang He
- Department of Ophthalmology, University of Texas Southwestern Medical Center, Dallas
| | - William R. Lucas
- Department of Ophthalmology, Wayne State University, Detroit, Michigan
| | - Timothy W. Winter
- Division of Ophthalmology, Department of Surgery, Health Sciences Center, University of New Mexico, Albuquerque
| | - Stephen D. Kicklighter
- Department of Pediatrics, Division of Neonatology, WakeMed Health and Hospitals, Raleigh, North Carolina
| | - Kartik Kumar
- Department of Pediatrics, McGovern Medical School, University of Texas Health Science Center, Houston
| | - Patricia R. Chess
- School of Medicine and Dentistry, University of Rochester, Rochester, New York
| | | | - Anna Marie Hibbs
- Department of Pediatrics, Rainbow Babies & Children’s Hospital, Case Western Reserve University, Cleveland, Ohio
| | | | - Heidi M. Harmon
- Department of Pediatrics, School of Medicine, Indiana University, Indianapolis
| | - Elisabeth C. McGowan
- Department of Pediatrics, Women & Infants’ Hospital, Brown University, Providence, Rhode Island
| | - Rosemary D. Higgins
- Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, Bethesda, Maryland
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27
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Laptook AR, Shankaran S, Tyson JE, Munoz B, Bell EF, Goldberg RN, Parikh NA, Ambalavanan N, Pedroza C, Pappas A, Das A, Chaudhary AS, Ehrenkranz RA, Hensman AM, Van Meurs KP, Chalak LF, Khan AM, Hamrick SEG, Sokol GM, Walsh MC, Poindexter BB, Faix RG, Watterberg KL, Frantz ID, Guillet R, Devaskar U, Truog WE, Chock VY, Wyckoff MH, McGowan EC, Carlton DP, Harmon HM, Brumbaugh JE, Cotten CM, Sánchez PJ, Hibbs AM, Higgins RD. Effect of Therapeutic Hypothermia Initiated After 6 Hours of Age on Death or Disability Among Newborns With Hypoxic-Ischemic Encephalopathy: A Randomized Clinical Trial. JAMA 2017; 318:1550-1560. [PMID: 29067428 PMCID: PMC5783566 DOI: 10.1001/jama.2017.14972] [Citation(s) in RCA: 173] [Impact Index Per Article: 24.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
IMPORTANCE Hypothermia initiated at less than 6 hours after birth reduces death or disability for infants with hypoxic-ischemic encephalopathy at 36 weeks' or later gestation. To our knowledge, hypothermia trials have not been performed in infants presenting after 6 hours. OBJECTIVE To estimate the probability that hypothermia initiated at 6 to 24 hours after birth reduces the risk of death or disability at 18 months among infants with hypoxic-ischemic encephalopathy. DESIGN, SETTING, AND PARTICIPANTS A randomized clinical trial was conducted between April 2008 and June 2016 among infants at 36 weeks' or later gestation with moderate or severe hypoxic-ischemic encephalopathy enrolled at 6 to 24 hours after birth. Twenty-one US Neonatal Research Network centers participated. Bayesian analyses were prespecified given the anticipated limited sample size. INTERVENTIONS Targeted esophageal temperature was used in 168 infants. Eighty-three hypothermic infants were maintained at 33.5°C (acceptable range, 33°C-34°C) for 96 hours and then rewarmed. Eighty-five noncooled infants were maintained at 37.0°C (acceptable range, 36.5°C-37.3°C). MAIN OUTCOMES AND MEASURES The composite of death or disability (moderate or severe) at 18 to 22 months adjusted for level of encephalopathy and age at randomization. RESULTS Hypothermic and noncooled infants were term (mean [SD], 39 [2] and 39 [1] weeks' gestation, respectively), and 47 of 83 (57%) and 55 of 85 (65%) were male, respectively. Both groups were acidemic at birth, predominantly transferred to the treating center with moderate encephalopathy, and were randomized at a mean (SD) of 16 (5) and 15 (5) hours for hypothermic and noncooled groups, respectively. The primary outcome occurred in 19 of 78 hypothermic infants (24.4%) and 22 of 79 noncooled infants (27.9%) (absolute difference, 3.5%; 95% CI, -1% to 17%). Bayesian analysis using a neutral prior indicated a 76% posterior probability of reduced death or disability with hypothermia relative to the noncooled group (adjusted posterior risk ratio, 0.86; 95% credible interval, 0.58-1.29). The probability that death or disability in cooled infants was at least 1%, 2%, or 3% less than noncooled infants was 71%, 64%, and 56%, respectively. CONCLUSIONS AND RELEVANCE Among term infants with hypoxic-ischemic encephalopathy, hypothermia initiated at 6 to 24 hours after birth compared with noncooling resulted in a 76% probability of any reduction in death or disability, and a 64% probability of at least 2% less death or disability at 18 to 22 months. Hypothermia initiated at 6 to 24 hours after birth may have benefit but there is uncertainty in its effectiveness. TRIAL REGISTRATION clinicaltrials.gov Identifier: NCT00614744.
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Affiliation(s)
- Abbot R Laptook
- Department of Pediatrics, Women & Infants Hospital, Brown University, Providence, Rhode Island
| | - Seetha Shankaran
- Department of Pediatrics, Wayne State University, Detroit, Michigan
| | - Jon E Tyson
- Department of Pediatrics, McGovern Medical School at the University of Texas Health Science Center at Houston
| | - Breda Munoz
- Social, Statistical, and Environmental Sciences Unit, RTI International, Research Triangle Park, North Carolina
| | - Edward F Bell
- Department of Pediatrics, University of Iowa, Iowa City
| | | | - Nehal A Parikh
- Perinatal Institute, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio
| | | | - Claudia Pedroza
- Department of Pediatrics, McGovern Medical School at the University of Texas Health Science Center at Houston
| | - Athina Pappas
- Department of Pediatrics, Wayne State University, Detroit, Michigan
| | - Abhik Das
- Social, Statistical, and Environmental Sciences Unit, RTI International, Rockville, Maryland
| | | | - Richard A Ehrenkranz
- Department of Pediatrics, Yale University School of Medicine, New Haven, Connecticut
| | - Angelita M Hensman
- Department of Pediatrics, Women & Infants Hospital, Brown University, Providence, Rhode Island
| | - Krisa P Van Meurs
- Department of Pediatrics, Division of Neonatal and Developmental Medicine, Stanford University School of Medicine, Palo Alto, California
- Lucile Packard Children's Hospital, Palo Alto, California
| | - Lina F Chalak
- Department of Pediatrics, University of Texas Southwestern Medical Center, Dallas
| | - Amir M Khan
- Department of Pediatrics, McGovern Medical School at the University of Texas Health Science Center at Houston
| | - Shannon E G Hamrick
- Emory University School of Medicine, Department of Pediatrics, Children's Healthcare of Atlanta, Atlanta, Georgia
| | - Gregory M Sokol
- Department of Pediatrics, Indiana University School of Medicine, Indianapolis
| | - Michele C Walsh
- Department of Pediatrics, Rainbow Babies & Children's Hospital, Case Western Reserve University, Cleveland, Ohio
| | - Brenda B Poindexter
- Perinatal Institute, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio
- Department of Pediatrics, Indiana University School of Medicine, Indianapolis
| | - Roger G Faix
- Department of Pediatrics, Division of Neonatology, University of Utah School of Medicine, Salt Lake City
| | | | - Ivan D Frantz
- Division of Newborn Medicine, Department of Pediatrics, Floating Hospital for Children, Tufts Medical Center, Boston, Massachusetts
| | - Ronnie Guillet
- University of Rochester School of Medicine and Dentistry, Rochester, New York
| | - Uday Devaskar
- Department of Pediatrics, University of California, Los Angeles
| | - William E Truog
- Department of Pediatrics, Children's Mercy Hospital, Kansas City, Missouri
- University of Missouri Kansas City School of Medicine, Kansas City
| | - Valerie Y Chock
- Department of Pediatrics, Division of Neonatal and Developmental Medicine, Stanford University School of Medicine, Palo Alto, California
- Lucile Packard Children's Hospital, Palo Alto, California
| | - Myra H Wyckoff
- Department of Pediatrics, University of Texas Southwestern Medical Center, Dallas
| | - Elisabeth C McGowan
- Department of Pediatrics, Women & Infants Hospital, Brown University, Providence, Rhode Island
| | - David P Carlton
- Emory University School of Medicine, Department of Pediatrics, Children's Healthcare of Atlanta, Atlanta, Georgia
| | - Heidi M Harmon
- Department of Pediatrics, Indiana University School of Medicine, Indianapolis
| | | | - C Michael Cotten
- Department of Pediatrics, Duke University, Durham, North Carolina
| | - Pablo J Sánchez
- Department of Pediatrics, Nationwide Children's Hospital, Columbus, Ohio
| | - Anna Maria Hibbs
- Department of Pediatrics, Rainbow Babies & Children's Hospital, Case Western Reserve University, Cleveland, Ohio
| | - Rosemary D Higgins
- Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, Bethesda, Maryland
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Abstract
The 21st century began with the FDA approval of inhaled nitric oxide therapy for the treatment of neonatal hypoxic respiratory failure associated with pulmonary hypertension in recognition of the 2 randomized clinical trials demostrating a significant reduction in the need for extracorporeal support in the term and near-term infant. Inhaled nitric oxide is one of only a few therapeutic agents approved for use through clinical investigations primarily in the neonate. This article provides an overview of the pertinent biology and chemistry of nitric oxide, discusses potential toxicities, and reviews the results of pertinent clinical investigations and large randomized clinical trials including neurodevelopmental follow-up in term and preterm neonates. The clinical investigations conducted by the Eunice Kennedy Shriver NICHD Neonatal Research Network will be discussed and placed in context with other pertinent clinical investigations exploring the efficacy of inhaled nitric oxide therapy in neonatal hypoxic respiratory failure.
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Affiliation(s)
- Gregory M. Sokol
- Section of Neonatal-Perinatal Medicine, Department of Pediatrics, Indiana University School of Medicine, Indianapolis, IN 46254
| | - G. Ganesh Konduri
- Division of Neonatology, Department of Pediatrics, Medical College of Wisconsin, Milwaukee, WI 53226
| | - Krisa P. Van Meurs
- Division of Neonatal and Developmental Medicine, Department of Pediatrics, Stanford University School of Medicine, Palo Alto, CA 94304
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Konduri GG, Sokol GM, Van Meurs KP, Singer J, Ambalavanan N, Lee T, Solimano A. Impact of early surfactant and inhaled nitric oxide therapies on outcomes in term/late preterm neonates with moderate hypoxic respiratory failure. J Perinatol 2013; 33:944-9. [PMID: 23867958 PMCID: PMC3841912 DOI: 10.1038/jp.2013.83] [Citation(s) in RCA: 36] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/24/2013] [Revised: 05/23/2013] [Accepted: 06/07/2013] [Indexed: 11/27/2022]
Abstract
OBJECTIVE We conducted a post-hoc analysis of early inhaled nitric oxide (iNO)-randomized controlled trial data to identify associations pertinent to the management of moderate hypoxic respiratory failure in term/late preterm infants. STUDY DESIGN Univariate and multivariate logistic regression analyses were used to determine risk factors for the progression of respiratory failure and extracorporeal membrane oxygenation (ECMO)/death. RESULT Among the 299 enrolled infants, oxygenation index (OI) <20 at enrollment (odds ratio 0.52, confidence interval (CI) 0.27 to 0.97) and surfactant use before randomization (odds ratio 0.47, CI 0.24 to 0.91) were associated with decreased ECMO/death rates. Early surfactant use for respiratory distress syndrome, perinatal aspiration syndrome and pneumonia/sepsis was associated with lower risk of ECMO/death (P<0.001). Early iNO (OI 15 to 25) decreased the progression of respiratory failure to OI >30 (P=0.002) and to composite outcome of OI >30 or ECMO/death (P=0.02). CONCLUSION This post-hoc analysis suggests that early use of surfactant and iNO in moderate respiratory failure is associated with improved outcomes.
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Affiliation(s)
- G G Konduri
- Division of Neonatology, Department of Pediatrics, Medical College of Wisconsin, Milwaukee, WI, USA,Division of Neonatology, Department of Pediatrics, Children's Corporate Center Suite C410, 999N 92 Street, Wauwatosa, WI 53226, USA. E-mail:
| | - G M Sokol
- Department of Pediatrics, Indiana University School of Medicine, Indianapolis, IN, USA
| | - K P Van Meurs
- Department of Pediatrics, Stanford University, Palo Alto, CA, USA
| | - J Singer
- Center for Health Evaluation and Outcome Sciences, St Paul's Hospital, Vancouver, BC, Canada
| | - N Ambalavanan
- Department of Pediatrics, University of Alabama at Birmingham, Birmingham, AL, USA
| | - T Lee
- Center for Health Evaluation and Outcome Sciences, St Paul's Hospital, Vancouver, BC, Canada
| | - A Solimano
- Department of Pediatrics, University of British Columbia, Vancouver, BC, Canada
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Konduri GG, Vohr B, Robertson C, Sokol GM, Solimano A, Singer J, Ehrenkranz RA, Singhal N, Wright LL, Van Meurs K, Stork E, Kirpalani H, Peliowski A, Johnson Y. Early inhaled nitric oxide therapy for term and near-term newborn infants with hypoxic respiratory failure: neurodevelopmental follow-up. J Pediatr 2007; 150:235-40, 240.e1. [PMID: 17307536 PMCID: PMC1906720 DOI: 10.1016/j.jpeds.2006.11.065] [Citation(s) in RCA: 63] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/05/2006] [Revised: 10/05/2006] [Accepted: 11/30/2006] [Indexed: 11/25/2022]
Abstract
OBJECTIVE To report the neurodevelopmental outcome of infants enrolled in a randomized multicenter trial of early inhaled nitric oxide (iNO) in term and near-term neonates with hypoxic respiratory failure and pulmonary hypertension. STUDY DESIGN Neonates born at > or = 34 weeks gestation who required assisted ventilation and had an oxygenation index > or = 15 and < 25 were randomized to an early iNO group or a control group. A comprehensive neurodevelopmental assessment of survivors was performed at age 18 to 24 months. RESULTS The trial enrolled 299 infants, of which 266 (89%) survived to age 18 to 24 months (136 in the early iNO group and 130 in the control group). Follow-up evaluations were done on 234 (88%) of surviving infants. There were no differences between the 2 groups in the incidence of neurodevelopmental impairment (early iNO, 27%; control, 25%) and hearing impairment (early iNO, 23%; control, 24%). Mental development index scores were similar in the 2 groups; however, psychomotor developmental index scores were significantly higher in the control group (early iNO, 89 +/- 17.7; control, 93.5 +/- 18.4). CONCLUSIONS Early iNO therapy for hypoxic respiratory failure in term and near-term infants is not associated with an increase in neurodevelopmental impairment or hearing loss at 18 to 24 months postnatal age.
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Affiliation(s)
- G Ganesh Konduri
- Medical College of WI, Dept of Pediatrics and the Children's Research Institute, Milwaukee, WI 53201-1997, USA.
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31
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Van Meurs KP, Wright LL, Ehrenkranz RA, Lemons JA, Ball MB, Poole WK, Perritt R, Higgins RD, Oh W, Hudak ML, Laptook AR, Shankaran S, Finer NN, Carlo WA, Kennedy KA, Fridriksson JH, Steinhorn RH, Sokol GM, Konduri GG, Aschner JL, Stoll BJ, D'Angio CT, Stevenson DK. Inhaled nitric oxide for premature infants with severe respiratory failure. N Engl J Med 2005; 353:13-22. [PMID: 16000352 DOI: 10.1056/nejmoa043927] [Citation(s) in RCA: 194] [Impact Index Per Article: 10.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
BACKGROUND Inhaled nitric oxide is a controversial treatment for premature infants with severe respiratory failure. We conducted a multicenter, randomized, blinded, controlled trial to determine whether inhaled nitric oxide reduced the rate of death or bronchopulmonary dysplasia in such infants. METHODS We randomly assigned 420 neonates, born at less than 34 weeks of gestation, with a birth weight of 401 to 1500 g, and with respiratory failure more than four hours after treatment with surfactant to receive placebo (simulated flow) or inhaled nitric oxide (5 to 10 ppm). Infants with a response (an increase in the partial pressure of arterial oxygen of more than 10 mm Hg) were weaned according to protocol. Treatment with study gas was discontinued in infants who did not have a response. RESULTS The rate of death or bronchopulmonary dysplasia was 80 percent in the nitric oxide group, as compared with 82 percent in the placebo group (relative risk, 0.97; 95 percent confidence interval, 0.86 to 1.06; P=0.52), and the rate of bronchopulmonary dysplasia was 60 percent versus 68 percent (relative risk, 0.90; 95 percent confidence interval, 0.75 to 1.08; P=0.26). There were no significant differences in the rates of severe intracranial hemorrhage or periventricular leukomalacia. Post hoc analyses suggest that rates of death and bronchopulmonary dysplasia are reduced for infants with a birth weight greater than 1000 g, whereas infants weighing 1000 g or less who are treated with inhaled nitric oxide have higher mortality and increased rates of severe intracranial hemorrhage. CONCLUSIONS The use of inhaled nitric oxide in critically ill premature infants weighing less than 1500 g does not decrease the rates of death or bronchopulmonary dysplasia. Further trials are required to determine whether inhaled nitric oxide benefits infants with a birth weight of 1000 g or more.
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MESH Headings
- Administration, Inhalation
- Bronchopulmonary Dysplasia/prevention & control
- Cerebral Hemorrhage/etiology
- Combined Modality Therapy
- Female
- Humans
- Infant, Newborn
- Infant, Premature
- Infant, Premature, Diseases/drug therapy
- Infant, Premature, Diseases/mortality
- Infant, Premature, Diseases/therapy
- Infant, Very Low Birth Weight
- Leukomalacia, Periventricular/etiology
- Male
- Nitric Oxide/adverse effects
- Nitric Oxide/therapeutic use
- Oxygen/blood
- Respiration, Artificial
- Respiratory Distress Syndrome, Newborn/complications
- Respiratory Insufficiency/complications
- Respiratory Insufficiency/drug therapy
- Respiratory Insufficiency/mortality
- Single-Blind Method
- Treatment Outcome
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Affiliation(s)
- Krisa P Van Meurs
- Division of Neonatal and Developmental Medicine, Department of Pediatrics, Stanford University School of Medicine, Palo Alto, Calif 94304, USA.
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32
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Konduri GG, Solimano A, Sokol GM, Singer J, Ehrenkranz RA, Singhal N, Wright LL, Van Meurs K, Stork E, Kirpalani H, Peliowski A. A randomized trial of early versus standard inhaled nitric oxide therapy in term and near-term newborn infants with hypoxic respiratory failure. Pediatrics 2004; 113:559-64. [PMID: 14993550 DOI: 10.1542/peds.113.3.559] [Citation(s) in RCA: 131] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
OBJECTIVE Inhaled nitric oxide (iNO) reduces the use of extracorporeal membrane oxygenation (ECMO)/incidence of death in term and near-term neonates with severe hypoxic respiratory failure. We conducted a randomized, double masked, multicenter trial to determine whether administration of iNO earlier in respiratory failure results in additional reduction in the incidence of these outcomes. METHODS Neonates who were born at > or =34 weeks' gestation were enrolled when they required assisted ventilation and had an oxygenation index (OI) > or =15 and <25 on any 2 measurements in a 12-hour interval. Infants were randomized to early iNO or to simulated initiation of iNO (control). Infants who had an increase in OI to 25 or more were given iNO as standard therapy. RESULTS The trial enrollment was halted after 75% of target sample size was reached because of decreasing availability of eligible patients. The 150 infants who were given early iNO and 149 control infants had similar baseline characteristics. Arterial oxygen tension increased by >20 mm Hg in 73% of early iNO and 37% of control infants after study gas initiation. Control infants received standard iNO and deteriorated to OI >40 more often than infants who were given early iNO. The incidence of death (early iNO, 6.7% vs control, 9.4%), ECMO (10.7% vs 12.1%), and their combined incidence (16.7% vs 19.5%) were similar in both groups. CONCLUSION iNO improves oxygenation but does not reduce the incidence of ECMO/mortality when initiated at an OI of 15 to 25 compared with initiation at >25 in term and near-term neonates with respiratory failure.
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Affiliation(s)
- G Ganesh Konduri
- Department of Pediatrics, Medical College of Wisconsin, Milwaukee, Wisconsin 53226, USA.
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33
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Abstract
The Neonatal Research Network developed and initiated 3 multicenter randomized controlled clinical trials evaluating inhaled nitric oxide therapy. Additional projects evolved from these efforts including basic science research and observational investigations. This article provides a historical prospective of the Network's investigations related to the diagnosis and management of neonatal hypoxic respiratory failure, especially those related to inhaled nitric oxide therapy. It will review the Network's contributions toward advancing the clinical care of the newborn with severe hypoxic respiratory failure.
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Affiliation(s)
- Gregory M Sokol
- Section of Neonatal-Perinatal Medicine, Department of Pediatrics, Indiana University School of Medicine, Indianapolis, IN 46202-5271, USA.
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34
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Abstract
We set out to evaluate changes in arterial oxygen tension (PaO(2)) when weaning neonates from inhaled nitric oxide (INO). We reviewed the records of 505 prospectively collected INO weaning attempts on 84 neonates with hypoxic respiratory failure. PaO(2) values before and 30 min after weaning attempts were recorded. Relationships between change in PaO(2) and decreases in INO concentrations were investigated using regression analysis and ANOVA. PaO(2) decreased (-18.7 +/- 1.8 torr; P < 0.001); when weaning INO. A stepwise decline in PaO(2) was observed weaning INO from 40 ppm. The greatest decline occurred when INO was discontinued (-42.1 +/- 4.1 torr). Forward stepwise multiple regression using variables with significant relationships to the decline in PaO(2) identified the specific dose reduction 7(P < 0.001), the prewean PaO(2) (P < 0.001), and surfactant therapy (P = 0.018) as the variables best describing the change in PaO(2)(P = 0.004, r = 0.51). In conclusion, a graded decline in PaO(2) occurs when reducing INO. INO should be weaned to less than 1 ppm before discontinuing its use. Prior surfactant treatment appears to enhance the oxygenation reserve when weaning INO.
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Affiliation(s)
- G M Sokol
- Department of Pediatrics, Indiana University School of Medicine, Indianapolis, Indiana 46202-5271, USA.
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Abstract
Abstract
Background: Nitrogen dioxide (NO2) is a toxic by-product of inhalation therapy with nitric oxide (NO). The rate of NO2 formation during NO therapy is controversial.
Methods: The formation of NO2 was studied under dynamic flows emulating a base case NO ventilator mixture containing 80 ppm NO in a 90% oxygen matrix. The difficulty in measuring NO2 concentrations below 2 ppm accurately was overcome by the use of tunable diode laser absorption spectroscopy.
Results: Using a second-order model, the rate constant, k, for NO2 formation was determined to be (1.19 ± 0.11) × 10−11 ppm−2s−1, which is in basic agreement with evaluated data from atmospheric literature.
Conclusions: Inhaled NO can be delivered safely in a well-designed, continuous flow neonatal ventilatory circuit, and NO2 formation can be calculated reliably using the rate constant and circuit dwell time.
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Affiliation(s)
- Gregory M Sokol
- Department of Pediatrics, Indiana University, Indianapolis, IN 46202
| | - Krisa P Van Meurs
- Department of Pediatrics, Stanford University Medical Center, Stanford, CA 94304
| | - Linda L Wright
- Neonatal Network, National Institute of Child Health and Human Development, Bethesda, MD 20892
| | - Oswaldo Rivera
- Department of Biomedical Engineering, Children’s Hospital National Medical Center, Washington, DC 20010
| | - William J Thorn
- Analytical Chemistry Division, National Institute of Standards and Technology, Gaithersburg, MD 20899
| | - Pamela M Chu
- Analytical Chemistry Division, National Institute of Standards and Technology, Gaithersburg, MD 20899
| | - Robert L Sams
- Analytical Chemistry Division, National Institute of Standards and Technology, Gaithersburg, MD 20899
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36
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Sokol GM, Van Meurs KP, Wright LL, Rivera O, Thorn WJ, Chu PM, Sams RL. Nitrogen dioxide formation during inhaled nitric oxide therapy. Clin Chem 1999; 45:382-7. [PMID: 10053039] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/11/2023]
Abstract
BACKGROUND Nitrogen dioxide (NO2) is a toxic by-product of inhalation therapy with nitric oxide (NO). The rate of NO2 formation during NO therapy is controversial. METHODS The formation of NO2 was studied under dynamic flows emulating a base case NO ventilator mixture containing 80 ppm NO in a 90% oxygen matrix. The difficulty in measuring NO2 concentrations below 2 ppm accurately was overcome by the use of tunable diode laser absorption spectroscopy. RESULTS Using a second-order model, the rate constant, k, for NO2 formation was determined to be (1.19 +/- 0.11) x 10(-11) ppm-2s-1, which is in basic agreement with evaluated data from atmospheric literature. CONCLUSIONS Inhaled NO can be delivered safely in a well-designed, continuous flow neonatal ventilatory circuit, and NO2 formation can be calculated reliably using the rate constant and circuit dwell time.
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Affiliation(s)
- G M Sokol
- Department of Pediatrics, Indiana University, Indianapolis, IN 46202,
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Sokol GM, Liechty EA, Boyle DW. Comparison of steady-state diffusion and transit time ultrasonic measurements of umbilical blood flow in the chronic fetal sheep preparation. Am J Obstet Gynecol 1996; 174:1456-60. [PMID: 9065111 DOI: 10.1016/s0002-9378(96)70588-4] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
OBJECTIVE Our purpose was to measure umbilical blood flow continuously by use of a transit time ultrasonic flow transducer and to compare the blood flow measurements with the steady-state diffusion method in the chronic fetal sheep preparation. STUDY DESIGN We compared umbilical blood flow measurements calculated by the steady-state diffusion method with ethanol as the diffusing substance and with the transit time ultrasonic flow transducer placed on the common umbilical artery in five chronically prepared fetal sheep. RESULTS There was no statistical difference between measurements of umbilical blood flow measured by the flow transducer versus the steady-state diffusion method, 600 +/- 22 versus 664 +/- 56 ml per minute (mean +/- SEM) (p = 0.23). The mean coefficient of variation within each study was 13.6% for the steady-state diffusion method versus 4.1% for the transit time flow transducer. Umbilical blood flow variance was significantly lower as measured by the flow transducer compared with the diffusion method (p < 0.0001). There were no differences in umbilical blood flow per kilogram or fetal oxygen uptake between the two methods. CONCLUSION We conclude that umbilical blood flow can be measured continuously under steady-state conditions by use of a transit time flow transducer. Because of the lower variability in the flow transducer-obtained measurements, we speculate that the flow transducer may differentiate alterations in umbilical blood flow with greater precision in chronic preparations. This may be advantageous for measuring absolute changes in fetal substrate uptake, especially under non-steady-state conditions.
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Affiliation(s)
- G M Sokol
- Department of Pediatrics, Indiana University School of Medicine, USA
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Berdashkevich IA, Belous AM, Borovitskaia AI, Engalycheva NA, Pogrebniak BA, Sokol GM, Tarasenko NN. [Incidence of orthopaedic-traumatologic diseases among the rural and urban population]. Ortop Travmatol Protez 1965; 26:60-6. [PMID: 5876323] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/17/2023]
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