Neighborhood Income Disparities in Unplanned Hospital Admission and In-Hospital Outcomes Among Children with Congenital Heart Disease.

Unplanned admissions are associated with worse clinical outcomes and increased hospital resource utilization. We hypothesized that children with congenital heart disease (CHD) from lower-income neighborhoods have higher rates of unplanned hospital admissions and greater resource utilization. Utilizing the Kids' Inpatient Database (2016 and 2019), we included children under 21 years of age with CHD, excluding newborn hospitalizations.

The impact of exclusive human milk diet on short-term growth of very preterm infants.

Objectives: The impact of exclusive human milk diet (EHMD) on postnatal growth remains controversial. This study aims to investigate the association between EHMD and short-term growth.

Methods: This multicenter retrospective study aims to compare growth between the EHMD and non-EHMD groups among infants <32 weeks of gestation.

Perceptions and impact of patient reviews: a survey of academic dermatologists.

Background: Patient reviews (PRs) have emerged as a method to assess patient experiences with healthcare in order to improve the quality of care. Both institutional and third-party organizations collect quantitative data and comments from these patient surveys, usually accessible to the public for review. Our study examined dermatologists' perceptions of PRs and assessed their impact on dermatologists.

The association between antenatal corticosteroids exposure and postnatal growth in infants born between 23 and 29 weeks of gestation.

Objective: To assess the association between antenatal corticosteroids exposure and postnatal growth in infants born at 23-29 weeks' gestation.

Study Design: This retrospective study used data from the Pediatrix Clinical Data Warehouse. Maternal-infant dyads from 2018 to 2020 were included.

A comparative study of postnatal anthropometric growth in very preterm infants and intrauterine growth.

Most growth references for very preterm infants were developed using measurements taken at birth, and were thought to represent intrauterine growth. However, it remains unclear whether the goal of approximating an intrauterine growth rate as stated by the American Academy of Pediatrics is attainable by very preterm infants. Using real-world measurement data from very preterm infants born between 2010 through 2020, we develop models to characterize the patterns of postnatal growth, and compare them to intrauterine growth.

When the Unknown Is Unknowable: Confronting Diagnostic Uncertainty.

The neonatology literature often refers to medical uncertainty and specifically the challenges of predicting morbidity for extremely premature infants, who can have widely varying outcomes. Less has been written about situations in which diagnoses are simply unknown or unattainable. This case highlights the importance of communication amidst uncertainty from a lack of knowledge about aspects of a patient's condition.

Comparison of Adverse Clinical Outcomes in Children Hospitalized for Myocarditis with and Without COVID-19.

We used a nationally representative database of the US, which included 1995 myocarditis cases, among whom 620 children had COVID-19. While the risk of in-hospital mortality was not higher, illness severity and length of hospital stay were higher in patients with myocarditis and COVID-19 than those without COVID-19.

Impact of congenital heart disease on outcomes among pediatric patients hospitalized for COVID-19 infection.

Background: COVID-19 infection is generally regarded as an acute self-limiting illness in children, but it can cause significant morbidity and mortality in both healthy and high-risk children. There are limited data on the outcomes of children with congenital heart disease (CHD) and COVID-19. This study aimed to examine the risks of mortality, in-hospital cardiovascular and non-cardiovascular complications in this patient population.

The association between bronchopulmonary dysplasia grade and risks of adverse neurodevelopmental outcomes among preterm infants born at less than 30 weeks of gestation.

Background: Bronchopulmonary dysplasia (BPD) is a multifactorial disease with neurodevelopmental implications. This study aims to quantify the risks of adverse neurodevelopmental outcomes for each BPD grade among preterm infants born at less than 30 weeks' gestation.

Methods: We retrospectively studied infants who received care in our institution until at least 36 weeks postmenstrual age and had a formal neurodevelopmental assessment in our infant follow-up clinic using the Bayley Scales for Infant and Toddler Development (BSID).

Oxygenation index in the first three weeks of life is a predictor of bronchopulmonary dysplasia grade in very preterm infants.

Background: The new bronchopulmonary dysplasia (BPD) grading system was developed based on its correlation with long-term respiratory and neurodevelopmental outcomes and may provide better personalized prognostication. Identifying early-life predictors for accurate BPD grade prediction may allow interventions to be tailored to individual needs. This study aimed to assess whether oxygenation index (OI) dynamics in the first three weeks of life are a predictor of BPD grade.

Developing a machine learning-based tool to extend the usability of the NICHD BPD Outcome Estimator to the Asian population.

The NICHD BPD Outcome Estimator uses clinical and demographic data to stratify respiratory outcomes of extremely preterm infants by risk. However, the Estimator does not have an option in its pull-down menu for infants of Asian descent. We hypothesize that respiratory outcomes in extreme prematurity among various racial/ethnic groups are interconnected and therefore the Estimator can still be used to predict outcomes in infants of Asian descent.

Machine learning for prediction of bronchopulmonary dysplasia-free survival among very preterm infants.

Background: Bronchopulmonary dysplasia (BPD) is one of the most common and serious sequelae of prematurity. Prompt diagnosis using prediction tools is crucial for early intervention and prevention of further adverse effects. This study aims to develop a BPD-free survival prediction tool based on the concept of the developmental origin of BPD with machine learning.

Impaired Cell Cycle Progression and Self-Renewal of Fetal Neural Stem and Progenitor Cells in a Murine Model of Intrauterine Growth Restriction.

Individuals with intrauterine growth restriction (IUGR) are at an increased risk for neurodevelopmental impairment. Fetal cortical neurogenesis is a time-sensitive process in which fetal neural stem cells (NSCs) follow a distinct pattern of layer-specific neuron generation to populate the cerebral cortex. Here, we used a murine maternal hypoxia-induced IUGR model to study the impact of IUGR on fetal NSC development.

In-Hospital Outcomes in Fontan Completion Surgery According to Age.

Actual timing of the Fontan operation is variable. Our aim was to evaluate the impact of age at the time of Fontan operation on mortality and clinical outcome and characterize patients with worse outcomes. We conducted a retrospective, cross-sectional study on the Fontan operation using nationally representative databases from 2003 to 2016 and categorized the patient into 1 of 5 groups according to their age at the time of surgery: <2, 2, 3, 4, and ≥5 years.

Sex differences in postnatal weight gain trajectories of extremely preterm newborns.

Objective: Both postnatal growth and sex play a crucial role in long-term outcomes of extremely preterm newborns (EPNs), but the relationship between sex and postnatal growth is not clear. This study aims to assess sex differences in weight trajectories.

Study Design: Weight data in the first 200 days of life from 4327 EPNs were used for generalized additive mixed modeling.

Machine Learning for Mortality Prediction in Pediatric Myocarditis.

Pediatric myocarditis is a rare disease. The etiologies are multiple. Mortality associated with the disease is 5-8%.

Quantifying Fetal Reprogramming for Biomarker Development in the Era of High-Throughput Sequencing.

Gestational hypertensive disorders continue to threaten the well-being of pregnant women and their offspring. The only current definitive treatment for gestational hypertensive disorders is delivery of the fetus. The optimal timing of delivery remains controversial.

Identification of prognostic factors for pediatric myocarditis with a random forests algorithm-assisted approach.

Background: Pediatric myocarditis is a rare disease with substantial mortality. Little is known regarding its prognostic factors. We hypothesize that certain comorbidities and procedural needs may increase risks of poor outcomes.

Impact of congenital heart disease on outcomes among pediatric patients hospitalized for influenza infection.

Background: Young children and those with chronic medical conditions are at risk for complications of influenza including cardiopulmonary compromise. Here we aim to examine risks of mortality, clinical complications in children with congenital heart disease (CHD) hospitalized for influenza.

Methods: We analyzed data from in-hospital pediatric patients from 2003, 2006, 2009, 2012 and 2016 using the nationally representative Kids Inpatient Database (KID).

The SLC25A42 Transcript Is a Biomarker for Fetal Reprogramming in Response to Placental Insufficiency in Preterm Newborns Under 32 Weeks Gestation-A Pilot Study.

Timing of medical delivery of preterm newborns exposed to placental insufficiency is largely determined by umbilical artery blood flow and maternal clinical manifestations. There is a lack of tools to properly assess fetal body response to placental insufficiency before or upon delivery. Yet, short- and long-term comorbidities associated with placental insufficiency and the consequential intrauterine growth restriction may be a result of fetal response following prolonged stress.