Erik Allen Jensen

All Publications

• Evidence-based early-post natal approaches to limiting pulmonary disease in extremely low birth weight infants. Current opinion in pediatrics Kaluarachchi, D. C., Travers, C. P., Jensen, E. A. 2026

  Abstract

  PURPOSE OF REVIEW: Bronchopulmonary dysplasia (BPD) is a common complication among extremely low birth weight Infants. Evidence suggest that the incidence of BPD is increasing. This review examines current evidence-based strategies initiated early in life for prevention of BPD.RECENT FINDINGS: In this review of early life approaches for prevention of BPD, perinatal interventions, respiratory support strategies, surfactant therapy, pharmacological therapies, fluid management, patent ductus arteriosus management, nutrition, and dietary supplements are discussed.SUMMARY: There is no single effective strategy to prevent BPD in all at risk infants. Therefore, clinicians must use multifaceted evidence-based strategies, beginning during the perinatal period, to reduce the risk of developing BPD in preterm infants.

  View details for DOI 10.1097/MOP.0000000000001539

  View details for PubMedID 41531332

• Association between route of furosemide administration and diuretic response in very preterm infants with bronchopulmonary dysplasia. Research square Bamat, N., Huber, M., Morris, H., Nelin, T., Downes, K., O'Brien, A., Laskin, B., Jensen, E., DeMauro, S., Eichenwald, E., Lorch, S. 2025

  Abstract

  Furosemide is commonly prescribed in hospitalized infants with grade 2-3 bronchopulmonary dysplasia (BPD). Intravenous (IV), gastric, and duodenal administrations are common, with a 1:2 IV-to-enteral conversion often used despite uncertain bioavailability. Our objective was to compare diuretic responses between routes in infants with BPD.Single-center observational cohort of very preterm infants with grade 2-3 BPD prescribed furosemide. The association between route (exposure) and diuretic response (change in net fluid balance after administration, outcome) was evaluated using multivariable regression adjusting for dosing and infant characteristics.Among 153 infants (median postmenstrual age of 43.3 weeks at exposure), furosemide reduced fluid balance by -25.6 (29.8) ml/kg/d. Adjusted mean changes were similar across routes: IV, -25.3 (-35.8, -14.7), gastric, -25.8 (-32.2, -19.4), and duodenal, -25.8 (-34.2, -17.4).Our data suggest a 1:2 IV-to-enteralconversion leads to comparable diuretic effects in infants with established BPD, supporting this common clinical practice.

  View details for DOI 10.21203/rs.3.rs-8197255/v1

  View details for PubMedID 41377981

  View details for PubMedCentralID PMC12687830

• Prognostic Accuracy of BPD Definitions for Long-Term Outcomes in Preterm Infants: A Systematic Review. Pediatrics Katz, T. A., de Ridder, R., Bancalari, E., Higgins, R. D., Isayama, T., Jensen, E. A., Offringa, M., Pillow, J. J., Shah, P. S., Soll, R. F., Stoecklin, B., Daams, J. G., van Kaam, A. H., Onland, W., Mugie, S. M. 2025

  Abstract

  Since the first description of bronchopulmonary dysplasia (BPD), multiple definitions to diagnose BPD and its grading have been published. Several studies have compared the predictive performance of these definitions for long-term outcomes. The objective was to identify the BPD definition with the optimal predictive performance for long-term respiratory and neurological outcomes in preterm infants.An electronic search identified studies in Medline and Embase from inception to August 2024. Studies assessing the performance of one or more BPD definitions for predicting long-term respiratory and/or neurological outcomes were included. We used the Quality in Prognostic Studies (QUIPS) tool for bias assessment. Reported prognostic accuracy of 5 BPD definitions (the 1988 Shennan, the 2001 National Institutes of Health [NIH], the 2017 Canadian Neonatal Network, the 2018 NIH, and the 2019 Neonatal Research Network definition) was tabulated using specificity, sensitivity, C statistic, risk, or odds ratio.Of the 6045 identified studies, 18 were included. Heterogeneity between studies resulted in inconsistent prognostic accuracy for long-term outcomes. The 2001 NIH definition showed higher prognostic accuracy for respiratory and neurological outcomes compared with the 1988 Shennan BPD definition. Only 5 studies showed a low to moderate risk of bias, and a sensitivity analysis confirmed the results. The limitations included challenges in comparing studies due to population heterogeneity and outcome definitions.This systematic review shows that comparisons between the 2001 NIH definition and newer BPD definitions yield inconsistent results for predicting long-term outcomes. None of the current BPD definitions consistently provided sufficient prognostic accuracy for long-term respiratory and neurodevelopmental sequelae in very preterm infants.

  View details for DOI 10.1542/peds.2025-070741

  View details for PubMedID 41083181

• Bronchopulmonary dysplasia, pulmonary hypertension, and neonatal gastroesophageal reflux: Association, causation, or neither? Seminars in perinatology Jensen, E. A. 2025: 152158

  Abstract

  Bronchopulmonary dysplasia (BPD) is among the most common and serious complications of prematurity. The pathobiology of BPD and BPD associated pulmonary arterial hypertension (BPD-PH) is multifactorial and not yet fully defined. Gastroesophageal reflux (GER), a physiologic process that occurs in most preterm infants and is typically benign, has been proposed as a potential contributor to the development or worsening of BPD and BPD-PH. Infants who develop BPD compared to those who do not are more frequently diagnosed with symptomatic GER and undergo therapeutic interventions to treat GER. However, current evidence does not support a direct causal relationship between GER and the onset or progression of BPD or BPD-PH in preterm infants. While GER may contribute to respiratory morbidity in individual cases, population-level data do not implicate it as a major driver of BPD pathogenesis. Moreover, the limited available data from clinical trials and observational studies does not consistently demonstrate improved outcomes in patients with BPD who are treated for GER. This narrative review summarizes the current literature evaluating the relationship between GER, BPD, and BPD-PH.

  View details for DOI 10.1016/j.semperi.2025.152158

  View details for PubMedID 41006081

• Use of hydrocortisone in extremely preterm infants: emphasis on those born least mature. Journal of perinatology : official journal of the California Perinatal Association Jensen, E. A., Rysavy, M. A., Kusuda, S. 2025

  Abstract

  The steroid hormone cortisol plays crucial roles in innate stress response, downregulation of inflammation, and promotion of glucose homeostasis. Infants born extremely preterm may be prone to cardiovascular compromise and inflammation-mediated respiratory disease due in part to insufficient cortisol production. Current data show that hydrocortisone, the exogenous medication form of cortisol, may help prevent or treat complications associated with relative adrenal insufficiency, although the full balance of treatment risks and benefits is uncertain. Prophylactic administration of hydrocortisone beginning in the first 1-2 postnatal days in extremely preterm infants likely results in earlier initial weaning from invasive ventilation and may reduce in-hospital mortality and the composite outcome of death or bronchopulmonary dysplasia (BPD). However, such use may increase the risk of sepsis in infants born less than 26 weeks' gestation and gastrointestinal perforation with concurrent exposure to indomethacin. Whether prophylactic hydrocortisone affects childhood neurodevelopment has not been adequately studied. Initiation of hydrocortisone after the first postnatal week in infants receiving invasive ventilation promotes successful extubation but does not affect risks of mortality, BPD, or neurodevelopmental impairment. In extremely preterm infants with hypotension, hydrocortisone can increase blood pressure, but short- and long-term safety for this indication and usefulness compared to other anti-hypotensive agents are not well established.

  View details for DOI 10.1038/s41372-025-02424-9

  View details for PubMedID 40975716

  View details for PubMedCentralID 4662771

• Bronchopulmonary Dysplasia in Asian American, Native Hawaiian, and Pacific Islander Infants with Very Low Birth Weight in California. The Journal of pediatrics Hendra, K., Cui, X., Main, E., Lee, H. C., Lin Gomez, S., Shariff-Marco, S., Jensen, E. A., Profit, J. 2025: 114706

  Abstract

  To characterize incidences of bronchopulmonary dysplasia (BPD) and oxygen use at discharge in infants with very low birth weight (VLBW) by Asian American, Native Hawaiian, and Pacific Islander (AANHPI) ethnicity.We studied infants with VLBW born in California from 2012-2019. Infants of AANHPI mothers were studied in aggregate, were disaggregated by maternal ethnicity, and were compared with infants of Black, Hispanic, and Non-Hispanic White (NHW) mothers. BPD was defined as the use of supplemental oxygen at 36 weeks postmenstrual age. Multivariable generalized estimating equation Poisson regression models adjusting for infant, maternal, and hospital-level factors compared outcomes across racial and ethnic groups using NHW as the reference.We studied 29,467 infants whose mothers self-identified as AANHPI (n=5,002), Black (n=3,711), Hispanic (n=14,168), and NHW (n=6,586). In infants of AANHPI mothers, incidences of BPD and oxygen use at discharge were 24.9% (disaggregated range: 16.9%-30.5%) and 9.2% (disaggregated range: 5.8%-14.5%), respectively. Compared with infants of NHW mothers, infants of Asian Indian mothers had a significantly lower risk of BPD (adjusted relative risk [aRR] 0.71) and oxygen use at discharge (aRR 0.66), whereas infants of Chinese and Korean mothers had a significantly higher risk of BPD (aRR 1.28 and aRR 1.45, respectively) and oxygen use at discharge (aRR 1.46 and aRR 1.77, respectively).AANHPI data disaggregation demonstrated variability in incidences of BPD and oxygen use at discharge, and variability in risk compared with infants of NHW mothers. Our study highlights disparities across this diverse group that is typically studied in aggregate.

  View details for DOI 10.1016/j.jpeds.2025.114706

  View details for PubMedID 40581095

• Gastroesophageal reflux during postpyloric versus gastric tube feeding in preterm infants with bronchopulmonary dysplasia. Journal of perinatology : official journal of the California Perinatal Association Jensen, E. A., Orians, C. M., Gibbs, K., Ryan, M. 2025

  Abstract

  BACKGROUND: Whether postpyloric feeding reduces gastroesophageal reflux (GER) in very preterm infants with bronchopulmonary dysplasia (BPD) is uncertain.METHODS: Prospective observational study comparing GER profiles measured using 24-h esophageal pH-impedance monitoring in infants with BPD receiving clinically prescribed postpyloric (n=21) or gastric (n=24) tube feeding.RESULTS: Participants (median gestational age 25.0 weeks, IQR 24.1-26.9) underwent testing at a median postmenstrual age of 46.6 weeks (IQR 42.7-52.4). The number of GER episodes recorded by impedance varied widely (median 27, range 1-195). Postpyloric versus gastric feeding was associated with fewer GER episodes (median, IQR: 16, 5-41 vs. 40, 19-60; p=0.07) and less exposure of the proximal esophagus to reflux (median duration, IQR: 0.1min, 0.005-0.6 vs. 0.77min, 0.16-1.8; p=0.045), but a higher proportion of acidic (pH<4) GER episodes (median, IQR: 91%, 70-100 vs. 31%, 16-54; p<0.001).CONCLUSION: Postpyloric feeding may reduce total GER burden but increase the relative proportion of acidic GERin infants with BPD.

  View details for DOI 10.1038/s41372-025-02301-5

  View details for PubMedID 40210988

• Systemic Corticosteroids to Prevent Bronchopulmonary Dysplasia: Balancing Risk and Reward. JAMA pediatrics Jensen, E. A. 2024

  View details for DOI 10.1001/jamapediatrics.2024.4572

  View details for PubMedID 39556388

• Intratracheal Budesonide Combined With Surfactant in Extremely Preterm Infants. JAMA Jensen, E. A. 2024

  View details for DOI 10.1001/jama.2024.19641

  View details for PubMedID 39527043

• Respiratory Outcomes of Infants Born Extremely Preterm in the Necrotizing Enterocolitis Surgery Trial. The Journal of pediatrics DeMauro, S. B., Jensen, E. A., McDonald, S. A., Hintz, S., Tyson, J., Stevenson, D. K., Blakely, M. L. 2024: 114391

  Abstract

  The multicenter Necrotizing Enterocolitis Surgery Trial compared initial peritoneal drainage with laparotomy among infants with extremely low birth weight and surgical necrotizing enterocolitis or intestinal perforation. In this post hoc analysis of trial data, initial drainage was associated with adverse respiratory outcomes, both in hospital and through 2 years corrected age.

  View details for DOI 10.1016/j.jpeds.2024.114391

  View details for PubMedID 39521175

• Heterogeneity of Treatment Effects of Hydrocortisone by Risk of Bronchopulmonary Dysplasia or Death Among Extremely Preterm Infants in the National Institute of Child Health and Human Development Neonatal Research Network Trial: A Secondary Analysis of a Randomized Clinical Trial. JAMA network open Gentle, S. J., Rysavy, M. A., Li, L., Laughon, M. M., Patel, R. M., Jensen, E. A., Hintz, S., Ambalavanan, N., Carlo, W. A., Watterberg, K. 2023; 6 (5): e2315315

  Abstract

  Extremely preterm infants who develop bronchopulmonary dysplasia (BPD) are at a higher risk for adverse pulmonary and neurodevelopmental outcomes. In the National Institute of Child Health and Human Development Neonatal Research Network (NICHD NRN) Hydrocortisone Trial, hydrocortisone neither reduced rates of BPD or death nor increased rates of neurodevelopmental impairment (NDI) or death.To determine whether estimated risk for grades 2 to 3 BPD or death is associated with the effect of hydrocortisone on the composite outcomes of (1) grades 2 to 3 BPD or death and (2) moderate or severe NDI or death.This secondary post hoc analysis used data from the NICHD NRN Hydrocortisone Trial, which was a double-masked, placebo-controlled, randomized clinical trial conducted in 19 US academic centers. The NICHD HRN Hydrocortisone Trial enrolled infants born at a gestational age of less than 30 weeks who received mechanical ventilation for at least 7 days, including at the time of enrollment, and who were aged 14 to 28 postnatal days. Infants were enrolled between August 22, 2011, and February 4, 2018, with follow-up between 22 and 26 months of corrected age completed on March 29, 2020. Data were analyzed from September 13, 2021, to March 25, 2023.Infants were randomized to 10 days of hydrocortisone or placebo treatment.Infants' baseline risk of grades 2 to 3 BPD or death was estimated using the NICHD Neonatal BPD Outcome Estimator. Differences in absolute and relative treatment effects by baseline risk were evaluated using interaction terms in models fitted to the efficacy outcome of grades 2 to 3 BPD or death and the safety outcome of moderate or severe NDI or death by follow-up.Among the 799 infants included in the analysis (421 boys [52.7%]), the mean (SD) gestational age was 24.9 (1.5) weeks, and the mean (SD) birth weight was 715 (167) g. The mean estimated baseline risk for grades 2 to 3 BPD or death was 54% (range, 18%-84%) in the study population. The interaction between treatment group and baseline risk was not statistically significant on a relative or absolute scale for grades 2 to 3 BPD or death; the size of the effect ranged from a relative risk of 1.13 (95% CI, 0.82-1.55) in quartile 1 to 0.94 (95% CI, 0.81-1.09) in quartile 4. Similarly, the interaction between treatment group and baseline risk was not significant on a relative or absolute scale for moderate or severe NDI or death; the size of the effect ranged from a relative risk of 1.04 (95% CI, 0.80-1.36) in quartile 1 to 0.99 (95% CI, 0.80-1.22) in quartile 4.In this secondary analysis of a randomized clinical trial, the effect of hydrocortisone vs placebo was not appreciably modified by baseline risk for grades 2 to 3 BPD or death.ClinicalTrials.gov Identifier: NCT01353313.

  View details for DOI 10.1001/jamanetworkopen.2023.15315

  View details for PubMedID 37256621

• Duration of noninvasive respiratory support and risk for bronchopulmonary dysplasia or death JOURNAL OF PERINATOLOGY Gentle, S. J., Carper, B., Laughon, M. M., Jensen, E. A., Williams, A., Travers, C. P., Ambalavanan, N., Lal, C., Carlo, W. A., Polin, R. A., Laptook, A. R., Keszler, M., Hensman, A. M., Vieira, E., Little, E., St Pierre, L., Walsh, M. C., Hibbs, A., Newman, N. S., Truog, W. E., Pallotto, E. K., Kilbride, H. W., Gauldin, C., Holmes, A., Johnson, K., Parimi, P. S., Gaetano, L., Poindexter, B. B., Schibler, K., Merhar, S. L., Alexander, B., Grisby, C., Kirker, K., Cotten, C., Goldberg, R. N., Finkle, J., Fisher, K. A., Bose, C. L., Bernhardt, J., Bose, G., Clark, C., Kicklighter, S. D., Rhodes-Ryan, G., White, D., Carlton, D. P., Stoll, B. J., Patel, R. M., Loggins, Y., Hale, E. C., Bottcher, D., Mackie, C., Bremer, A. A., Higgins, R. D., Archer, S., Sokol, G. M., Herron, D. E., Joyce, J., Tyson, J. E., Khan, A. M., Kennedy, K. A., Eason, E., Stephens, E. K., McDavid, G. E., Arldt-McAlister, J., Burson, K., Garcia, C., Hall, D., Martin, K., Martin, S. C., Rodgers, S., Tate, P., Wright, S. L., Sanchez, P. J., Nelin, L. D., Jadcherla, S. R., Luzader, P., Clark, E., Fortney, C. A., Gutentag, J., Park, C., Shadd, J. C., Stein, M., Grothause, J. L., Baugher, H., Yosseff-Salameh, L., McCool, J., Das, A., Gantz, M. G., Bann, C. M., Wallace, D., Crawford, M., Gabrio, J., Leblond, D., Auman, J., Huitema, C., Zaterka-Baxter, K. M., Van Meurs, K. P., Chock, V. Y., Stevenson, D. K., Ball, M., Proud, M. S., Reichert, E. N., Williams, R., Collins, M., Cosby, S. S., McNair, T., Estes, M., Hagood, K., Devaskar, U., Garg, M., Chanlaw, T., Geller, R., Bell, E. F., Colaizy, T. T., Baack, M. L., Ellsbury, D. L., Brumbaugh, J. E., Johnson, K. J., Henning, M. M., Elenkiwich, C., Goeke, C. A., Broadbent, M., Hogden, L. A., Klein, J. M., Dagle, J. M., Schmelzel, M. L., Walker, J. R., Bass, D. B., Tud, T. L., Watterberg, K. L., Fuller, J., Ohls, R. K., Lacy, C., Beauman, S., Hartenberger, C., Hanson, M., Kuan, E., Eichenwald, E. C., Schmidt, B., Kirpalani, H., DeMauro, S. B., Abbasi, S., Catts, C., Chaudhary, A. S., Ghavam, S., Mancini, T., Snyder, J., D'Angio, C. T., Guillet, R., Reynolds, A., Lakshminrusimha, S., Kent, A., Binion, K., Bowman, M., Donato, J., Guilford, S., Hunn, J., Jensen, R. L., Li, E., Maffett, D., Orme, C., Prinzing, D., Reubens, L., Rochez, D., Rowan, M., Sabaratnam, P., Sacilowski, M., Scorsone, A., Wadkins, H. I. M., Williams, A., Wynn, K., Jones, R., Wyckoff, M., Brion, L. P., Vasil, D. M., Chen, L., DeLeon, M. M., Eubanks, F., Pavageau, L., Sepulveda, P., Yoder, B. A., Baserga, M., Minton, S. D., Sheffield, M. J., Rau, C. A., Burnett, J., Davis, B., Christensen, S., Loertscher, M. C., Marchant, T., Maxson, E., McGrath, K., Elmont, J. O., Parry, M., Schaefer, S. T., Weaver-Lewis, K., Woodbury, K. D., Shankaran, S., Natarajan, G., Chawla, S., Sood, B. G., Childs, K., Panaitescu, B., Bara, R., Barks, J., Christensen, M. K., Wiggins, S. A., White, D. F., NICHD Neonatal Res Network 2022

  Abstract

  To determine whether the duration of noninvasive respiratory support exposure is associated with bronchopulmonary dysplasia (BPD) or death in preterm infants.Multicenter, retrospective study of infants born at <29 weeks' gestation. The association between days on noninvasive respiratory support and BPD or death was determined using instrumental variable techniques and generalized propensity score matching to account for potential confounding by illness severity.Among 6268 infants 36% developed BPD or died. The median duration of noninvasive respiratory support was 18 days. There was inconsistency in the association between noninvasive support and BPD or death when analyzed by instrumental variable techniques (Average Marginal Effect -0.37; 95% CI -1.23 to 0.50) and generalized propensity score matching (Average Marginal Effect 0.46; 95% CI 0.33 to 0.60).Findings on the association between duration of exposure to noninvasive respiratory support and the development of BPD or death were inconclusive. CLINICALTRIALS.Generic Database:NCT00063063.

  View details for DOI 10.1038/s41372-021-01269-2

  View details for Web of Science ID 000742796200001

  View details for PubMedID 35034096

• Blanket temperature during therapeutic hypothermia and outcomes in hypoxic ischemic encephalopathy JOURNAL OF PERINATOLOGY Flibotte, J., Laptook, A. R., Shankaran, S., McDonald, S. A., Baserga, M. C., Bell, E. F., Cotten, C., Das, A., DeMauro, S. B., DuPont, T. L., Eichenwald, E. C., Heyne, R., Jensen, E. A., Van Meurs, K. P., Dysart, K., Eunice Kennedy Shriver Natl Inst C, Human Dev Neonatal Res Network 2022

  Abstract

  Determine whether blanket temperatures during therapeutic hypothermia (TH) are associated with 18-22 month outcomes for infants with hypoxic ischemic encephalopathy (HIE).Retrospective cohort study of 181 infants with HIE who received TH in two randomized trials within the Neonatal Research Network. We defined summative blanket temperature constructs and evaluated for association with a primary composite outcome of death or moderate/ severe disability at 18-22 months.Each 0.5 °C above 33.5 °C in the mean of the highest quartile blanket temperature was associated with a 52% increase in the adjusted odds of death/ disability (aOR 1.52, 95% CI 1.09-2.11). Having >8 consecutive blanket temperatures above 33.5 °C rendered an aOR of death/disability of 5.04 in the first 24 h (95% CI 1.54-16.6) and 6.92 in the first 48 h (95% CI 2.20-21.8) of TH.Higher blanket temperature during TH may be an early, clinically useful biomarker of HIE outcome.

  View details for DOI 10.1038/s41372-021-01302-4

  View details for Web of Science ID 000740402100001

  View details for PubMedID 34999716

• Performance Evaluation of Nasal Prong Interface for CPAP Delivery on a Critical Care Ventilator: A Bench Experiment. Respiratory care Napolitano, N., Roberts, T., Nickel, A. J., McDonough, J., Sun, H., Feng, R., Jensen, E. A., Dysart, K., Lin, R. 2021

  Abstract

  BACKGROUND: The RAM cannula (Neotech, Valencia, CA) has become a commonly used interface for CPAP in neonatal intensive care. Performance characteristics of this interface used with a critical care ventilator are not well described.METHODS: This was a bench study utilizing a lung simulator configured as an actively breathing infant (weights of 800 g, 1.5 kg, and 3 kg) with moderate lung disease and a critical care ventilator in CPAP mode with leak compensation on. Three sizes of the RAM cannulae (preemie, newborn, and infant) were compared to 3 BabyFlow nasal prongs (Drager Medical, Lubeck, Germany) (medium, large, and extra-large). Fabricated nasal models produced a 70% occlusive fit for the RAM cannula and an occlusive fit with the Drager prongs. Delivered flow and pressure levels were recorded at 9 CPAP levels between 5 and 20 cm H2O.RESULTS: The Drager prongs produced a mean airway pressure (Paw) within 0.20 cm H2O (range -0.10 to 0.35) of the set CPAP across all evaluated prong sizes and CPAP levels. In contrast, the RAM cannula produced Paw values that averaged 8.5 cm H2O (range -15 to -3.5) below the set CPAP levels. The deficit in delivered versus target CPAP level for the RAM cannula increased with greater set CPAP. Set CPAP of 5 cm H2O delivered Paw values that ranged from 0.6 to 1.5 cm H2O (difference of 3.5-4.4 cm H2O). Set CPAP of 20 cm H2O delivered Paw values that ranged from 5.0 to 8.4 cm H2O (difference of 11.7-15 cm H2O). Inspiratory flow required to achieve set CPAP levels did not differ between interfaces, suggesting high resistance in the RAM cannula device masks the delivered CPAP levels.CONCLUSIONS: Use of the RAM cannula with a 30% leak on a critical care ventilator delivered Paw values lower than set CPAP. This may be clinically meaningful and should be considered when choosing a nasal interface.

  View details for DOI 10.4187/respcare.09018

  View details for PubMedID 34230212

• Timing of postnatal steroids for bronchopulmonary dysplasia: association with pulmonary and neurodevelopmental outcomes JOURNAL OF PERINATOLOGY Harmon, H. M., Jensen, E. A., Tan, S., Chaudhary, A. S., Slaughter, J. L., Bell, E. F., Wyckoff, M. H., Hensman, A. M., Sokol, G. M., DeMauro, S. B., Caplan, M. S., Laptook, A. R., Keszler, M., Vohr, B. R., Alksninis, B., Basso, K. M., Burke, R., Caskey, M., Johnson, K., Keszler, M., Knoll, A. M., Leach, T. M., Little, E., McGowan, E. C., Vieira, E., Watson, V. E., Ventura, S., Walsh, M. C., Hibbs, A., Wilson-Costello, D. E., Newman, N. S., Payne, A. H., Siner, B. S., Bhola, M., Yalcinkaya, G., Truog, W. E., Pallotto, E. K., Kilbride, H. W., Gauldin, C., Holmes, A., Johnson, K., Scott, A., Schibler, K., Donovan, E. F., Grisby, C., Bridges, K., Alexander, B., Fischer, E. E., Mincey, H. L., Hessling, J., Gratton, T. L., Jackson, L., Kirker, K., Muthig, G., Steichen, J. J., Tepe, S., Yolton, K., Goldberg, R. N., Cotten, C., Goldstein, R. F., Ashley, P. L., Malcolm, W. F., Auten, K. J., Fisher, K. A., Grimes, S., Gustafson, K. E., Lohmeyer, M. B., Finkle, J., Laughon, M. M., Bose, C. L., Bernhardt, J., Bose, G., Warner, D., Wereszczak, J., Carlton, D. P., Stoll, B. J., Adams-Chapman, I., Hale, E. C., Loggins, Y., Blackwelder, A., Wineski, L. C., LaRossa, M., Carter, S. L., Higgins, R. D., Archer, S., Poindexter, B. B., Dusick, A. M., Papile, L., Gunn, S., Hamer, F., Herron, D. E., Hines, A. C., Lytle, C., Minnich, H. M., Smiley, L., Wilson, L., Kennedy, K. A., Tyson, J. E., McDavid, G. E., Alaniz, N., Arldt-McAlister, J., Burson, K., Dempsey, A. G., Duncan, A. F., Evans, P. W., Green, C. E., Harris, B., Jiminez, M., John, J., Jones, P. M., Lillie, L. M., Lis, A. E., Martin, S. C., Morris, B. H., Poundstone, M., Rodgers, S., Siddiki, S., Simmons, M. C., Sperry, D., Tate, P., Wright, S. L., Sanchez, P. J., Nelin, L. D., Jadcherla, S. R., Luzader, P., Fortney, C. A., Besner, G. E., Parikh, N. A., Das, A., Wallace, D., Gantz, M. G., Poole, W., Newman, J. E., Auman, J., Crawford, M. M., Gabrio, J., Huitema, C., Zaterka-Baxter, K. M., Van Meurs, K. P., Stevenson, D. K., Hintz, S. R., Ball, M., Davis, A. S., Palmquist, A. W., Proud, M. S., Bentley, B., Bruno, E., DeAnda, M., DeBattista, A. M., Earhart, B., Huffman, L. C., Kohn, J. G., Krueger, C., Weiss, H. E., Frantz, I. D., Fiascone, J. M., MacKinnon, B. L., Furey, A., Nylen, E., Sibley, C. E., Brussa, A. K., Carlo, W. A., Ambalavanan, N., Peralta-Carcelen, M., Collins, M., Cosby, S. S., Biasini, F. J., Johnston, K. C., Nelson, K. G., Patterson, C. S., Phillips, V. A., Whitley, S., Devaskar, U., Garg, M., Purdy, I. B., Chanlaw, T., Geller, R., Finer, N. N., Vaucher, Y. E., Kaegi, D., Rasmussen, M. R., Arnell, K., Demetrio, C., Fuller, M. G., Rich, W., Colaizy, T. T., Acarregui, M. J., Brumbaugh, J. E., Ellsbury, D. L., Widness, J. A., Johnson, K. J., Campbell, D. B., Eastman, D. L., Walker, J. R., Duara, S., Bauer, C. R., Everett-Thomas, R., Fajardo-Hiriart, S., Rigaud, A., Calejo, M., Eguaras, S., Berkowits, M., Garcia, A., Pierre, H., Stoerger, A., Watterberg, K. L., Lowe, J. R., Fuller, J. F., Ohls, R. K., Lacy, C., Montman, R., Beauman, S., Schmidt, B., Kirpalani, H., Abbasi, S., Mancini, T., Cucinotta, D. M., Bernbaum, J. C., Gerdes, M., Hurt, H., D'Angio, C. T., Phelps, D. L., Guillet, R., Lakshminrusimha, S., Johnson, J., Reubens, L. J., Horihan, C. A., Hust, D., Jensen, R. L., Kushner, E., Merzbach, J., Myers, G. J., Wadkins, H. I. M., Guilford, S., Maffett, D., Farooq, O., Prinzing, D., Reynolds, A., Rowan, M., Sacilowski, M. G., Williams, A., Wynn, K., Yost, K., Zorn, W., Zwetsch, L., Brion, L. P., Heyne, R. J., Salhab, W. A., Rosenfeld, C. R., Vasil, D. M., Chen, L., Guzman, A., Hensley, G., Leps, M. H., Miller, N. A., Morgan, J. S., Adams, S. S., Boatman, C., Heyne, E. T., Madden, L. A., Lee, L. E., Faix, R. G., Yoder, B. A., Osborne, K. A., Spencer, C., Weaver-Lewis, K., Baker, S., Bird, K., Burnett, J., Steffen, M., Jensen, J. J., Winter, S., Zanetti, K., O'Shea, T., Dillard, R. G., Washburn, L. K., Jackson, B. G., Peters, N., Chiu, K., Allred, D., Goldstein, D. J., Halfond, R., Peterson, C., Waldrep, E. L., Welch, C. D., Morris, M., Hounshell, G., Shankaran, S., Pappas, A., Barks, J., Bara, R., Goldston, L. A., Natarajan, G., Bajaj, M., Chawla, S., De Jesus, L. C., Sood, B. G., Christensen, M., Wiggins, S. A., White, D., Ehrenkranz, R. A., Jacobs, H., Butler, C. G., Cervone, P., Greisman, S., Konstantino, M., Poulsen, J., Taft, J., Williams, J., Romano, E., Eunice Kennedy Shriver Natl Inst 2020

  Abstract

  To determine the associations between age at first postnatal corticosteroids (PNS) exposure and risk for severe bronchopulmonary dysplasia (BPD) and neurodevelopmental impairment (NDI).Cohort study of 951 infants born <27 weeks gestational age at NICHD Neonatal Research Network sites who received PNS between 8 days of life (DOL) and 36 weeks' postmenstrual age was used to produce adjusted odds ratios (aOR).Compared with infants in the reference group (22-28 DOL-lowest rate), aOR for severe BPD was similar for children given PNS between DOL 8 and 49 but higher among infants treated at DOL 50-63 (aOR 1.77, 95% CI 1.03-3.06), and at DOL ≥64 (aOR 3.06, 95% CI 1.44-6.48). The aOR for NDI did not vary significantly by age of PNS exposure.For infants at high risk of BPD, initial PNS should be considered prior to 50 DOL for the lowest associated odds of severe BPD.

  View details for DOI 10.1038/s41372-020-0594-4

  View details for Web of Science ID 000511094300001

  View details for PubMedID 32020038

• Gastrostomy Tube Feeding in Extremely Low Birthweight Infants: Frequency, Associated Comorbidities, and Long-term Outcomes JOURNAL OF PEDIATRICS Warren, M. G., Do, B., Das, A., Smith, P., Adams-Chapman, I., Jadcherla, S., Jensen, E. A., Goldstein, R. F., Goldberg, R. N., Cotten, C., Bell, E. F., Malcolm, W. F., Caplan, M. S., Laptook, A. R., Keszler, M., Vohr, B. R., Hensman, A. M., Alksninis, B., Basso, K. M., Burke, R., Caskey, M., Johnson, K., Keszler, M., Knoll, A. M., Leach, T. M., Little, E., McGowan, E. C., Vieira, E., Watson, V. E., Ventura, S., Walsh, M. C., Hibbs, A., Wilson-Costello, D. E., Newman, N. S., Payne, A. H., Siner, B. S., Bhola, M., Yalcinkaya, G., Truog, W. E., Pallotto, E. K., Kilbride, H. W., Gauldin, C., Holmes, A., Johnson, K., Scott, A., Schibler, K., Donovan, E. F., Grisby, C., Bridges, K., Alexander, B., Fischer, E. E., Mincey, H. L., Hessling, J., Gratton, T. L., Jackson, L., Kirker, K., Muthig, G., Steichen, J. J., Tepe, S., Yolton, K., Ashley, P. L., Auten, K. J., Fisher, K. A., Grimes, S., Gustafson, K. E., Lohmeyer, M. B., Finkle, J., Laughon, M. M., Bose, C. L., Bernhardt, J., Bose, G., Warner, D., Wereszczak, J., Carlton, D. P., Stoll, B. J., Hale, E. C., Loggins, Y., Blackwelder, A., Wineski, L. C., LaRossa, M., Carter, S. L., Higgins, R. D., Archer, S., Sokol, G. M., Poindexter, B. B., Dusick, A. M., Papile, L., Gunn, S., Hamer, F., Harmon, H. M., Herron, D. E., Hines, A. C., Lytle, C., Minnich, H. M., Smiley, L., Wilson, L., Kennedy, K. A., Tyson, J. E., McDavid, G. E., Alaniz, N., Arldt-McAlister, J., Burson, K., Dempsey, A. G., Duncan, A. F., Evans, P. W., Green, C. E., Harris, B., Jiminez, M., John, J., Jones, P. M., Lillie, L. M., Lis, A. E., Martin, S. C., Morris, B. H., Poundstone, M., Rodgers, S., Siddiki, S., Simmons, M. C., Sperry, D., Tate, P., Wright, S. L., Sanchez, P. J., Nelin, L. D., Luzader, P., Fortney, C. A., Besner, G. E., Parikh, N. A., Wallace, D., Gantz, M. G., Poole, W., Newman, J. E., Auman, J., Crawford, M. M., Gabrio, J., Huitema, C., Zaterka-Baxter, K. M., Van Meurs, K. P., Stevenson, D. K., Hintz, S. R., Ball, M., Davis, A. S., Palmquist, A. W., Proud, M. S., Bentley, B., Bruno, E., DeAnda, M., DeBattista, A. M., Earhart, B., Huffman, L. C., Kohn, J. G., Krueger, C., Weiss, H. E., Frantz, I. D., Fiascone, J. M., MacKinnon, B. L., Furey, A., Nylen, E., Sibley, C. E., Brussa, A. K., Carlo, W. A., Ambalavanan, N., Peralta-Carcelen, M., Collins, M., Cosby, S. S., Biasini, F. J., Johnston, K. C., Nelson, K. G., Patterson, C. S., Phillips, V. A., Whitley, S., Devaskar, U., Garg, M., Purdy, I. B., Chanlaw, T., Geller, R., Finer, N. N., Vaucher, Y. E., Kaegi, D., Rasmussen, M. R., Arnell, K., Demetrio, C., Fuller, M. G., Rich, W., Colaizy, T. T., Acarregui, M. J., Brumbaugh, J. E., Ellsbury, D. L., Widness, J. A., Johnson, K. J., Campbell, D. B., Eastman, D. L., Walker, J. R., Duara, S., Bauer, C. R., Everett-Thomas, R., Fajardo-Hiriart, S., Rigaud, A., Calejo, M., Eguaras, S., Berkowits, M., Garcia, A., Pierre, H., Stoerger, A., Watterberg, K. L., Lowe, J. R., Fuller, J. F., Ohls, R. K., Lacy, C., Montman, R., Beauman, S., Schmidt, B., Kirpalani, H., DeMauro, S. B., Chaudhary, A. S., Abbasi, S., Mancini, T., Cucinotta, D. M., Bernbaum, J. C., Gerdes, M., Hurt, H., D'Angio, C. T., Phelps, D. L., Guillet, R., Lakshminrusimha, S., Johnson, J., Reubens, L. J., Horihan, C. A., Hust, D., Jensen, R. L., Kushner, E., Merzbach, J., Myers, G. J., Wadkins, H. I. M., Guilford, S., Maffett, D., Farooq, O., Prinzing, D., Reynolds, A., Rowan, M., Sacilowski, M. G., Williams, A., Wynn, K., Yost, K., Zorn, W., Zwetsch, L., Wyckoff, M. H., Brion, L. P., Heyne, R. J., Salhab, W. A., Rosenfeld, C. R., Vasil, D. M., Chen, L., Guzman, A., Hensley, G., Leps, M. H., Miller, N. A., Morgan, J. S., Adams, S. S., Boatman, C., Heyne, E. T., Madden, L. A., Lee, L. E., Faix, R. G., Yoder, B. A., Osborne, K. A., Spencer, C., Weaver-Lewis, K., Baker, S., Bird, K., Burnett, J., Steffen, M., Jensen, J. J., Winter, S., Zanetti, K., O'Shea, T., Dillard, R. G., Washburn, L. K., Jackson, B. G., Peters, N., Chiu, K., Allred, D., Goldstein, D. J., Halfond, R., Peterson, C., Waldrep, E. L., Welch, C. D., Morris, M., Hounshell, G., Shankaran, S., Pappas, A., Barks, J., Bara, R., Goldston, L. A., Natarajan, G., Bajaj, M., Chawla, S., De Jesus, L. C., Sood, B. G., Christensen, M., Wiggins, S. A., White, D., Ehrenkranz, R. A., Jacobs, H., Butler, C. G., Cervone, P., Greisman, S., Konstantino, M., Poulsen, J., Taft, J., Williams, J., Romano, E., Eunice Kennedy Shriver Natl Inst 2019; 214: 41-+

  Abstract

  To assess the frequency of gastrostomy tube (GT) placement in extremely low birth weight (ELBW) infants, associated comorbidities, and long-term outcomes.Analysis of ELBW infants from 25 centers enrolled in the National Institute of Child Health and Human Development Neonatal Research Network's Generic Database and Follow-up Registry from 2006 to 2012. Frequency of GT placement before 18-22 months, demographic and medical factors associated with GT placement, and associated long-term outcomes at 18-22 months of corrected age were described. Associations between GT placement and neonatal morbidities and long-term outcomes were assessed with logistic regression after adjustment for center and common co-variables.Of the 4549 ELBW infants included in these analyses, 333 (7.3%) underwent GT placement; 76% had the GT placed postdischarge. Of infants with GTs, 11% had birth weights small for gestational age, 77% had bronchopulmonary dysplasia, and 29% severe intraventricular hemorrhage or periventricular leukomalacia. At follow-up, 56% of infants with a GT had weight <10th percentile, 61% had neurodevelopmental impairment (NDI), and 55% had chronic breathing problems. After adjustment, small for gestational age, bronchopulmonary dysplasia, intraventricular hemorrhage/periventricular leukomalacia, poor growth, and NDI were associated with GT placement. Thirty-two percent of infants with GTs placed were taking full oral feeds at follow-up.GT placement is common in ELBW infants, particularly among those with severe neonatal morbidities. GT placement in this population was associated with poor growth, NDI, and chronic respiratory and feeding problems at follow-up. The frequency of GT placement postneonatal discharge indicates the need for close nutritional follow-up of ELBW infants.ClinicalTrials.gov: NCT00063063.

  View details for DOI 10.1016/j.jpeds.2019.06.066

  View details for Web of Science ID 000492192700010

  View details for PubMedID 31427096

  View details for PubMedCentralID PMC6815700

• Prolonged duration of early antibiotic therapy in extremely premature infants PEDIATRIC RESEARCH Greenberg, R. G., Chowdhury, D., Hansen, N., Smith, P., Stoll, B. J., Sanchez, P. J., Das, A., Puopolo, K. M., Mukhopadhyay, S., Higgins, R. D., Cotten, C., Caplan, M. S., Polin, R. A., Laptook, A. R., Keszler, M., Hensman, A. M., Basso, K. M., Vieira, E., Little, E., Walsh, M. C., Fanaroff, A. A., Hibbs, A., Newman, N. S., Siner, B. S., Truog, W. E., Kilbride, H. W., Pallotto, E. K., Gauldin, C., Holmes, A., Johnson, K., Knutson, A., Poindexter, B. B., Schibler, K., Alexander, B., Grisby, C., Jackson, L. D., Kirker, K., Muthig, G., Goldberg, R. N., Fisher, K. A., Grimes, S., Finkle, J., Laughon, M. M., Bose, C. L., Bernhardt, J., Bose, G., Carlton, D. P., Hale, E. C., Blackwelder, A., Loggins, Y. C., Bottcher, D., Archer, S., Sokol, G. M., Wilson, L., Herron, D. E., Kennedy, K. A., Tyson, J. E., Arldt-McAlister, J., Burson, K., Garcia, C., Harris, B., Martin, K., Martin, S. C., McDavid, G. E., Rodgers, S., Tate, P., Wright, S. L., Nelin, L. D., Jadcherla, S. R., Luzader, P., Fortney, C. A., Besner, G. E., Parikh, N. A., Wallace, D., Gantz, M. G., Auman, J., Crawford, M. M., Gabrio, J., Huitema, C., Zaterka-Baxter, K. M., Van Meurs, K. P., Adams, M. M., Stevenson, D. K., Ball, M., Palmquist, A. W., Proud, M. S., Frantz, I. D., Fiascone, J. M., MacKinnon, B. L., Nylen, E., Carlo, W. A., Ambalavanan, N., Collins, M., Cosby, S. S., Devaskar, U., Garg, M., Chanlaw, T., Geller, R., Bell, E. F., Ellsbury, D. L., Widness, J. A., Colaizy, T. T., Johnson, K. J., Campbell, D. B., Walker, J. R., Watterberg, K. L., Ohls, R. K., Lacy, C., Tomson, R. A., Hartenberger, C., Beauman, S., Schmidt, B., Kirpalani, H., DeMauro, S. B., Dysart, K. C., Chaudhary, A. S., Abbasi, S., Mancini, T., Cucinotta, D. M., Jensen, E. A., D'Angio, C. T., Guillet, R., Lakshminrusimha, S., Reynolds, A., Reubens, L. J., Jensen, R., Maffett, D., Wadkins, H. I. M., Sacilowski, M. G., Williams, A., Guilford, S., Rowan, M., Prinzing, D. M., Hunn, J., Scorsone, A., Wynn, K., Bowman, M., Phelps, D. L., Horan, A., Wyckoff, M. H., Brion, L. P., Chen, L., Guzman, A., Morgan, J. S., Pavageau, L., Vasil, D. M., Torres, L. E., Faix, R. G., Yoder, B. A., Osborne, K. A., Bird, K., Burnett, J., Jensen, J. J., Spencer, C., Weaver-Lewis, K., Zanetti, K., Shankaran, S., Barks, J., Bara, R., Johnson, M., Christensen, M., Wiggins, S., Ehrenkranz, R. A., Jacobs, H., Cervone, P., Konstantino, M., Poulsen, J., Taft, J., Eunice Kennedy Shriver Natl Inst C 2019; 85 (7): 994–1000

  Abstract

  Prolonged early antibiotics in extremely premature infants may have negative effects. We aimed to assess prevalence and outcomes of provision of prolonged early antibiotics to extremely premature infants in the absence of culture-confirmed infection or NEC.Cohort study of infants from 13 centers born without a major birth defect from 2008-2014 who were 401-1000 grams birth weight, 22-28 weeks gestation, and survived ≥5 days without culture-confirmed infection, NEC, or spontaneous intestinal perforation. We determined the proportion of infants who received prolonged early antibiotics, defined as ≥5 days of antibiotic therapy started at ≤72 h of age, by center and over time. Associations between prolonged early antibiotics and adverse outcomes were assessed using multivariable logistic regression.A total of 5730 infants were included. The proportion of infants receiving prolonged early antibiotics varied from 30-69% among centers and declined from 49% in 2008 to 35% in 2014. Prolonged early antibiotics was not significantly associated with death (adjusted odds ratio 1.17 [95% CI: 0.99-1.40], p = 0.07) and was not associated with NEC.The proportion of extremely premature infants receiving prolonged early antibiotics decreased, but significant center variation persists. Prolonged early antibiotics were not significantly associated with increased odds of death or NEC.

  View details for DOI 10.1038/s41390-019-0300-4

  View details for Web of Science ID 000468524800018

  View details for PubMedID 30737489

• Home Oxygen and 2-Year Outcomes of Preterm Infants With Bronchopulmonary Dysplasia PEDIATRICS DeMauro, S. B., Jensen, E. A., Bann, C. M., Bell, E. F., Hibbs, A., Hintz, S. R., Lorch, S. A. 2019; 143 (5)

  View details for DOI 10.1542/peds.2018-2956

  View details for Web of Science ID 000474923900027

• Home Oxygen and 2-Year Outcomes of Preterm Infants With Bronchopulmonary Dysplasia. Pediatrics DeMauro, S. B., Jensen, E. A., Bann, C. M., Bell, E. F., Hibbs, A. M., Hintz, S. R., Lorch, S. A. 2019

  Abstract

  OBJECTIVES: To compare medical and developmental outcomes over the first 2 years of life in extremely preterm infants with bronchopulmonary dysplasia (BPD) who were discharged on supplemental oxygen via nasal cannula with outcomes of infants with a similar severity of respiratory illness who were discharged breathing in room air.METHODS: We performed a propensity score-matched cohort study. Eligible infants were born at <27 weeks' gestation, were receiving supplemental oxygen or respiratory support at 36 weeks' postmenstrual age, and were assessed at 18 to 26 months' corrected age. Study outcomes included growth, resource use, and neurodevelopment between discharge and follow-up. Outcomes were compared by using multivariable models adjusted for center and age at follow-up.RESULTS: A total of 1039 infants discharged on supplemental oxygen were propensity score matched 1:1 to infants discharged breathing in room air. Infants on oxygen had a marginal improvement in weight z score (adjusted mean difference 0.11; 95% confidence interval [CI] 0.00 to 0.22), with a significantly improved weight-for-length z score (adjusted mean difference 0.13; 95% CI 0.06 to 0.20) at 22 to 26 months' corrected age. Infants on oxygen were more likely to be rehospitalized for respiratory illness (adjusted relative risk 1.33; 95% CI 1.16 to 1.53) and more likely to use respiratory medications and equipment. Rates of neurodevelopmental impairment were similar between the groups.CONCLUSIONS: In this matched cohort of infants with BPD, postdischarge oxygen was associated with marginally improved growth and increased resource use but no difference in neurodevelopmental outcomes. Ongoing and future trials are critical to assess the efficacy and safety of postdischarge supplemental oxygen for infants with BPD.

  View details for PubMedID 30975699

• Association between Use of Prophylactic Indomethacin and the Risk for Bronchopulmonary Dysplasia in Extremely Preterm Infants. The Journal of pediatrics Jensen, E. A., Dysart, K. C., Gantz, M. G., Carper, B., Higgins, R. D., Keszler, M., Laughon, M. M., Poindexter, B. B., Stoll, B. J., Walsh, M. C., Schmidt, B. 2017; 186: 34-40.e2

  Abstract

  To assess the association between prophylactic indomethacin and bronchopulmonary dysplasia (BPD) in a recent, large cohort of extremely preterm infants.Retrospective cohort study using prospectively collected data for infants with gestational ages < 29 weeks or birth weights of 401-1000 g born between 2008 and 2012 at participating hospitals of the National Institute of Child Health and Human Development Neonatal Research Network. Infants treated with indomethacin in the first 24 hours of life were compared with those who were not. Study outcomes were BPD, defined as use of supplemental oxygen at 36 weeks postmenstrual age among survivors to that time point, death, and the composite of death or BPD. Prespecified subgroup analyses were performed.Prophylactic indomethacin use varied by hospital. Treatment of a patent ductus arteriosus after the first day of life was less common among 2587 infants who received prophylactic indomethacin compared with 5244 who did not (21.0% vs 36.1%, P < .001). After adjustment for potential confounders, use of prophylactic indomethacin was not associated with higher or lower odds of BPD (OR 0.89, 95% CI 0.72-1.10), death (OR 0.80, 95% CI 0.64-1.01), or death or BPD (OR 0.87, 95% CI 0.71-1.05). The only evidence of subgroup effects associated with prophylactic indomethacin were lower odds of death among infants with birth weights above the 10th percentile and those who were not treated for a patent ductus arteriosus after the first day of life.Prophylactic indomethacin was not associated with either reduced or increased risk for BPD or death.ClinicalTrials.gov: NCT00063063.

  View details for DOI 10.1016/j.jpeds.2017.02.003

  View details for PubMedID 28258737

  View details for PubMedCentralID PMC5484725