• Interpretable Prediction of Necrotizing Enterocolitis from Machine Learning Analysis of Premature Infant Stool Microbiota. The Hooven Laboratory published findings on a new machine learning tool they developed to help predict which premature neonates are most at risk for necrotizing enterocolitis. Their tool analyzes the microbiota characteristics of the infant’s stool to find the signals characteristic of impending NEC.
  
  
• Ventilator-Associated Pneumonia in the Neonatal Intensive Care Unit. Division fellow Ayesha Alriyami, MD, along with James R. Kiger, MD, medical director of neonatal respiratory therapy, and Thomas Hooven, MD, published a new review article on ventilator assisted pneumonia in the NICU. Their paper reviews all of the most up-to-date literature in diagnosing, treating, preventing, ventilator-associated pneumonia, along with new research that is emerging related to pathogenesis and best treatment approaches.
  
  
• Neonatal Ventilation. In this review paper published in Seminars in Pediatric Surgery, James R. Kiger, MD, provides a thorough review on the mechanisms of lung injury in mechanical ventilation, structural and functional variations between adult and neonate lungs. He also discusses noninvasive ventilation approaches.
  
  
• Inhibition of Heat Shock Factor 1 Signaling Decreases Hepatoblastoma Growth via Induction of Apoptosis. Edward Hurley, MD, and The Monga Laboratory published new findings in their hepatoblastoma research in The American Journal of Pathology. The study found that inhibiting Heat shock factor 1 (HSF1) may be a potential target for therapeutic development against hepatoblastoma. Inhibiting HSF1 in their models led to smaller tumor size and fewer tumors.
  
  
• Nitric Oxide Production and Effects in Group B Streptococcus Chorioamnionitis. In this multicenter study led by the Hooven Laboratory, research teams found mechanisms that allow group B Streptococcus, a major cause of chorioamnionitis that can result in preterm birth or miscarriage, to persist in the face of increased nitric oxide production by the placenta as a means to combat the infection.
  
  
• Impact of a Standardized Management Guideline for Infants With CDH: A Single-Center Experience. Burhan Mahmood, MD, FAAP, was the senior author of this new study from the Newborn Medicine Program outlining their clinical outcomes in treating congenital diaphragmatic hernia through a standardized clinical practice guideline. The study found improved outcomes, less use of ECMO, improved rates of survival.
  
  
• UPMC Newborn Medicine Program Expands Translational Research Studies of Novel Platelet Therapeutics. The Diacovo Laboratory at UPMC Children’s Hospital of Pittsburgh, led by Thomas G. Diacovo, MD, has worked to upend this suboptimal treatment paradigm with new research and revelations, technological advances, and novel animal models that will lead to important new clinical trials in neonatal subjects.
  
  
• Novel Variant Findings and Challenges Associated With the Clinical Integration of Genomic Testing. An Interim Report of the Genomic Medicine for Ill Neonates and Infants (GEMINI) Study. Director of neonatal research, Thomas Diacovo, MD, co-authored this multicenter study in JAMA Pediatrics that is investigating whether targeted genome sequencing to aid in diagnosing genetic conditions or disorders in infants and neonates compared to rapid whole-genome sequencing paradigms.
  
  
• Nutritional Considerations in the Neonate. Review article in Seminars in Pediatric Surgery, co-authored by clinical director Abeer Azzuqa, MD, and pediatric surgery colleague Paul Waltz, MD, reviews the basis for optimal nutritional strategies and benchmarks for NICU babies, including discussions on both parenteral and enteral feeding.
  
  
• Telemedicine Across the Continuum of Neonatal-perinatal Care. Dr. Azzuqa co-authored this multicenter review paper in Seminars in Fetal & Neonatal Medicine discussing the state of telemedicine in relationship to neonatal and perinatal care. In addition to her role at clinical director, Dr. Azzuqa also is director of telemedicine services for the Newborn Medicine Program at UPMC.
  
  
• Ventilation Strategies During Extracorporeal Membrane Oxygenation for Neonatal Respiratory Failure: Current Approaches Among Level IV Neonatal ICUs. John Ibrahim, MD, was the lead author of this multicenter study investigating how level IV NICUs employ ventilation strategies in ECMO for patients with neonatal respiratory failure.
  
  
• Resuscitation With Epinephrine Worsens Cerebral Capillary No-Reflow After Experimental Pediatric Cardiac Arrest: An In Vivo Multiphoton Microscopy Evaluation. Onome Oghifobibi, MD, MSc, FAAP, led and was the first author of a multidisciplinary study from UPMC Children’s, UPMC, and the University of Pittsburgh that further explored how epinephrine used to treated cardiac arrest in pediatric patients can lead to decreased microvascular blood flow and consequently neurologic injury.
  
  
• Utility of Postnatal Chest X-Ray in Newborns for the Evaluation of Prenatally Suspected Congenital Pulmonary Airway Malformation: A Single-Center Experience. Kalyani Vats, MD, was the senior author of this single-center study examining the utility and necessity of thoracic x-rays in newborns hospitalized for suspected, prenatally diagnosed congenital pulmonary airway malformation. The found that immediate postnatal x-rays did not alter the course of treatment or follow-up in asymptomatic patients.
  
  
• UPMC Newborn Medicine Program Expands Translational Research Studies of Novel Platelet Therapeutics

• Neonatal Antibiotics and Outcomes (NANO) Study. This multicenter study, led by University of Pittsburgh and UPMC faculty, which began recruitment in 2022, is designed to test whether exposure to empiric antibiotics in the first few days of life affects outcomes of extremely premature infants. Michael Morowitz, MD, FACS, from the University of Pittsburgh Department of Surgery, is the multicenter study’s primary investigator. Toby D. Yanowitz, MD, MS, director of Clinical Research in the Division of Newborn Medicine is the site PI.
  
  
• Two new clinical trials in the Division will begin recruiting participants in 2023.
  • Cool Prime Study. This investigation is designed to assess the efficacy and outcomes of therapeutic hypothermia in infants with mild hypoxic-ischemic encephalopathy.
  • OPTIStart Study. The OPTIStart multicenter study will probe the ideal oxygen saturation goals in the delivery room for preterm infants.

• The Newborn Medicine Program welcomed the following new faculty members to the Division in 2022:
  • Julie Ann Dillard, MD, Medical Director of Neonatal Transport Services and Community Outreach.
  • Danielle Browning, DO, Director of Medical Student and Resident Rotations in the NICU.
  • Alice P. Randall, MD, MPH, assistant professor of Pediatrics, joined the division as faculty after completing her fellowship training in the Division.
    
    
• Paris S. Ekeke, MD, was named the co-Director of the Center for Advanced Fetal Diagnosis.
  
  
• Carey Welsh, MD, was appointed Associate Regional Medical Director for Central Pennsylvania.
  
  
• That’s Pediatrics Podcast: Abeer Azzuqa, MD, Discusses “All About the NICU” at UPMC Children’s and UPMC Magee.
  
  
• Nicole Dobson, MD, director of the Neonatal-Perinatal Medicine Fellowship Program was featured in episode #102 of The Incubator Podcast.
  
  
• Brian King, MD, was also featured in an episode of the Incubator Podcast.
  
  
• Jennifer Kloesz, MD, was featured in an episode of the UPMC Healthbeat Podcast in a segment on newborn screening.

• New Collaborative Shared Decision-Making Program Supports Women and Families Facing Complex Early Preterm and Peri-Viable Births. The new program places emphasis on multidisciplinary and long-term care of the mother-baby dyad, understanding that the health of the mother and the health of the fetus are intertwined and symbiotic. The new program also considers the acute and long-term behavioral health and psychosocial outcomes that such traumatic pregnancies can inflict on families regardless of the outcomes.
  
  
• UPMC Children’s Multidisciplinary NICU/GI Intestinal Care Collaborative Program Works to Improve Patient Outcomes and Facilitate Transitions in Care. Multidisciplinary teams from the newborn medicine, pediatric surgery, and pediatric gastroenterology divisions at UPMC Children’s Hospital of Pittsburgh have joined forces to create a collaborative partnership focused on intestinal care for critically ill newborns experiencing intestinal failure and other severe disorders that may adversely affect a child’s ability to take in or process nutrition.
  
  
• Multidisciplinary NICU Golden Hour Program at UPMC Magee-Womens Hospital Works to Enhance Short and Long-Term Outcomes in Extremely Premature Neonates. The Golden Hour project, a multidisciplinary collaborative quality improvement program between Newborn Medicine, Obstetrics and Gynecology, Radiology, and Pharmacy divisions and departments at UPMC Magee-Womens Hospital, is designed to standardize and optimize the care during the first hour of life of extremely premature neonates who are born at or less than 29-weeks’ gestation.
  
  
• In 2022, the Neonatal ECMO Program, led by Burhanuddin Mahmood, MD, FAAP, earned the Center of Excellence Platinum Level designation from the Extracorporeal Life Saving Organization (ELSO). The award signals a commitment to quality, systems, patients and families, and ongoing improvement.
  
  
• Neonatal-Perinatal Fellowship Advanced ECMO Training Program. The Division of Newborn Medicine implemented the “Neonatal-Perinatal Fellowship Advanced ECMO Training Program” for the neonatology fellows to ensure superior competency, an outstanding knowledge base, and exceptional troubleshooting skills in managing neonates on ECMO support. The program follows Extracorporeal Life Support Organization (ELSO) Guidelines for ECLS Training, including didactic coursework and high-fidelity simulation. Upon successful completion, neonatal fellows receive ECMO Certification from UPMC Children’s ECMO Program at the time of fellowship graduation.
  
  
• The Division of Newborn Medicine and the Heart Institute at UPMC Children’s are collaborating on a patent ductus arteriosus (PDA) closure program. James Kiger, MD, medical director of neonatal respiratory care in the Division of Newborn Medicine Program and Bryan H. Goldstein, MD, director of cardiac catheterization and intervention lead the program.
  
  
• Neonatal APP Fellowship Training Program. Created in 2015 and currently led by Carey Welsh, MD, medical director of the program, and Alexandra Mastro PA-C, MPAS, lead APP of the program, continue to train individuals in the medical knowledge, critical thinking skills, and procedures in neonatal critical care and newborn medicine that will allow them to provide world class clinical care in the Neonatal Intensive Care Unit. Graduates of the program are prepared to help meet the ongoing demand for mid-level providers in the Neonatal Intensive Care Unit.

Faculty, fellows, and residents from the UPMC Newborn Medicine Program presented lectures, abstracts, and posters at numerous conferences and symposia during the year, including:

• Pediatric Academic Societies Meeting
• Children’s Hospitals Neonatal Consortium Annual Symposium
• American Academy of Pediatrics Annual Conference and Exhibition
• Experimental Biology Conference
• American Heart Association Annual Conferences
• McGill International Palliative Care Conference
• Streptococcal Biology Gordon Research Conference
• International Congenital Diaphragmatic Hernia Symposium
• 13^th Annual Neonatal & Pediatric ECLS Educational Conference