Inder visits with a young patient in the BWH NICU

As the youngest department, with the youngest patients, the Department of Pediatric Newborn Medicine has been looking to firmly establish its research mission. Department Chair Terrie Inder, MBChB, discusses how the department is using the BRI Director’s Transformative Award to do so.

Can a baby be stressed? While a baby doesn’t have responsibilities, commitments or deadlines to worry about, the environment of a newborn – particularly an infant born preterm – can be full of stressors, including barrages of medical procedures and long-term separation from parents. Simple interventions such as parent contact, music and breastmilk, are thought to ease stress levels, but how do you quantify a newborn’s anxiety?

Stress in the womb and in a newborn’s environment is just one of many aspects of newborn health that may impact health in adulthood. Adverse experiences early in development are thought to have a profound impact on one’s risk for chronic diseases later in life, but relatively little research has quantified these risk factors and their repercussions.

Researchers from the Department of Pediatric Newborn Medicine, led by department Chair Terrie Inder, MBChB, are hoping better understand how the first nine months can shape someone’s health for the rest of their life through the Healthy Start to Life project, supported by the BRI Director’s Transformative Award. The award supports teams proposing transformative projects that are groundbreaking, interdepartmental and interdisciplinary, which will accelerate discoveries to improve human health.  With $250,000 from the award, Inder and her colleagues from the Department of Pediatric Newborn Medicine, including Lianne Woodward, PhD, Mandy Brown Belfort, MD, and Katherine Gregory, PhD, RN, plan to develop the LifeCodes cohort to include new neonatal and childhood data and an expanded population of high-risk infants.

A Growing Resource for Newborn Research

The LifeCodes cohort, established by Thomas McElrath, MD, PhD, and David Cantonwine, PhD, of the Department of Obstetrics and Gynecology, is one of the nation’s largest pregnancy cohort studies, with more than 5,000 women currently enrolled, and growing at a rate of eight women per week. An extensive bank of biospecimens, including blood, urine and placenta samples, has been collected from the LifeCodes cohort at 10 weeks, 26 weeks, and 35 weeks of pregnancy and at delivery.

To date, there has been limited neonatal and childhood data collected on the babies born to women enrolled in LifeCodes. Through the Healthy Start to Life project, Inder and her colleagues plan to recruit prospective LifeCodes mothers to participate in the expanded project, and collect neonatal and childhood data and biospecimens from their future children.

The team will recruit women who come to BWH to give birth. Inder says that this aspect of the project has helped foster a new research collaboration with the Department of Obstetrics and Gynecology. “Even though we would see our colleagues from obstetrics every day in the clinic delivering babies, we have never collaborated with them on cutting-edge research before,” she said. The Department of Pediatric Newborn Medicine hopes to build a platform that will attract further collaboration from investigators across BWH.


A Special Focus on Preterm Newborns

The Healthy Start to Life team is also focusing on a smaller, targeted population to ask a more directed question: How does preterm birth impact health later in life? “We hope to do a deeper dive into the ‘exposomes’ of preterm birth – a quantitative measure of the exposures a preterm newborn faces compared to full-term births,” says Inder.

As well as collecting blood samples, stool specimens and body composition from 24 preterm and 24 full-term size matched controls, the team hopes to leverage a novel technology developed at MIT that uses lie detector technology to measure skin conductivity and heart rate to quantify newborn stress.

Additionally, through a partnership with the Department of Radiology, Inder and her colleagues plan to use the neuroimaging facilities in the Hale Building for Transformative Medicine, along with a custom-built pediatric neonatal head piece, to take high resolution images of the brains of newborns in the preterm birth study. Such high resolution neuroimages will allow the researchers to investigate brain structure, connectivity and background cerebral blood flow, providing information not just on the structure of the newborn brains but on the functional connectivity. The team hopes that high-resolution neuroimages will allow them to determine the influence of preterm birth on brain development.