Sharp Mary Birch Hospital, Neonatal Research Institute: Research Contributions Summary
Since December 2019, I have worked as a mixed methods research associate for 8+ clinical studies at Sharp Mary Birch’s Neonatal Research Institute under the advisement of Dr. Anup Katheria.
Contributions Summary
MINVI - Umbilical Cord Milking (UCM) in Non-Vigorous Infants
Background
Role: Research Associate
Methods: Pragmatic cluster randomized crossover study, prospective chart review, close and open ended surveys
Timeline: August 1, 2018- Present (Estimated 5 years)
Goals
Client’s Goal: Should Physicians practice umbilical cord milking or early cord clamping in neonates who are non-vigorous at birth?
Study Design Goal: Evaluate the efficacy of UCM in 35-42 week neonates who are non-vigorous at birth compared to Early Cord Clamping (ECC). Specifically, level of H&H, outcomes of cardiac ultrasound or echo, and up to 2 years neonatal developmental outcomes.
Participants: Obstetrics Gynecologists
Contributions & Accomplishments
Assisted with recruitment of 200+ term mothers, consenting of 50+ mothers, and the extraction of 1000+ patient data out of Cerner charts, our EHR system, into RedCap
Performed 200+ open and close ended in person and phone surveys at 3, 9, 12, 18, and 24 month children enrolled in the study to evaluate their developmental outcomes
PREMOD - Premature Infants Receiving Milking or Delayed Cord Clamping
Background
Role: Research Associate
Methods: Randomized Control Trial, prospective chart review, and close and open ended surveys
Timeline: April 2017- Present (Estimated 5 years)
Goals
Client’s Goal: Should Physicians practice umbilical cord milking or delayed cord clamping in preterm neonates?
Study Design Goal: This study is being done to find out whether umbilical cord milking (UCM) is at least as good as or better than delayed cord clamping (DCC) to reduce bleeding in the brain or prevent death in premature newborns. We will study short and long term outcomes of infants delivered before 32 weeks gestation that receive either UCM or DCC.
Participants: Obstetrics Gynecologists
Contributions & Accomplishments
Assisted with recruitment of 200+ term mothers, consenting of 50+ mothers, and the extraction of 500+ patient data out of Cerner charts, our EHR system, into RedCap
Performed 10+ open and close ended phone surveys in mandarin at 12, 18, and 24 month children enrolled in the study to evaluate their developmental outcomes
Association Between Umbilical Cord Management and 5 Minute Peripheral Oxygenation In Preterm Infants
Background
Role: Research Associate
Methods: Retrospective Cohort Chart Review
Timeline: October 2020 - January 2021 (4 months)
Goals
Client’s Goal: Should Physicians practice umbilical cord milking or delayed cord clamping in preterm infants?
Study Design Goal: To compare 5 minute SpO2 and FiO2 levels between two different placental transfusion techniques in 23 to 31 weeks of gestation resuscitated premature infants in the delivery room.
Participants: Obstetrics Gynecologists
Contributions & Accomplishments
Lead research design and met with physicians, nurses, data scientists, and others to determine scope, purpose of the project, and start a new delivery room database for the NRI
Watched 30+ videos to collect quantitative data crucial for data analysis
Used Python and Pycharm to combine 3 previous multi-centered data sets to total 328 preterm babies used in this study
Impact
Our research concluded that physicians should consider administering higher oxygenation (FiO2) during DCC due to low SpO2 levels and reserve prospective UCM techniques for more mature infants. This has been advised to many hospitals in the United States
Findings presented at Cools Topic for Neonatology and Pediatric Academic Societies national conference
Two-year neuro-developmental outcomes of preterm infants who received red blood cell transfusion
Background
Role: Research Associate
Methods: Retrospective Cohort Chart Review
Timeline: February 2020- January 2021 (11 months)
Goals
Client’s Goal: Should physicians decrease the amount of red blood cell transfusions in preterm infants?
Study Design Goal: Our primary aim was to examine the relationship between receipt of RBC transfusion in preterm infants and their subsequent neurodevelopment at two years of age. We also conducted secondary analyses of:
1) cumulative number of transfusions
2) transfusions received in the first week of life
3) transfusions in a subcohort of extremely preterm infants with a gestational age <28 weeks.
Participants: Obstetrics Gynecologists, Registered nurses
Contributions & Accomplishments
Assisted with research design and met with physicians, nurses, data scientists, and others to determine scope, purpose of the project
Input 1000+ neonatal charts into RedCap database
Used logistic and linear regression models, chi squared test, and other analytical models to identify associations between blood transfusion and neurodevelopmental outcomes in 654 study participants
Impact
Our research concluded that physicians should attempt to decrease the amount of red blood cell transfusions in preterm neonates. Our study demonstrates an association between RBC transfusion and lower cognitive and motor outcomes at two-years after adjustment for prematurity and illness at birth. Increasing number of transfusions was associated with an even greater severity of NDI. Prospective studies utilizing blood-saving strategies (placental transfusion or minimal blood draws) to avoid blood transfusion and improve long term outcomes are needed to confirm this association.