Brenda Poindexter, M.D., M.S. & Ravi Patel, M.D., M.Sc

Involvement with the Neonatal Research Network, part of the Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD) of the National Institutes of Health (NIH), has played a huge role in neonatology research at Emory University and Children's Healthcare of Atlanta. The NICHD Neonatal Research Network is a collaboration between NICUs from academic medical centers across the U.S. that conduct multi-center clinical trials and observational studies in critically ill and premature newborn babies admitted to NICUs. There are 15 academic medical centers that successfully competed to be part of the network, including Emory and Children’s, and each center participates in multiple ongoing research studies. This network has continuously funded Emory and Children’s neonatal research for more than 30 years.  

Children’s and Emory investigators, Brenda Poindexter, MD, MS, Professor of Pediatric Neonatology at Emory and Division Chief of Neonatology at Children’s, and Ravi Patel, MD, MSc, Associate Professor of Pediatric Neonatology at Emory and Neonatologist at Children's, say research influences survival and other important outcomes for babies. Dr. Poindexter has been a part of the network for nearly 20 years and currently leads the scientific review process. Dr. Patel has been a part of the network for almost nine years and currently serves as the principal investigator, managing research coordinators, ensuring experimental activities run smoothly, developing new clinical studies and representing Emory and Children’s on the steering committee.

Dr. Poindexter emphasizes the important roles of research coordinators who talk to parents under challenging circumstances. The research coordinators have a close and detailed understanding of the babies’ medical conditions, serve as a resource of information and sometimes counsel parents during their NICU stay. Dr. Poindexter says building trust with families is central to success in recruiting for their studies. Dr. Patel highlights how research conducted by the network has improved clinical care provided to infants in Georgia. One example is the use of body cooling for infants with brain injury, which is now routinely provided to infants after studies by the network showed it improves survival without disability.

Children’s and Emory researchers within the network published a paper in the New England Journal Medicine on a clinical trial looking at higher or lower hemoglobin transfusion thresholds for premature babies. Children’s and Emory researchers enrolled 90 premature babies with a very low birth weight of 2.2 pounds or less and randomly assigned them to receive red-cell transfusions at higher or lower levels of hemoglobin right after birth. Researchers wanted to know if babies should be given more blood to improve their long-term cognitive outcome. This trial showed that giving a baby a higher level of blood transfusion did not improve the baby’s survival or long-term developmental outcomes and did not make as much of a difference as the research team hypothesized. There were 1,824 total babies enrolled in this multi-center trial, the largest such trial conducted anywhere to date. Complementary to this NICHD Neonatal Research Network study, there are also ongoing studies conducted outside the network by Children’s and Emory researchers to better understand the impact of transfusions.

Dr. Poindexter notes the longevity of Emory and Children’s participation with the network and says: “We’ve made it through six to seven competitive renewals, and we make things better for patients now and in the future with our research. The research coordinators are available day and night when there are sensitivities to recruiting babies for studies. When we interview fellows, they note that participation in the network is one of the biggest strengths of our institutions.”