Department of Pediatrics

Neonatal Research

By: Ada Chong

Emory University and Children's involvement with the Neonatal Research Network (NRN), organized by the Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD), has played a huge role in neonatal research at our institutions. The NRN conducts multi-center clinical trials and observational studies in neonatal medicine. There are 15 academic centers who successfully competed to be part of the network, including Emory, and each center participates in multiple ongoing research studies. Research conducted by Emory has been funded continuously for more than 30 years through this network.

Our Children’s and Emory researchers Drs. Brenda Poindexter and Ravi Patel say research influences survival and other important outcomes for babies. Dr. Poindexter has been a part of the NRN for nearly 20 years and leads the scientific review process for the network and Dr. Patel has been a part of NRN for almost nine years and currently serves as the principal investigator, managing the researcher coordinators, ensuring research activities run smoothly, and representing our center in the NRN steering committee. He is also involved in the development of new clinical studies that the NRN will conduct.  

Dr. Poindexter emphasizes the important roles of research coordinators who talk to parents under challenging circumstances. The research coordinators need detailed and special understanding of what’s going on medically with the babies and serve as a resource of information and sometimes even counsel mothers over their Neonatal Intensive Care Unit (NICU) stay. Dr. Poindexter says building trust with families is why they have been successful in recruiting for their studies. Dr. Patel highlights how research conducted by the NRN 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 NRN showed it improves survival without disability.

Last December, Children’s and Emory researchers in the NRN 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 at our affiliated institutions with a birth weight of 1,000 grams 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 it didn’t make as much of a difference as people considered it might. There were 1,824 total babies enrolled in this multi-center trial, the largest such trial conducted anywhere to date. Complementary to this NRN study are ongoing studies developed by Children’s and Emory researchers to better understand the impact of transfusion that are being conducted outside the NRN.

Dr. Poindexter notes the longevity of our participation with the NRN and says, “we’ve made it through 6 to 7 competitive renewals and we make things better for patients now and in the future with participation of our research. The research coordinators are available day and night when there’s sensitivities to getting babies in studies. When we interview fellows, they note that participation in the network is a big strength of our institution.”