Environmental Influences on Neurodevelopmental Outcome in Infants Born Very Preterm (ECHO-NOVI)

The Environmental influences on Child Health Outcomes (ECHO) program is part of a National Institutes of Health (NIH)'s seven-year initiative to support multiple, synergistic, longitudinal studies using existing study populations, called cohorts, to investigate environmental exposures — including physical, chemical, biological, social, behavioral, natural and built environments — on child health and development. ECHO plans to enroll over 50,000 children from across the United States in an attempt to collect a broad amount of data that helps determine the trajectory of health development, prediction of disease development and new tools and approaches for both environmental and pediatric monitoring.

We are focusing on the neurodevelopmental outcomes related to the ECHO initiative, through our study, "The Neonatal Neurobehavior and Outcomes in Very Preterm Infants (NOVI)." We are calling this integration of NOVI into the ECHO initiative, "ECHO-NOVI".

About one-third of infants born less than 30 weeks suffer long-term developmental challenges. We hope to identify which infants are more likely to become developmentally impaired and determine whether special types of care in the neonatal intensive care unit (NICU) and early developmental intervention services after discharge could improve the developmental outcomes for premature infants and their families. To date in the NOVI study, we have collected data on these infant's early behavioral development up to the age of two. In ECHO-NOVI, we plan to follow these children through age seven to further determine potential mechanisms that lead to developmental and child health outcomes. Primary Investigator: Barry Lester PhD.

Preterm Infant outcome in the Single Family Room Model of Care 

Preterm infants are often cared for in “open bay” Neonatal Intensive Care Units (NICU) that can be crowded, noisy and overstimulating and with little privacy for families to provide and interact with their babies.  A new model of care, the Single Family Room NICU, in which each infant has their own room, has been proposed as a way to improve infant medical and developmental outcome.  Women and Infants Hospital transitioned from an open bay to a Single Family Room NICU enabling us to compare a group of babies who were cared for in the open bay NICU with a group of babies cared for in the single family room NICU.  We are comparing them at hospital discharge on medical and developmental outcome and at 18 months follow-up. We are also studying “mediators” or factors that may explain the how and why of improved outcome in the single family room model.  Primary Investigators:  Barry Lester PhD, James Padbury MD.

The Neonatal Neurobehavior and Outcomes in Very Preterm Infants (NOVI)

Infants born less than 30 weeks gestational age are at high risk for developing severe impairment including cognitive, language, and behavior disorders and autism. Unfortunately, there is no method to identify which of these infants will become impaired and which will not. The purpose of the NOVI study is to follow approximately 900 infants across six sites from hospital discharge to two years of age and to determine if our neurobehavioral exam (NNNS) , medical factors and epigenetic marks, can identify infants that will be impaired by age 2.  Acoustic cry measures will also be used to help identify infants at risk for autism. Early identification can lead to interventions that can ameliorate or prevent later deficits. Primary Investigator: Barry Lester PhD.