After long deliberations, Little Giraffe Foundation voted to fund 16 initiatives for 2015, totaling over $42,000 – 4 Neonatal Research Grants to forward medical care for premature babies and 12 NICU Support Grants designed to improve the lives of the families and babies in the NICU.

2015 Neonatal Research Grants

Mayo Clinic College of Medicine, Minneapolis, MN - $10,000 Awarded

Research: Tocolysis for preterm premature rupture of membranes (PPROM): a randomized, placebo-controlled, double-blind trial to evaluate neonatal and maternal outcomes.

Kristi Borowski, MD – PI, Assistant Professor of Obstetrics & Gynecology

Our project goal is to determine if tocolysis through the steroid window in pregnancies affected by PPROM can minimize neonatal morbidity by completing a course of corticosteroids without resulting in increased maternal or neonatal infection rates. We propose a randomized, placebo-controlled, double-blind trial to evaluate the effect of tocolysis compared to placebo among women who experience PPROM between 23 0/7 and 33 4/7 weeks gestation. Both study groups will receive current standard of care for PPROM, which includes a 48 hour corticosteroid course and latency antibiotics. Participants will be randomized to receive placebo or nifedipine tocolysis through the corticosteroid administration period. Per the standard of care, study participants will remain inpatient until an indication for delivery develops (i.e. intra-amniotic infection) or until they reach 34 0/7 weeks gestation. Neonatal and postpartum maternal outcomes will also be assessed through manual electronic chart review.

Rainbow Babies and Children’s Hospital, Cleveland, OH - $10,000 Awarded

Research: Stem Cell-Based Therapy in Hyperoxia-induced Lung Injury, a Model of Bronchopulmonary Dysplasia

Christopher Nitkin, MD – PI, Neonatology Fellow

Bronchopulmonary dysplasia (BPD) is a common lung disease seen in babies born prematurely, and although a variety of therapies are available, there is no cure for BPD. Lung damage results from both inflammation and excess oxygen, and several genes are important in protecting the lungs against this injury. Mice or rats exposed to increased levels of oxygen develop lung injury similar to that found in BPD, and giving stem cells to these animals has been shown to treat and prevent this lung injury, but it is not known how stem cells accomplish this. We propose studying the mechanism by which stem cells exert anti-inflammatory and anti-oxidant effects, comparing the effect of stem cells obtained from healthy adult humans to those obtained from umbilical cord blood, providing valuable insight that may aid in optimizing stem cell-based clinical therapies. To accomplish these goals, we will use our recently developed in vitro and in vivo models of hyperoxia-induced lung injury.

University of Connecticut School of Nursing, Storrs, CT - $6,210 Awarded

Research: Continuing to Explore our Knowledge of the Relationships Between FKBP5 and Early Life Stress in the NICU.

Amy D'Agata, MS, RN – PI, Doctoral Candidate

While prematurity is the greatest risk factor, both genetics and environment serve as contributing risk factors for health trajectories for infants spending extended lengths of stay (LOS) in the neonatal intensive care unit (NICU). The purpose of this study is to explore the relationship between stressful early life NICU experiences, genetic variation of a stress response-associated gene (FKBP5) and neurobehavioral outcomes.

We will examine genetic variation in relationship to stress experience for effects on neurobehavioral outcomes in a total of 93 preterm infants. This proposal extends the work begun during a pilot study currently underway with 50 preterm infants in the NICU. This study increases the initial sample size and adds the opportunity for more complex analyses of the outcomes. Buccal swabs are collected for genotyping of FKBP5 SNPs. Exploratory data analysis will be used to obtain initial insights into the effects of FKBP5 genotype, NICU stress experience, and their interaction on infant neurobehavioral development at 35 weeks post-menstrual age.

Understanding the genetic and environmental risk factors for neurodevelopmental impairment will provide for the development of evidence-based practice initiatives to protect those that are most vulnerable due to the combination of genetic susceptibility to stress and medical fragility. Evidence from this study has the potential to lead to neuro-protective and stress reduction protocols.

University of Virginia, Charlottesville, VA - $5,000 Awarded

Research: Vitamin conservation in premature infants: a role of megalin in the proximal tubule of the kidney

Jennifer Charlton, MD, Msc – PI, Assistant Professor

With the improvement of premature infant mortality, there is a critical need to find modifiable factors to improve the long-term morbidity of the vulnerable premature population. There is emerging evidence of the significant risk for chronic kidney disease (CKD) during childhood in former very low birth weight infants. Every filtering unit (nephron) of the kidney is developed prior to birth in a healthy human. A multitude of factors are involved in this progression towards chronic kidney disease but many are unique to the premature infant including kidney immaturity and exposure to nephrotoxins. It is critical to understand the causal pathway between premature birth and CKD to improve outcomes. An under-studied area in the development of chronic kidney disease is the role of the proximal tubule and the developmental regulation of its receptors, in particular the receptor, megalin. The long-term goal of our group is to protect the brief and exclusive window of nephron formation in premature infants. To work towards this long-term goal, the objective of this proposal is to explore the developmental expression of the receptor megalin in the proximal tubule in a premature mouse model to explore a novel mechanism for the development of kidney disease in premature infants.