Medical Student Research Fellowship for Summer 2009

Mentor: Susan Raff, M.D. and
Gregory ("Greg") L. Jackson, M.D., M.B.A.
Department: Pediatrics
Room number: Parkland Memorial Hospital Newborn Nursery
Mail Code: 9063
Phone number: (214) 590-8034
E-mail: greg.jackson@utsouthwestern.edu
Project title: Characteristics of Hypoglycemia
in the Late Preterm Neonate

Human subjects IRB approved project number (where applicable):
IRB is pending

Animal subjects IRB approved project number (where applicable): N/A

Project Type (patient-based research, animal-based research, or basic research; this characterization is only to permit a general classification for grouping similar types of projects) - Patient-based

Brief Description of Project:
This prospective observational chart review study will assess those neonates admitted to the Parkland Memorial Hospital Newborn Nursery (NBN) who are routinely screened for hypoglycemia by current protocol (Figure). Designed as a chart review to assess our existing glucose screening protocol and learn more about hypoglycemia in high-risk neonates, there are no changes in patient management related to this data collection.
We will utilize the EPIC Patient Care Management System to identify all neonates who have a point-of-care EBG determination (performed by current technology utilized in the NBN) and/or serum glucose during their nursery stay. This daily report will include the MRN and individual values of these glucose determinations and the MRN will link to other pertinent infant and maternal data. The student will review the medical record of all neonates in the NBN who are identified by this report and gather the data listed under study procedures.
Once the data is collected, we will analyze our population of neonates with low glucose determinations, with particular attention paid to those neonates with assigned gestational ages of 34-36 6/7 weeks.

Importance / implications of the research:
The National Institutes of Health has stated that late-preterm infants "are more prone to problems related to delayed transition and overall immaturity, and should therefore be treated differently than their more mature full term counterparts." (Jain 2007) Of the estimated 250,000 babies born each year between 34-36 weeks gestation, several problems have been recognized, leading to increased morbidity. (March of Dimes 2006; Walker 2008) Nevertheless, these babies typically are admitted to a 'normal' newborn nursery. This national health concern has led to greater awareness of this group of babies that have been admitted to normal newborn nurseries and has highlighted a need for more research on this neonatal subpopulation.(Davidoff 2006) (Tomashek, Shapiro-Mendoza et al. 2007), (Petrini, Dias et al. 2009). While data have shown that hypoglycemia in preterm neonates is more common than in term neonates, data that defines specific risk factors and response to treatment at each gestational age n the late-preterm group is lacking.

Role of the student: The student will be involved in electronic medical record chart review, prospective identification of neonates who require screening for hypoglycemia in our Admissions Nursery at Parkland Newborn Nursery, and management of the data in a secured database.