Medical Student Research Fellowship for Summer 2010
Mentor: Charles R. Rosenfeld, MD, Donna Persaud, MD
Department: Pediatrics, Division of Neonatal-Perinatal Medicine
Room number: E3.600
Mail Code: 9063
Phone number: ext 83903
Project title: Pediatric Obesity and Neonatal Macrosomia
Human subjects IRB approved project number (where applicable): 012010-029
Animal subjects IRB approved project number (where applicable): NA
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:
Women with diabetes in pregnancy have an increased incidence of delivering a neonate with macrosomia, i.e., a birth weight (BW) >90thcentile and referred to as large for gestational age (LGA). These neonates have insulin resistance at birth, elevated plasma leptin and are at risk for childhood obesity and diabetes. We have shown that LGA neonates delivered of nondiabetic women also have insulin resistance at birth, elevated leptin and their mothers have an increase in BMI greater than expected, which others suggest predicts delivery of an LGA neonate. It is unclear if they also are at risk of childhood obesity and/or diabetes. In the proposed retrospective study, we will review the medical records of children 1-5 years of age followed in the Parkland COPC between 2004-2008 with an ICD-9 diagnosis of obesity (estimated to be ~600). We will randomly select 100 children that were LGA at birth and 100 matched controls (non-obese, same year birth, gender and ethnicity). By chart review we will assess gestational age, BW, length and head circumference, presence or absence of maternal diabetes in pregnancy, and maternal prenatal and postconceptional BMI. We will collect similar data in the matched controls. These data may demonstrate factors that identify the subsequent risk of the nondiabetic LGA neonate for childhood morbidities as well as suggest alterations in fetal programming. The summer student will participate in data collection by chart review, construct a data spread sheet, participate in the data analyses, and contribute to the production of a manuscript if the data result in one.
Previous Research Activities or Publications with Medical Students:
Dr. Rosenfeld has mentored 14 Medical Students over the past 30 years from UT Southwestern and other institutions. They have worked with him on either lab or clinical based research projects. The last student was Folashade Afolabi, MD, who is presently a resident in Pediatrics at Children's Medical Center of Dallas. Her project/data on the prevalence of nosocomial infections in VLBW neonates is being reviewed for manuscript preparation and hopefully submission for publication. Of the other students, several have published manuscripts:
Corbett SS, Rosenfeld CR, Laptook AR, Risser R, Maravilla AM, Dowling S, Lasky RE. Intraobserver and interobserver reliability in the assessment of the cranial ultrasound in very-low-birth-weight infants. Early Human Develop 27:9-17, 1991.
Rosenfeld CR, Jackson GM. Estrogen-induced refractoriness to the pressor effects of infused angiotensin II. Am J Obstet Gynecol 148:429-435, 1984.
Naden RP, Iliya CA, Arant BS, Jr., Gant NF, Jr., Rosenfeld CR. Hemodynamic effects of indomethacin in chronically-instrumented pregnant sheep. Am J Obstet Gynecol 151:484-494, 1985.
Chern J, Kamm KE, Rosenfeld CR. Smooth muscle myosin heavy chain isoforms are developmentally regulated in male fetal and neonatal sheep. Pediatr Res 38:697-703, 1995.
Arens Y, Chapados R, Cox BE, Kamm KE, Rosenfeld CR. Differential development of umbilical and systemic arteries: II. Contractile proteins. Am J Physiol 274:R1815-1823, 1998.