The University of Iowa is one of 15 clinical centers selected competitively to participate in the Neonatal Research Network (NRN) of the Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD). The University of Iowa center has a satellite site at Sanford Children’s Hospital in Sioux Falls, South Dakota. The NRN has existed since 1986, and participating centers are selected by a competitive application process every 5 years. Iowa has been a member of the NRN since 2006.

The NICHD established the NRN to conduct multicenter clinical trials and observational studies in neonatal medicine. The network was created because many of the treatment and management strategies in 1986 had become standards without being properly evaluated. In addition, multiple clinical centers were necessary to provide a large enough population from which appropriate samples could be drawn with adequate statistical power to detect clinically important differences.

Some of the most important clinical trials of recent decades in neonatal medicine have been conducted by the NRN. Examples include:

• First large trial of whole-body hypothermia for hypoxic-ischemic encephalopathy (Shankaran S et al, N Eng J Med 2005)
• Impact of oxygen saturation target range on risks or mortality and retinopathy in extremely preterm infants (Carlo WA et al, N Engl J Med 2010)
• Comparison of early CPAP vs surfactant and intubation for extremely preterm infants (Finer NN et al, N Engl J Med 2010)
• Comparison of cooling temperatures and durations for hypoxic-ischemic encephalopathy (Shankaran S et al, JAMA 2014, JAMA 2017)
• Efficacy of therapeutic hypothermia initiated 6-24 hours after hypoxic-ischemic encephalopathy (Laptook A et al, JAMA 2017)
• Comparison of laparotomy and drain for extremely low birth weight infants with necrotizing enterocolitis who require surgery (Blakely ML et al)
• High vs low hemoglobin transfusion thresholds for extremely preterm infants (Kirpalani H et al)

Other important clinical studies from the NRN have included:

• Changing pathogens in early-onset neonatal sepsis (Stoll BJ et al, N Engl J Med 2002)
• The impact of early nutrition on growth and neurological outcome in preterm infants (Ehrenkranz RA et al, Pediatrics 2006)
• Prediction of survival and handicap-free survival for extremely preterm infants based on gestational age and 4 other factors (Tyson JE et al, N Engl J Med 2008)
• Benefits of antenatal corticosteroids for infants born at 22 to 25 weeks’ gestation (Carlo WA et al, JAMA 2011)
• Hospital differences in active treatment and survival of extremely preterm infants (Rysavy MA et al, N Engl J Med 2015)
• Trends in mortality and morbidity for extremely preterm infants (Stoll BJ et al, JAMA 2015)
• Updated tool for predicting survival of extremely preterm infants (Rysavy MA et al, JAMA Pediatr 2020)

As of July 15, 2020, investigators of the NRN had published 415 papers resulting from NRN studies. The number of publications increases each year. The most impactful NRN paper (Shankaran S et al, N Eng J Med 2005) had been cited more than 1770 times by July 15, 2020.

The University of Iowa Children’s Hospital Neonatal Intensive Care Unit and its Sanford partner participate in all NRN studies. As of December 31, 2019, we had enrolled over 3200 patients in NRN studies since joining the Network in 2006.

The key players on our team are our nurse coordinators, who are led by our Nurse Coordinator Karen Johnson. Karen has been our Nurse Coordinator since we were first admitted to the NRN in 2006. We owe our successful participation in the NRN to Karen and her team of coordinators, including her counterpart, Megan Henning at Sanford. Name and photos of key personnel on the Iowa NRN team are shown below.

Ed Bell, MD
Principal Investigator

Tarah Colaizy, MD, MPH
Alternate PI

Heidi Harmon, MD
Follow-Up PI

Michelle Baack, MD
Satellite Lead Investigator

Laurie Hogden, MD
Satellite Follow-Up Investigator

Karen Johnson
Nurse Manager

Mendi Schmelzel
Research Nurse

Jacky Walker
Research Nurse

Sarah Faruqui
Research Nurse

Diane Eastman
Follow-Up Coordinator

Megan Henning

Satellite Nurse Coordinator

Sarah Vanmuyden
Satellite Research Nurse

Chelsey Elenkiwich
Satellite Research Nurse

Aimee Brodkorb
Satellite Research Nurse

Wendy Graff
Satellite Bayley Examiner