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Articles by Sandra E. Juul
Barriers and facilitators to neurodevelopmental follow-up among at-risk newborns across Washington State
Neurodevelopmental surveillance and early intervention for high-risk neonates can improve childhood outcomes [1,2,3]. However, nearly two-thirds of infants are lost to follow-up by age two due to medical, family, sociodemographic, and systemic barriers [4,5,6]. Washington state faces unique geographic challenges, with 18% of the population, ~1.4 million individuals, living in a county without a neurodevelopmental follow-up (NDFU) center, making follow-up care inaccessible for many at-risk infants.
Erythropoietin for Neonatal Hypoxic-Ischemic Encephalopathy : A Randomized Clinical Trial
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Erythropoietin for Neonatal Hypoxic-Ischemic Encephalopathy: A Randomized Clinical Trial Supplement 1. Supplement 2. Statistical Analysis Plan Supplement 3. Independent Data and Safety Monitoring Committee Supplement 4. eTable 1. Stratification of Enrollment (by Study Site of Recruitment and Severity of Encephalopathy at Enrollment) eTable 2. Completion of Treatment and Reasons for Cessation of Treatment eTable 3. Comparison of Tertiary Outcomes eTable 4.
By Helen G. Liley, Rod W Hunt, Rachel O’Connell, Malcolm R. Battin, Iona Novak, Yvonne Wu, Roberta A. Ballard, Lisa Askie, Nadia Badawi, Susan Jacobs, Sandra E. Juul, Lucille Sebastian, Deepika Wagh, Jennifer Bowen, Paul Colditz, Lisa Gold, Wendy Hague, Kei Lui, Dominic Wilkinson, Nicola Austin, Sarah Bellhouse, Max Berry, Clare Collins, Amanda Dyson, Koert de Waal, Leah Hickey, David Hou, Alison Kent, Scott Morris, Arun Nair Verified, David L. Osborn, Victor Samuel Rajadurai, Nadia Schmidt, Jason Tan, Mark Tracy, Flora Wong, Sarah Finlayson, Shannon Hunt, Alpana Ghadge, R. John Simes, Shannon Clough, Girsih Deshpande, Bevan Headley, James Holberton, Vinayak Kodur, Richard Mausling, Carbo Yeung, Laurence Ralston
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Piloting the better research interactions for every family (BRIEF) researcher intervention to support recruitment for a neonatal clinical trial: parent experience and infant enrollment | Journal of Perinatology
Abstract Recruiting for neonatal clinical trials is difficult for families and participation rates are low. We partnered with the DIVI (Darbepoetin plus slow-release IntraVenous Iron) trial for pilot feasibility evaluation of the BRIEF (Better Research Interactions for Every Family) intervention. Pre/post design to compare infant data and parent surveys and interviews before and after the BRIEF intervention as well as comparing DIVI enrolled and DIVI not enrolled.
Reflections on Neonatal Erythropoietin Neuroprotection Studies
In the current issue of JAMA Network Open, the study by Wehrle et al1 presents school-aged follow-up of a subset of infants enrolled in the Swiss EPO Neuroprotection Trial (NCT00413946).
New frontiers in neonatal red blood cell transfusion research - Journal of Perinatology
Abstract Red blood cell (RBC) transfusions are common in neonates requiring intensive care. Recent studies have compared restricted versus liberal transfusion guidelines, but limitations exist on evaluations of outcomes in populations that never required a transfusion compared to those receiving any transfusion.
Maternal Nutritional Status and the Microbiome across the Pregnancy and the Post-Partum Period
Abstract : Appropriate nutrition during pregnancy and the post-partum period is vital for both the mothers and their offspring. Both under- and over-nourished status may have important microbial implications on the maternal and infant gut microbiomes. Alterations in the microbiome can have implications for a person’s risk of obesity and metabolic diseases.
Safety of High Dose Erythropoietin Used with Therapeutic Hypothermia as Treatment for Newborn Hypoxic-Ischemic Encephalopathy: Secondary Analysis of the HEAL Randomized Controlled Trial
To assess whether high dose erythropoietin (Epo) treatment of cooled infants with neonatal hypoxic ischemic encephalopathy results in a higher risk of prespecified serious adverse events (SAEs). 500 infants born at ≥36 weeks of gestation with moderate or severe hypoxic ischemic encephalopathy undergoing therapeutic hypothermia were randomized to Epo or placebo on days 1, 2, 3, 4 and 7.
Predicting 2-year neurodevelopmental outcomes in extremely preterm infants using graphical network and machine learning approaches
Predicting 2-year neurodevelopmental outcomes in extremely preterm infants using graphical network and machine learning approaches - eClinicalMedicine
Iron supplementation should be monitored closely to ensure optimal iron status.
We thank Drs. Domello¨f and Fewtrell for their thoughtful review of our report. We agree that like all post-hoc analyses, the findings from this study should be interpreted with caution. While we controlled for several potential confounders that affect iron status and neurodevelopment, causation cannot be ascertained.
Effect of High-Dose Erythropoietin on Blood Transfusions in Extremely Low Gestational Age Neonates
[Skip to Content Landing] Original Investigation August 17, 2020 JAMA Pediatr. 2020;174(10):933-943. doi:10.1001/jamapediatrics.2020.2271 Full Text Key Points Question Does high-dose erythropoietin given within 24 hours of birth to postmenstrual age of 32 weeks decrease the number of blood transfusions, cumulative volume of transfusions, and unique donor exposures in extremely preterm infants?
EPO not neuroprotective in extremely preterm infants
Treatment with high-dose erythropoietin, or EPO, is not associated with a lower risk for death or severe neurodevelopmental impairment at 2 years of age in extremely preterm infants, according to phase 3 trial results published in The New England Journal of Medicine. The study was the first to explore the benefits of EPO therapy in extremely preterm infants. Previous, preclinical models of neonatal brain injury had shown a neuroprotective effect of EPO.
Urine hepcidin and iron regulation in preterm infants
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Neuroprotective Strategies in Neonatal Brain Injury
Epo and its receptor (EpoR) are required for normal brain development. Astrocytes are the main source of brain Epo, and many cell types express the receptor, including neurons, oligodendrocytes, and epithelial cells. The EpoR is expressed in hippocampal and cerebral cortical neurons, and expression of both Epo and EpoR decline postnatally in brain but remain present at lower levels throughout adulthood.59, 60 Prolonged hypoxic exposure leads to upregulation of EpoR gene expression.
Ultrafast Doppler As a Novel Bedside Measure of Cerebral Perfusion in Preterm Infants
Ultrafast Doppler As a Novel Bedside Measure of Cerebral Perfusion in Preterm Infants Edin Mehic, Pierre D. Mourad, Sandra E. Juul Pediatrics Sep 2017, 140 (3) 64; DOI: 10.1542/peds.140.3.64
Ultrafast Doppler As a Novel Bedside Measure of Cerebral Perfusion in Preterm Infants
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