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Articles by Terrie E. Inder
Whole Genomes, Clearer Diagnoses—Precision Care for Children With Neurologic Disease
Diagnostic uncertainty hinders appropriate management, counseling, and holistic family care in children with pediatric neurological diseases. Whole-genome sequencing is now providing a new light in a dark tunnel for these children and their families. This is of greater relevance as genetic precision therapies, such as N-of-1 gene therapy programs, continue to emerge with efficacy greatest before irreversible neuronal injury.
Anxiety and mood disorders from childhood to adulthood in very preterm and term-born individuals
Abstract Very preterm (VP) birth has been associated with higher rates of anxiety and mood disorders, but the emergence and persistence from childhood to adulthood is unknown. This study examined prevalence rates and early risk factors of these disorders in VP and term-born individuals.
Associations between opioid exposure and brain size among extremely preterm infants
Abstract Morphine and fentanyl are commonly used drugs in extremely preterm infants in the neonatal intensive care unit (NICU), but their impact on brain growth is unclear. This study aimed to evaluate the relationship between opioid exposure and brain size in extremely preterm infants. This is a retrospective cohort study of preterm infants born less than 28 weeks gestation who received opioids and underwent term-equivalent brain magnetic resonance imaging.
Incidence and risk factor profile for subcutaneous fat necrosis among newborns undergoing therapeutic hypothermia: a multi-center regional cohort
Abstract To determine the incidence, risk factors, and outcomes associated with subcutaneous fat necrosis (SCFN) in a regional cohort of newborns treated with therapeutic hypothermia (TH) for neonatal encephalopathy (NE). Data from a regional Neonatal Encephalopathy Registry was retrospectively analysed. All newborns treated with TH between 2018 and 2022 were included. The primary outcome was the incidence of SCFN. Secondary outcomes included associated risk factors and complications.
Therapeutic hypothermia at 35 weeks’ gestation: navigating controversy between randomized evidence, real-world practice, and shared decision-making
The role of therapeutic hypothermia (TH) in infants born at 35 weeks’ gestation remains uncertain, with discordant findings between randomized and observational studies and evolving clinical guidance. This commentary examines how this uncertainty has translated into substantial variability in clinical practice and highlights the limitations of relying on any single evidence source in isolation.
Assessment of parasympathetic tone during therapeutic hypothermia in infants with brain injury following neonatal encephalopathy
Abstract Neonatal encephalopathy remains the leading cause of acquired brain injury in term infants. While therapeutic hypothermia (TH) has significantly improved outcomes in moderate to severe cases, many infants continue to experience long-term morbidity. Early, non-invasive biomarkers are needed to better identify infants at risk. This study assessed changes in high-frequency heart rate variability (HF-HRV), reflecting parasympathetic tone, during TH and rewarming.
Evolution of the auditory environment of very preterm infants before term-equivalent age in relation to room type and parental presence
Abstract Very preterm (VP) infants undergo rapid brain development while hospitalized in the neonatal intensive care unit (NICU). Meaningful auditory experiences enhance brain development, yet understanding VP infants’ auditory environment remains a challenge. We examined the trajectories of auditory exposures of VP infants before term-equivalent age. This was a prospective, observational study of 25 VP infants born ≤32 weeks and 6 days gestation in a hybrid-design NICU.
Relationships between cerebral blood flow and cognition in young adults born very preterm and at term
Abstract The mechanisms underpinning persistent cognitive challenges in young adults born very preterm (VP; < 32 weeks’ gestation) are unclear, but may include altered cerebral blood flow (CBF). We explored whether CBF differed between adults born VP and at term, and the associations between CBF and cognitive outcomes. Seventy-two participants born VP and 16 term-born controls born in Victoria, Australia, completed Arterial Spin Labelling-MRI and a neuropsychological assessment at 20 years of age.
Music Therapy in the Neonatal Intensive Care Unit: A Center’s Experience with Program Development, Implementation, and Preliminary Outcomes
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A unit’s experience with hybrid NICU design: description of care model and implications for patients, families, and professionals - Journal of Perinatology
Abstract As the first extra-uterine setting for hospitalized infants, the neonatal intensive care unit (NICU) environment can make a lasting impact on their long-term neurodevelopment. This impact is likely mediated through both specific characteristics of the physical design of the care environment, as well as the experiences that occur within this environment. Recent studies document many established benefits of single-family rooms (SFRs).
Brain Injury in Infants Evaluated for, but not Treated, with Therapeutic Hypothermia
Previous Presentations: Portions of this study were presented as a poster during the Pediatric Academic Societies Virtual Meeting, April 30th - June 4th, 2021; as a poster during the International Newborn Brain Virtual Conference, February 10-12, 2022; and as a poster during the Pediatric Academic Societies Meeting, April 21-25, 2022, Denver, CO. Funding: This research received a grant from the CRICO/Risk Management Foundation of the Harvard Medical Institutions Incorporated.
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Terrie E. Inder, MBCHB, MD Terrie E. Inder Correspondence Corresponding Author: Terrie Inder Department of Pediatric Newborn Medicine PBB142, 15 Francis St, Boston MA 02115 Phone: 617-5256650 Affiliations Department of Pediatric Newborn Medicine, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA Search for articles by this author Linda S. de Vries, MD, PhD Linda S.
Neuroimaging of the Preterm Brain: Review and Recommendations
Abbreviations: AAP (American Academy of Pediatrics), cUS (Cranial ultrasound), GMH-IVH (Germinal matrix-intraventricular hemorrhage), c-PVL (Cystic periventricular leukomalacia), NICU (Neonatal intensive care unit), NPV (Negative predictive value), PHVD (Posthemorrhagic ventricular dilatation), Pre-OL (Pre-oligodendrocyte), PVHI (Periventricular hemorrhagic infarction), PVL (Periventricular leukomalacia), PWML (Punctate white matter lesions), TEA (Term equivalent age) See related article, p...
Management of Post-hemorrhagic Ventricular Dilatation in the Preterm Infant
Stoll B.J. Hansen N.I. Bell E.F. Walsh M.C. Carlo W.A. Shankaran S. et al. Trends in Care Practices, Morbidity, and Mortality of Extremely Preterm Neonates, 1993-2012. JAMA. 2015; 314: 1039-1051 Murphy B.P. Inder T.E. Rooks V. Taylor G.A. Anderson N.J. Mogridge N. et al. Posthaemorrhagic ventricular dilatation in the premature infant: Natural history and predictors of outcome. Archives of Disease in Childhood: Fetal and Neonatal Edition. 2002; 87: F37-F41 Kinney HC, Volpe JJ.
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To view the full text, please login as a subscribed user or purchase a subscription. Click here to view the full text on ScienceDirect. Magnetic resonance imaging (MRI) at term equivalent to predict the developmental outcome of the preterm infant has been shown consistently to be a stronger prognostic tool than cranial ultrasound examination, neurologic examination, or clinical factors.
Cerebrospinal fluid biomarkers of infantile congenital hydrocephalus
CSF levels of APP, sAPP?, sAPP?, A? 42 , tau, pTau, L1CAM, and NCAM-1 but not AQP4 or TP were increased in untreated CHC. CSF TP and normalized L1CAM levels were associated with FOR in CHC subjects, while normalized CSF tau levels were associated with FOR in control subjects.
Abnormal Cerebral Structure Is Present at Term in Premature Infants
Background. Long-term studies of the outcome of very prematurely born infants have clearly documented that the majority of such infants have significant motor, cognitive, and behavioral deficits. However, there is a limited understanding of the nature of the cerebral abnormality underlying these adverse neurologic outcomes. Aim.
Holes in holistic care after discharge of complex NICU infants - the gaps Hurt
In the poignant reflection published in the Journal by a father, Ryan Kline, on surviving the post-neonatal intensive care unit (NICU) storm,1one may also relate to his story as a continued series of severe aftershocks occurring after a devastating initial earthquake. These aftershocks are accompanied by unpredictability, physical exhaustion, prolonged anxiety, and an unstable environment.
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