The Incubator's Journal Club

Епизоде

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  #466 - [Journal Club] - 📌 Does IVF Really Raise the Risk of VACTERL Birth Defects? 17.09.2026 18мин

  Ben and Daphna dig into a large, population-based study linking IVF conception to VACTERL association, a rare but serious pattern of congenital anomalies spanning the vertebral, anal, cardiac, tracheoesophageal, renal, and limb systems. Drawing on over 1.5 million births across four US states and linked SART registry data, the study finds IVF-conceived infants face significantly higher odds of VACTERL and related multiple anomaly syndromes compared to naturally conceived infants. Daphna...
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  #466 - [Journal Club] - 📌 Should we start CPAP at 8 instead of 5 in the delivery room for very preterm infants? 16.09.2026 16мин

  Ben and Daphna dig into a pilot RCT that asks a deceptively simple delivery-room question: should very preterm infants start on CPAP of 5 or CPAP of 8 cmH2O? The PHILODENDRON trial, out of Milan's Buzzi Children's Hospital, randomized 56 babies born between 26 and 29 weeks to find out — testing feasibility, safety, and early physiological adaptation before committing to a larger multicenter trial. No major safety signals emerged, but babies on lower CPAP reached surfactant thresholds faster, ...
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  #466 - [Journal Club] - 📌 Oral isn't IM: Sweden's vitamin K data in two million infants 15.09.2026 22мин

  Is the newborn vitamin K shot really being skipped more often these days, and does that actually matter clinically? This week on Journal Club, Ben and Daphna review a nationwide Swedish cohort study of over two million births, published in JAMA Pediatrics, examining trends in non-receipt of intramuscular vitamin K and its link to bleeding in infancy. Non-receipt nearly doubled between 2006 and 2021, and infants without intramuscular vitamin K had significantly higher odds of bleeding, includi...
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  #466 - [Journal Club] - 📌 Do We Still Need a DAT on Every Newborn at Risk of Hemolytic Disease? 14.09.2026 26мин

  Do we really need a DAT on every baby born to a group O or Rh-negative mother? This week on Journal Club, Ben and Daphna dig into a new Pediatrics study questioning routine Direct Antiglobulin Testing (DAT) in low-risk neonates with ABO or RhD incompatibility. Using data from over 1,300 infants, the authors found that transcutaneous bilirubin alone predicted the need for phototherapy just as well as DAT in ABO-incompatible babies, and that passive anti-D from RhoGAM rarely caused significant ...
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  #462 - [Journal Club] - 📌 Dexamethasone Eye Drops Prevent Treatment Requiring ROP? 03.09.2026 16мин

  Steroids again? This time in the eye. Daphna brings the DROP-ROP trial from JAMA Pediatrics, a double-masked randomized study across fourteen Swedish centers asking whether topical dexamethasone can stop pre-threshold ROP from progressing to type one disease. One hundred infants, born under 30 weeks, dosed for up to twelve weeks, some still getting drops at home. Twenty percent needed laser or anti-VEGF in the dexamethasone arm versus thirty-eight percent on placebo, a relative risk reduction...
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  #462 - [Journal Club] - 📌 Continuous vs Bolus Feeding, Which One Grows Babies Better? 02.09.2026 17мин

  Every unit has a bolus camp and a continuous camp, and both are usually dug in. Ben brings a single center non-inferiority trial from India, published in the Journal of Pediatrics, randomizing 132 infants born before 29 weeks and under a thousand grams to extended infusion feeding or two hourly bolus feeds. Weight gain at discharge was essentially identical at 15.3 versus 15.7 grams per kilo per day, but the infusion group lost two fewer days to interrupted feeds. Ben and Daphna talk through ...
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  #462 - [Journal Club] - 📌 After HEAL Does a Second Trial Close the Book on EPO? 01.09.2026 21мин

  We already had HEAL, so why run this trial at all? Daphna brings PAEAN from JAMA Pediatrics, a phase three trial across 24 units in Australia, New Zealand, and Singapore that gave high dose erythropoietin to 313 late preterm and term infants already receiving therapeutic hypothermia for HIE. Same drug, same dosing, nearly the same eligibility criteria as HEAL, by design. Death or moderate to severe developmental deficit at two years was 34 percent with EPO versus 29 percent with placebo. Ben ...
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  #462 - [Journal Club] - 📌 After LISA Does CPAP Perform as Well as NIMV Below 30 Weeks? 31.08.2026 20мин

  Most trials comparing CPAP and NIMV leave a lingering doubt about whether surfactant explained the difference. This one does not. Ben brings a multicenter noninferiority trial from JAMA Network Open in infants born between 24 and 29 weeks, randomized to nasal CPAP or NIMV with every baby receiving less invasive surfactant administration. The trial stopped early for futility after 312 infants. Noninvasive ventilation failure within 72 hours was 26 percent on CPAP versus 13 percent on NIMV. Ben...
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  #458 - [Journal Club] - 📌 Can the respiratory severity score show us where a baby is heading? 14.08.2026 25мин

  The respiratory severity score is one multiplication most of us already do in our heads, mean airway pressure times FiO2. This week Dr. Dinushan Kaluarachchi joins Journal Club to walk through three papers built on it, RSS trajectories across gestational age in the PROP cohort, an RSS based grading of BPD at 36 weeks, and RSS after 40 weeks as a predictor of tracheostomy. He also talks about writing that last paper with his son, a high school junior, and why a brief communication is a realist...
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  #458 - [Journal Club] - 📌 Could a handheld light probe detect NEC before the X-ray does? 13.08.2026 21мин

  NEC still tends to announce itself on an X-ray, usually later than we want. This week Daphna reviews the first-in-human study of broadband optical spectroscopy, a handheld transcutaneous probe out of Lurie Children's that reads reflected light from 350 to 2500 nanometers to look at bowel beneath the skin. Just under 100 preterm infants, more than 11,000 scans, and a machine learning model that separated NEC from non-NEC scans with 100% sensitivity and a 100% negative predictive value, though ...
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  #458 - [Journal Club] - 📌 Is this the trial that brings probiotics back to the NICU? 12.08.2026 25мин

  Probiotics left US NICUs after the FDA reclassified them, and NEC rates went up. This week Ben reviews the Connection Study, a 2,158 infant phase 3 trial of IBP-9414, a live biotherapeutic product containing Limosilactobacillus reuteri, run under an IND with the regulatory rigor probiotics never had. Neither primary endpoint reached significance, but all cause mortality fell 27%, and surgically confirmed NEC favored treatment after 14 days of dosing. The discussion may be the real story, incl...
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  #458 - [Journal Club] - 📌 Does holding during cooling change NICU outcomes in HIE? 11.08.2026 17мин

  Parents of babies undergoing therapeutic hypothermia often wait days before they can hold their child, and many never get the chance during cooling at all. This week on Journal Club, Daphna reviews a new Journal of Perinatology retrospective cohort from two level IV NICUs, 379 infants with HIE, where 28% were held during cooling. Held infants reached full oral feeds sooner, were more likely to go home on breast milk, and had shorter stays, but they were also less sick to begin with. Ben pushe...
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  #458 - [Journal Club] - 📌 Should late preterm infants born by cesarean receive prophylactic CPAP? 10.08.2026 36мин

  Late preterm babies born by cesarean fill our NICUs, and most of them are there for respiratory distress that resolves in a day or two. Could 20 minutes of CPAP in the operating room keep them out? This week on Journal Club, Ben and Daphna break down the PLaNT trial, a five center randomized pilot of prophylactic CPAP at 5 to 6 cm of water in spontaneously breathing infants born at 34 to 36 weeks by cesarean. They then sit down with senior author Dr. Edgardo Szyld to talk pneumothorax risk, t...
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  #456 - [Journal Club] - 🫀 From The Heart - Do These Newborns Have Diastolic Dysfunction, or Just Different Physiology? 30.07.2026 13мин

  In this prospective study, Adrianne and Nim dig into an area with almost no normative pediatric data: right ventricular diastolic function. Comparing 57 infants with RV pressure overload after intervention for pulmonic stenosis or tetralogy of Fallot to 134 healthy controls, the authors found a consistent pattern, reduced beat-to-beat variability, a higher atrial contribution to filling, and an E/A ratio inversion that was nearly universal in the CHD group versus about half of controls. It's ...
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  #456 - [Journal Club] - 🫀 From The Heart - Why Does a Sicker Mom Sometimes Mean a Stronger Neonatal Heart? 29.07.2026 13мин

  In this small prospective pilot study, Adrianne and Nim explore a domain rarely discussed on rounds, how a mother's cardiovascular function in preeclampsia shapes her newborn's circulatory transition. Using maternal echo and neonatal electrical cardiometry across 13 mother-baby dyads, the authors found an inverse relationship: the worse the mother's cardiac function, the higher the neonate's cardiac output, though vascular tone barely budged. It's a compelling hypothesis about placental strai...
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  #456 - [Journal Club] - 🫀 From The Heart - Why Is CHD Mortality Rising Again After 15 Years of Progress? 28.07.2026 11мин

  In this retrospective national study, Adrianne and Nim look at 25 years of congenital heart disease mortality in the US using CDC WONDER data. Infant mortality remains staggeringly high (54 per 100,000), and after years of steady decline, it has been climbing again since 2014. Disparities run throughout: higher deaths among males, non-Hispanic Black and American Indian/Alaska Native populations, and in rural, Midwestern regions, pointing more to gaps in access and resources than to disease bi...
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  #456 - [Journal Club] - 🫀 From The Heart - Should an Abnormal Brain MRI Change the Decision to Operate in Critical CHD? 27.07.2026 19мин

  In this systematic review and meta-analysis, Nim and Adrianne dig into just how common brain injury really is in neonates with critical congenital heart disease. Pooling 31 studies spanning two decades, the authors found that nearly 70% of these babies show some form of ischemic brain injury, split roughly between pre-operative and post-operative timing. Counter to what most clinicians would predict, kids who went to surgery earlier (days 4-6) had higher rates of white matter injury than thos...
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  #453 - [Journal Club] - 📌 What Happened to NEC When Centers Stopped Using Probiotics? 16.07.2026 16мин

  When the FDA warning landed in late 2023, probiotic use in high-use NICUs collapsed from 86% to under 7% almost overnight. What happened to NEC? This week Daphna brings Tolia and Patel's new Journal of Perinatology analysis of the Pediatrix Clinical Data Warehouse, a natural experiment across 347 NICUs and more than 10,000 extremely preterm infants. Centers that stopped saw NEC climb from 2.7% to 4.4%. Centers that never used probiotics saw nothing change. Ben and Daphna work through the diff...
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  #453 - [Journal Club] - 📌 Should We Cool 35 Week Infants with Encephalopathy? 15.07.2026 14мин

  Cooling works at 36 weeks. At 35 weeks, nobody is sure. Ben brings a new Journal of Perinatology analysis of the National Inpatient Sample, covering 1.4 million infants from 2016 to 2022, asking what happens when therapeutic hypothermia is offered just below the evidence line. Cooled 35-weekers died at higher rates than cooled 36-weekers, but within the 35-week group, cooling changed nothing either way. Coagulopathy rose with cooling. Mediation analysis says it wasn't the cause. Ben and Daphn...
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  #453 - [Journal Club] - 📌 Can We Rewire a Preterm Baby's Brain for Language? 14.07.2026 21мин

  In this Journal Club, Daphna takes the reins with the MIND randomized controlled trial from Nathalie Maitre and colleagues in The Journal of Pediatrics. Can a multisensory bundle, combining infant-directed voice, a parent's scent, holding, and gentle containment, do more for a preterm baby's developing brain than recorded voice alone? Using event-related potentials to track how infants tell speech sounds apart, the team followed language outcomes all the way to age two. Daphna and Ben unpack ...