Citations 6
Stool Microbiota, Metabolites, and Fecal Incontinence in Women
Arya, Lily A. , Kashyap, Purna , Carnes, Megan U., Mathur, Ravi, Richter, Holly E., Andy, U., Jelovsek, J. Eric, Siddiqui, Nazema Y., Morrow, Casey D. , Lefkowitz, Elliot J. , Pol, William J. Van Der, Broeckling, Corey, Carper, Benjamin, Jeney, Sarah E.S., Zyczynski, Halina M. , Dyer, Keisha Y., Carberry, Cassandra, Mazloomdoost, D., Network, for the NICHD Pelvic Floor Disorders, Arya, Lily A. , Carnes, Megan Ulmer , Mathur, Ravi , Richter, Holly E , Andy, Uduak Umoh , Pol, William J. Van Der, Broeckling, Corey D. , Carper, Benjamin , Jeney, Sarah E.S. , Carberry, Cassandra, Mazloomdoost, Donna , Gantz, Marie G.
Urogynecology | June 4, 2026 | Volume: No volume available | Issue: No issue available | Pages: No page available
Importance Stool metabolites influencing gut motility and sensation may contribute to fecal incontinence (FI). Objective The objective of this study was to test whether FI is associated with higher levels of butyrate and Clostridiales taxa in stool. Study Design Stool metabolites and microbiota were compared between 96 women with FI and 42 controls. FI frequency and subtype (urgency vs insensible) were measured using a 14-day bowel diary, St. Mark’s score, and the Accidental Bowel Leakage questionnaire. Metabolite analysis included targeted analysis (8 short-chain fatty acids including butyrate, 17 bile acids, and 8 tryptophan derivatives) and untargeted analysis. Stool microbiota were characterized using 16S rRNA gene sequencing. Multivariable and exploratory multiomics factor analysis were performed with statistical significance defined as false discovery rate (FDR) ≤0.10. Results The FI group had a higher proportion of Bristol stool types 2 and 6 than controls ( P = 0.005). The mean number of leaks for the FI group was 1.7 ± 1.7 per day, 38% had urgency FI, and 39% had insensible FI. There was no significant difference between groups in butyrate levels and Clostridiales taxa. Multiomics analysis identified glycerolipids (monoacylglycerols and diacylglycerols) associated with FI (FDR = 0.08). In addition, insensible FI was associated with glycerolipids, long-chain saturated and monounsaturated fatty acids, phospholipids, and dipeptides (FDR = 0.08–0.09). The top weighted microbiota associated with these metabolites were Lachnospiraceae and Ruminococcaceae; however, these taxa were not directly associated with FI. Conclusion Butyrate and Clostridiales were not associated with FI. Novel stool metabolite signatures were identified, suggesting new biological pathways and potential therapeutic targets for FI.
S728 Comparative Effectiveness of Biofeedback and Dextranomer/Hyaluronate Injection for Treatment of Fecal Incontinence: A Multicenter Randomized Controlled Trial
Bharucha, Adil E. , Whitehead, William E. , Meyer, Isuzu , Chey, William D. , Busby‐Whitehead, Jan, Chua, Heidi K, Menees, Stacy B. , Perry, William C., Szarka, Lawrence A., Hamilton, Frank A., Perry, William , Perry, William R , Rao, Satish S.C. , Gantz, Marie G. , Richter, Holly E. , Sridhar, Amaanti , Wu, Jennifer M.
American Journal of Gastroenterology | October 24, 2024 | Volume: 119 | Issue: 10S | Pages: S500-S500
Social Determinants of Health and Redirection of Care for Infants Born Extremely Preterm
Bann, Carla , Vohr, Betty R. , McGowan, Elisabeth C. , Harmon, Heidi M. , Hintz, Susan R. , Duncan, Andrea F. , Polin, Richard A. , Laptook, Abbot R. , Mayne, Julie, Lamberson, Vita, Keszler, Mary Lenore, Hensman, Angelita M. , Vieira, Elisa , Pierre, Lucille St., Burke, Robert T., Alksninis, Barbara, Leach, Teresa M., Knoll, Andrea M., Moffat, Stephanie, Newman, Nancy S., Wilson-Costello, Deanne E. , Siner, Bonnie S., Friedman, Harriet, Truog, William E., Pallotto, Eugenia K. , Kilbride, Howard W. , Gauldin, Cheri, Holmes, Anne, Johnson, Kathy, Scott, Allison, Parimi, Prabhu S., Gaetano, Lisa, Merhar, Stephanie L. , Schibler, Kurt, Poindexter, Brenda B. , Cahill, Tanya E., Dudley, Juanita , Gratton, Teresa L., Grisby, Cathy, Henkes, Lisa, Kirker, Kristin, Stacey, Sara, Wuertz, Sandra, Cotten, C. Michael , Goldberg, Ronald N., Goldstein, Ricki F., Malcolm, William , Ashley, Patricia L., Mago-Shah, Deesha, Finkle, Joanne, Fisher, Kimberley A. , Gustafson, Kathryn E. , Bose, Carl , Bernhardt, Janice, Bose, Gennie, Clark, Cindy, Wereszczak, Janice, Warner, Diane, Talbert, Jennifer, Kicklighter, Stephen D. , Bentley, Alexandra, Edwards, Laura , Rhodes-Ryan, Ginger, Carlton, David P., Loggins, Yvonne, Adams‐Chapman, Ira , Bottcher, Diane I., Carter, Sheena L., Hale, Ellen C., Kendrick-Allwood, Salathiel, Laursen, Judith, LaRossa, Maureen Mulligan, Mackie, Colleen, Sanders, Amy , Smikle, Gloria V., Wineski, Lynn, Walsh, Michele C. , Bremer, Andrew A. , Higgins, Rosemary D. , Archer, Stephanie Wilson , Sokol, Gregory M. , Papile, L.A., Herron, Dianne E., Hines, Abbey C. , Lytle, Carolyn, Smiley, Lucy, Wilson, Leslie Dawn, Watkins, Donna, Gunn, Susan, Joyce, Jeff, Tyson, Jon E., Kennedy, Kathleen A. , Mosquera, Ricardo A. , Eason, Elizabeth, Stephens, Emily K. , Alaniz, Nora I., Allain, Elizabeth, Arldt-McAlister, Julie, Boricha, Fatima, Burson, Katrina, Garcia, Carmen, Hall, Donna J., John, Janice , Jones, Patrick M., Lillie, M. Layne, Mason, Carrie M., Martin, Karen , Martin, Sara C., McDavid, Georgia E., McKee, Shannon L. , Poe, Michelle, Rennie, Kimberly , Reddy, Tina, Rodgers, Shawna, Siddiki, Saba Khan, Sperry, Daniel K., Tate, Patti L. Pierce, Wright, Sharon L., Zanger, Dinorah, Jadcherla, Sudarshan R. , Timan, Christopher J., Luzader, Patricia, Batterson, Nancy, Baugher, Hallie, Beckford, Demi R., Burkhardt, Stephanie, Carey, Helen , Chao, Michelle, Cira, Courtney, Clark, Erna, DeSantis, Brittany, Fowler, Aubrey, Gutentag, Julie, Grothause, Jennifer L., Hague, Cole , Levengood, Katelyn, Marzec, Laura, McCool, Jacqueline, Miller, Bethany, Nelin, Mary Ann , Park, Courtney, Purnell, Jessica, Seabrook, Ruth , Shadd, Julie C., Small, Kristi , Stein, Melanie, Sullivan, Margaret, Sullivan, Rox Ann, Warnimont, Kyrstin, Yossef‐Salameh, Lina, Fearns, Erin, Wallace, Dennis, Auman, Jeanette O’Donnell , Gabrio, Jenna, Huitema, Carolyn M. Petrie , Zaterka-Baxter, Kristin M. , Meurs, Krisa P. Van , Chock, Valerie Y. , Stevenson, David K. , Ball, M. Bethany , Bahmani, Dona, Adams, Marian M. , Bentley, Barbara, DeAnda, Maria Elena, DeBattista, Anne M., Earhart, Beth, Huffman, Lynne C. , Krueger, Casey E., Lucash, Ryan E., Proud, Melinda S., Reichert, Elizabeth N., Weiss, Hali E., Williams, R. Jordan , Peralta-Carcelén, Myriam , Collins, Monica V., Cosby, Shirley S., Bailey, Kirstin J., Biasini, Fred J., Chopko, Stephanie A., Domnanovich, Kristy A., Jno-Finn, Chantel J., Ladinsky, Morissa, Moses, Mary Beth, Buie, Cindie, McNair, Tara E., Phillips, Vivien A., Preskitt, Julie , Rector, Richard V., Stringer, Kimberlly, Whitley, Sally, Chapman, Sheree York, Devaskar, Uday, Garg, Meena, Purdy, Isabell B., Chanlaw, Teresa , Geller, Rachel , Johnson, Karen, Eastman, Diane L., Walker, Jacky R., Goeke, Claire A., Schmelzel, Mendi L., Faruqui, Sarah E., Coulter, Brenda J., Schrimper, Bailey M., Jellison, Sydney S., Knosp, L.K., Arnold, Sandra J., Andrews, Haley A., Ellsbury, Dan L., Bass, Donia B., Tud, Tracy L., Baack, Michelle , Richards, Laurie A., Henning, Megan M., Elenkiwich, Chelsey, Broadbent, Megan, Muyden, Sarah Van, Brodkorb, Aimee, Watterberg, Kristi L. , Fuller, Janell, Ohls, Robin K. , Lacy, Conra Backstrom, Hartenberger, Carol, Beauman, Sandra Sundquist , Hanson, Mary, Lowe, Jean, Kuan, Elizabeth, Eichenwald, Eric C. , Abbasi, Soraya, Chaudhary, Aasma S. , Cucinotta, Dara M., Bernbaum, Judy, Gerdes, Marsha , Ghavam, Savin, Hurt, Hallam, Snyder, Jonathan, Ziolkowski, Kristina, Dhawan, Megan , Booth, Lauren, Catts, Christine, D’Angio, Carl T., Guillet, Ronnie , Myers, Gary J. , Reynolds, Anne Marie , Wadkins, Holly I.M., Sacilowski, Michael G., Jensen, Rosemary L., Merzbach, Joan, Zorn, William, Farooq, Osman , Maffett, Dee, Williams, Ashley, Hunn, Julianne, Guilford, Stephanie , Yost, Kelley, Rowan, Mary, Prinzing, Diane, Bowman, Melissa, Reubens, Linda J., Scorsone, Ann Marie, Harley-McAndrew, Michelle, Fallone, Caitlin, Binion, Kyle, Orme, Constance, Sabaratnam, Premini , Jones, Rachel , Boylin, Elizabeth, Rochez, Daisy, Li, Emily, Kachelmeyer, Jennifer , McKee, Kimberly G., Coleman, Kelly R., Moreland, Melissa, Cavanaugh, Brenna, Wyckoff, Myra H. , Heyne, Roy J. , Vasil, Diana M., Adams, Sally S., Chen, Lijun , Leon, Maria Magdalena, Duran, Joanne, Eubanks, Frances, McDougald, Rebecca, Pavageau, Lara, Sepulveda, Pollieanna , Guzman, Alicia, Harrod, M. J. E., Heyne, Elizabeth T., Madden, Linda A., Lee, Lizette E. , Puentez, Anna E., Tolentino-Plata, Kristine , Boatman, Cathy Twell, Vera, Azucena, Waterbury, Jillian, Yoder, Bradley A. , Baserga, Mariana , Faix, Roger G., Minton, Stephen D., Sheffield, Mark J., Rau, Carrie A., Baker, Shawna, Burnett, Jill, Christensen, Susan, Bledsoe, Laura Cole, Cunningham, Sean D. , Davis, Brandy, Elmont, Jennifer O., Hall, Becky, Jensen, Erika R., Loertscher, Manndi C., Marchant, Trisha, Maxson, Earl, McGrath, Kandace M., Mickelsen, Hena G., Morshedzadeh, Galina, Parry, Dilys M. , Reich, Brixen A., Schaefer, Susan T., Stout, Kelly, Stuart, Ashley L., Weaver-Lewis, Kimberlee, Winter, Sarah , Woodbury, Kathryn D., Osborne, Karen A., Bird, Karie, Coleman, Kathleen, Francom, Barbara L., Jordan, Jamie, Steffen, Mike, Tice, Katherine, Shankaran, Seetha , Natarajan, Girija , Pappas, Athina, Sood, Beena G. , Bajaj, Monika , February, Melissa, Agarwal, Prashant , Chawla, Sanjay , Bara, Rebecca, Childs, Kirsten, Woldt, Eunice, Goldston, Laura A., Wiggins, Stephanie A., Christensen, Mary, Carlson, Martha, White, Diane F., Baack, Michelle L , Brumbaugh, Jane E. , Bell, Edward F. , Travers, Colm P. , Carlo, Waldemar A. , Keszler, Martin , Watson, Victoria E. , Hibbs, Anna Maria , Kim, Jae Hong , Yolton, Kimberly , Russell, David G. , Laughon, Matthew Maxwell , White, Donna, Patel, Ravi M. , Stoll, Barbara J. , Sewell, Elizabeth , Maitre, Nathalie L. , (deceased), Jeff Joyce, Khan, Amir M , Rysavy, Matthew A. , Dempsey, Allison G. , White, Michelle, Sánchez, Pablo J. , Slaughter, Jonathan L. , Nelin, Leif Daniel , Yeates, Keith Owen , Fortney, Christine A. , Keim, Sarah A. , Newton, Julia L. , Pietruszewski, Lindsay , Das, Abhik , Gantz, Marie G. , Wiener, Laura Elizabeth , Crawford, Margaret M. , Newman, Jamie E. , Parlberg, Lindsay M. , Taylor, Heather Lee , Ambalavanan, Namasivayam , Colaizy, Tarah T. , Widness, John A. , DeMauro, Sara B. , Schmidt, Barbara Kristina , Kirpalani, Haresh Murli , Mancini, Toni, Lakshminrusimha, Satyan , Kent, Alison , Brion, Luc P. , Leon, Maria M. De, Harrod, Michelle, Parry, D. Melody, Coleman, Kathleen, Barks, John
JAMA Pediatrics | March 11, 2024 | Volume: 178 | Issue: 5 | Pages: 454
10.1001/jamapediatrics.2024.0125
ImportanceRedirection of care refers to withdrawal, withholding, or limiting escalation of treatment. Whether maternal social determinants of health are associated with redirection of care discussions merits understanding.ObjectiveTo examine associations between maternal social determinants of health and redirection of care discussions for infants born extremely preterm.Design, Setting, and ParticipantsThis is a retrospective analysis of a prospective cohort of infants born at less than 29 weeks’ gestation between April 2011 and December 2020 at 19 National Institute of Child Health and Human Development Neonatal Research Network centers in the US. Follow-up occurred between January 2013 and October 2023. Included infants received active treatment at birth and had mothers who identified as Black or White. Race was limited to Black and White based on service disparities between these groups and limited sample size for other races. Maternal social determinant of health exposures were education level (high school nongraduate or graduate), insurance type (public/none or private), race (Black or White), and ethnicity (Hispanic or non-Hispanic).Main Outcomes and MeasuresThe primary outcome was documented discussion about redirection of infant care. Secondary outcomes included subsequent redirection of care occurrence and, for those born at less than 27 weeks’ gestation, death and neurodevelopmental impairment at 22 to 26 months’ corrected age.ResultsOf the 15 629 infants (mean [SD] gestational age, 26 [2] weeks; 7961 [51%] male) from 13 643 mothers, 2324 (15%) had documented redirection of care discussions. In unadjusted comparisons, there was no significant difference in the percentage of infants with redirection of care discussions by race (Black, 1004/6793 [15%]; White, 1320/8836 [15%]) or ethnicity (Hispanic, 291/2105 [14%]; non-Hispanic, 2020/13 408 [15%]). However, after controlling for maternal and neonatal factors, infants whose mothers identified as Black or as Hispanic were less likely to have documented redirection of care discussions than infants whose mothers identified as White (Black vs White adjusted odds ratio [aOR], 0.84; 95% CI, 0.75-0.96) or as non-Hispanic (Hispanic vs non-Hispanic aOR, 0.72; 95% CI, 0.60-0.87). Redirection of care discussion occurrence did not differ by maternal education level or insurance type.Conclusions and RelevanceFor infants born extremely preterm, redirection of care discussions occurred less often for Black and Hispanic infants than for White and non-Hispanic infants. It is important to explore the possible reasons underlying these differences.
Incidence of and Neurodevelopmental Outcomes After Late-Onset Meningitis Among Children Born Extremely Preterm
Bell, Edward F. , Barbara, T. , Greenberg, Rachel G. , Stoll, Barbara J. , DeMauro, Sara B. , Harmon, Heidi M. , Hintz, Susan R. , Das, Abhik , Puopolo, Karen M. , Bailey, Kirstin J., Biasini, Fred J., Chopko, Stephanie A., Collins, Monica V., Cosby, Shirley S., Johnston, Kristen C. , Moses, Mary Beth, Nelson, Kathleen G., Patterson, Cryshelle S., Peralta-Carcelén, Myriam , Phillips, Vivien A., Preskitt, Julie , Rector, Richard V., Whitley, Sally, Alksninis, Barbara, Bishop, Carmena, Burke, Robert T., Caskey, Melinda, Hensman, Angelita M. , Hoffman, Laurie , Johnson, Katharine, Keszler, Mary Lenore, Knoll, Andrea M., Lamberson, Vita, Laptook, Abbot R. , Leach, Theresa M., Little, Emilee, McGowan, Elizabeth C., Pierre, Lucille St., Stephens, Bonnie E., Ventura, Suzy, Vieira, Elisa , Vohr, Betty R. , Coleman, Kelly R., Guilford, Stephanie , Hartley-McAndrew, Michelle, Li, Emily, Reynolds, Anne Marie , Sacilowski, Michael G., Williams, Ashley, Zorn, William, Bhola, Monika , Fanaroff, Avroy A., Friedman, Harriet, Newman, Nancy S., Siner, Bonnie S., Walsh, Michele C. , Wilson-Costello, Deanne E. , Yalcinkaya, Gulgun, Caplan, Michael S. , Beiersdorfer, Traci , Bridges, Kate, Cahill, Tanya E., Donovan, Edward F., Dudley, Juanita , Fischer, Estelle E., Gratton, Teresa L., Grisby, Cathy, Hayes, Devan, Hessling, Jody, Jackson, Lenora, Kallapur, Suhas G. , Kirker, Kristin, Merhar, Stephanie L. , Mincey, Holly L., Muthig, Greg, Poindexter, Brenda B. , Schibler, Kurt, Stacey, Sara, Steichen, Jean J., Tepe, Stacey, Thompson, Julia, Mersmann, Marcia Worley, Wuertz, Sandra, Polin, Richard A. , Adams, Sally S., Leon, Maria Magdalena, Eubanks, Frances, Guzman, Alicia, Hensley, Gaynelle, Heyne, Elizabeth T., Heyne, Roy J. , Hickman, Jackie F., Lee, Lizette E. , Leps, Melissa H., Madden, Linda A., McDougald, E. Rebecca, Miller, Nancy A., Morgan, Janet S., Pavageau, Lara, Salhab, Walid A., Sepulveda, Pollieanna , Boatman, Catherine Twell, Vasil, Diana M., Waterbury, Jillian, Wyckoff, Myra H. , Ashley, Patricia L., Auten, Kathy J., Cotten, C. Michael , Finkle, Joanne, Fisher, Kimberley A. , Goldberg, Ronald N., Goldstein, Ricki F., Grimes, Sandra, Gustafson, Kathryn E. , Lohmeyer, Melody B., Malcolm, William , Adams‐Chapman, Ira , Blackwelder, Ann M., Bottcher, Diane I., Carlton, David P., Carter, Sheena L., Hale, Ellen C., Kendrick-Allwood, Salathiel, Laursen, Judith, Loggins, Yvonne, Mackie, Colleen, LaRossa, Maureen Mulligan, Sanders, Amy , Seabrook, Irma, Smikle, Gloria V., Wineski, Lynn, Akpa, Esther, Alaniz, Nora I., Allain, Elizabeth, Arldt-McAlister, Julie, Bradt, Pamela J., Burson, Katrina, Dieterich, Susan, Duncan, Andrea F. , Eason, Elizabeth, Evans, Patricia W., Harris, Beverly Foley, Franco, Claudia I., Garcia, Carmen, Hall, Donna J., Jiménez, Margarita, John, Janice , Jones, Patrick M., Kennedy, Kathleen A. , Siddiki, Saba Khan, Lillie, Layne M., Major-Kincade, Terri L., Martin, Sara C., McDavid, Georgia E., McKee, Shannon L. , Morris, Brenda H., Orekoya, Patricia Ann, Pedrozza, Claudia, Perez, Carrie M., Tate, Patti L. Pierce, Reddoch, Stacey, Rodgers, Shawna, Simmons, Maegan C., Sperry, Daniel K., Stephens, Emily K. , Tyson, Jon E., Whitely, Laura L., Wright, Sharon L., Dusick, Anna M., Gunn, Susan, Hamer, Faithe, Herron, Dianne E., Hines, Abbey C. , Joyce, Jeffery, Lemons, James A., Lytle, Carolyn, Miller, Lucy , Minnich, Heike M., Papile, L.A., Richard, Leslie, Smiley, Lucy, Sokol, Gregory M. , Wilson, Leslie Dawn, Acarregui, Michael J., Colaizy, Tarah T. , Eastman, Diane L., Goeke, Claire A., Johnson, Karen, Krutzfield, Nancy J., Schmelzel, Mendi L., Walker, Jacky R., Bass, Donia B., Ellsbury, Dan L., Tud, Tracy L., Bauer, Charles R., Duara, Shahnaz , Everett‐Thomas, Ruth , Fajardo-Hiriart, Sylvia, Eguaras, Silvia M. Frade, Garcia, Andrea, Berkovits, Michelle Harwood, Pierre, Helina, Riguard, Arielle, Stoerger, Alexandra, Gaetano, Lisa, Gauldin, Cheri, Holmes, Anne, Johnson, Kathy, Kilbride, Howard W. , Pallotto, Eugenia K. , Parimi, Prabhu S., Scott, Allison, Truog, William E., Besner, Gail E. , Clark, Erna, Gutentag, Julie, Jadcherla, Sudarshan R. , Luzader, Patricia, Park, Courtney, Shadd, Julie C., Stein, Melanie, Sullivan, Margaret, Bremer, Andrew A. , Higgins, Rosemary D. , Archer, Stephanie Wilson , Abbasi, Soraya, Bernbaum, Judy, Catts, Christine, Chaudhary, Aasma S. , Cucinotta, Dara M., Eichenwald, Eric C. , Gerdes, Marsha , Ghavam, Sarvin, Hurt, Hallam, Snyder, Jonathan, Vangala, Sarith, Ziolkowski, Kristina, Johnson, Julie Babish, Binion, Kyle, Bowman, Melissa, Burnell, Erica, D’Angio, Carl T., Fallone, Caitlin, Farooq, Osman , Guillet, Ronnie , Horihan, Cassandra A., Hunn, Julianne, Hust, Diane, Jensen, Rosemary L., Jones, Rachel , Kachelmeyer, Jennifer , Kushner, Emily, Maffett, Deanna, McKee, Kimberly G., Merzbach, Joan, Myers, Gary J. , Orme, Constance, Phelps, Dale L. , Dm, Prinzing, Reubens, Linda J., Rochez, Daisy, Rowan, Mary, Sabaratnam, Premini, Scorsone, Ann Marie, Wadkins, Holly I.M., Yost, Kelley, Zwetsch, Lauren, Gabrio, Jenna, Hastings, Betty K., LeBlond, David, Auman, Jeanette O’Donnell , Huitema, Carolyn M. Petrie , Poole, W. Kenneth, Wallace, Dennis, Zaterka-Baxter, Kristin M. , Baack, Michelle , Broadbent, Megan, Elenkiwich, Chelsey, Henning, Megan M., Hogden, Laurie A., Adams, Marian M. , Bahmani, Dona, Ball, M. Bethany , Bentley, Barbara, Bruno, Elizabeth F., Chock, Valerie Y. , Davis, Alexis S. , DeAnda, Maria Elena, DeBattista, Anne M., Earhart, Beth, Huffman, Lynne C. , Ismael, Magdy, Kohn, Jean G., Krueger, Casey E., Lee-Ancajas, Julie C., Lowe, Janice, Lucash, Ryan E., Palmquist, Andrew W., Patel, Jessica, Proud, Melinda S., Reichert, Elizabeth N., Sivakumar, Dharshi, John, Nicholas H. St., Stevenson, David K. , Meurs, Krisa P. Van , Wager, Natalie, Williams, R. Jordan , Weiss, Hali E., Brussa, Ana K. , Church, Paige , Fiascone, John M., Frantz, Ivan D. , Furey, Anne, Kurfiss, Anne, MacKinnon, Brenda L., McGowan, Elisabeth C. , Nylen, Ellen, Sibley, Cecelia, Chanlaw, Teresa , Devaskar, Uday, Garg, Meena, Geller, Rachel , Purdy, Isabell B., Arnell, Kathy, Demetrio, Clarence, Finer, Neil N., Fuller, Martha G. , Henderson, Christopher, Kaegi, David, Rasmussen, Maynard R., Rich, Wade , Vaucher, Yvonne E. , Wozniak, Paul R., Bernhardt, Janice, Bose, Carl , Bose, Gennie, Clark, Cynthia L., Warner, Diane, Wereszczak, Janice, Lacy, Conra Backstrom, Fuller, Janell, Hanson, Mary, Hartenberger, Carol H., Kuan, Elizabeth, Lowe, Jean, Ohls, Robin K. , Beauman, Sandra Sundquist , Thomson, Rebecca A., Watterberg, Kristi L. , Carlson, Martha, Christensen, Mary, Wiggins, Stephanie A., Baker, Shawna, Baserga, Mariana , Bird, Karie, Burnett, Jill, Christensen, Susan, Bledsoe, Laura Cole, Cunningham, Sean D. , Davis, Brandy, Elmont, Jennifer O., Faix, Roger G., Hall, Becky, Jensen, Erika R., Jensen, Jennifer J., Jordan, Jamie, Loertscher, Manndi C., Marchant, Trisha, Maxson, Earl, McGrath, Kandace M., Minton, Stephen D., Morshedzadeh, Galina, Osborne, Karen A., Parry, Dilys M. , Rau, Carrie A., Reich, Brixen A., Schaefer, Susan T., Sheffield, Mark J., Spencer, Cynthia, Steffen, Michael, Stout, Kelly, Stuart, Ashley L., Tice, Katherine, Weaver-Lewis, Kimberlee, Winter, Sarah , Woodbury, Kathryn D., Yoder, Bradley A. , Zanetti, Karen, Chiu, Korinne, Dillard, Robert G., Allred, Deborah Evans, Goldstein, Donald J., Halfond, Raquel, Jackson, Barbara G., O’Shea, T. Michael , Peters, Nancy, Peterson, Carroll, Waldrep, Ellen, Washburn, Lisa K. , Welch, Cherrie D. , Morris, Melissa Whalen, Hounshell, Gail, Kicklighter, Stephen D. , Rhodes-Ryan, Ginger, Abramczyk, Katherine, Agarwal, Prashant , Bajaj, Monika , Bara, Rebecca, Billian, Elizabeth, Chawla, Sanjay , Childs, Kirsten, Jesus, Lilia C. De, Driscoll, D., February, Melissa, Goldston, Laura A., Muran, Geraldine, Natarajan, Girija , Pappas, Athina, Prentice, Jeannette E., Shankaran, Seetha , Sood, Beena G. , White, Diane F., Woldt, Eunice, Butler, Christine G., Cervone, Patricia, Ehrenkranz, Richard A., Gettner, Patricia, Greisman, Sheila, Jacobs, Harris C., Konstantino, Monica, Poulsen, JoAnn, Romano, Elaine, Taft, Janet, Brumbaugh, Jane E. , Das, Abhik , Baack, Michelle L , Ambalavanan, Namasivayam , Carlo, Waldemar A. , Keszler, Martin , Oh, William, Watson, Victoria E. , Lakshminrusimha, Satyan , Hibbs, Anna Maria , Payne, Allison H. , Alexander, Barbara D. , Jobe, Alan Hall , Yolton, Kimberly , Brion, Luc P. , Chen, Lijun , Leon, Maria M. De, Miller, Nancy A., Rosenfeld, Charles R. , Sánchez, Pablo J. , Patel, Ravi M. , Dempsey, Allison G. , Green, Charles E. , Khan, Amir M , Lis, Anna E. , Martin, Karen , Dagle, John M. , Klein, Jonathan M. , Widness, John A. , Calejo, Maria, Fortney, Christine A. , Maitre, Nathalie L. , Nelin, Leif Daniel , Parikh, Nehal A. , Cook, Noah , Kirpalani, Haresh Murli , Mancini, Toni, Schmidt, Barbara Kristina , Vangala, Saritha, Kent, Alison , Sabaratnam, Premini , Bann, Carla , Crawford, Margaret M. , Gantz, Marie G. , Leblond, David, Newman, Jamie E. , Taylor, Heather Lee , Henderson, Christopher, Laughon, Matthew Maxwell , DuPont, Tara L. , Barks, John , Sarkar, Subrata , Parry, D. Melody, Spencer, Cynthia, Steffen, Michael, White, Donna, Johnson, Mary E. , Panaitescu, Bogdan , Williams, Joanne W.
JAMA Network Open | December 8, 2022 | Volume: 5 | Issue: 12 | Pages: e2245826
10.1001/jamanetworkopen.2022.45826
ImportanceLate-onset meningitis (LOM) has been associated with adverse neurodevelopmental outcomes in children born extremely preterm.ObjectiveTo report the incidence of LOM during birth hospitalization and neurodevelopmental outcomes at 18 to 26 months’ corrected age.Design, Setting, and ParticipantsThis cohort study is a secondary analysis of a multicenter prospective cohort of children born at 22 to 26 weeks’ gestation between 2003 and 2017 with follow-up from 2004 to 2021. The study was conducted at 25 Eunice Kennedy Shriver National Institute of Child Health and Human Development Neonatal Research Network centers.ExposuresCulture-confirmed LOM.Main Outcomes and MeasuresIncidence and microbiology of LOM (2003-2017); lumbar puncture (LP) performance in late-onset sepsis (LOS) evaluations (2011-2017); composite outcome of death or neurodevelopmental impairment (NDI; 2004-2021).ResultsAmong 13 372 infants (median [IQR] gestational age, 25.4 [24.4-26.1] weeks; 6864 [51%] boys), LOM was diagnosed in 167 (1%); LOS without LOM in 4564 (34%); and neither LOS nor LOM in 8641 (65%). The observed incidence of LOM decreased from 2% (95% CI, 1%-3%) in 2003 to 0.4% (95% CI, 0.7%-1.0%) in 2017 (P < .001). LP performance in LOS evaluations decreased from 36% (95% CI, 33%-40%) in 2011 to 24% (95% CI, 21%-27%) in 2017 (P < .001). Among infants with culture-confirmed LOS, LP performance decreased from 58% (95% CI, 51%-65%) to 45% (95% CI, 38%-51%; P = .008). LP performance varied by center among all LOS evaluations (10%-59%, P < .001) and among those with culture-confirmed LOS (23%-79%, P < .001). LOM occurred in the absence of concurrent LOS in 27 of 167 cases (16%). The most common LOM isolates were coagulase-negative Staphylococcus (98 [59%]), Candida albicans (38 [23%]), and Escherichia coli (27 [16%]). Death or NDI occurred in 22 of 46 children (48%) with LOM due to coagulase-negative Staphylococcus, 43 of 67 (64%) due to all other bacterial pathogens, and 26 of 33 (79%) due to fungal pathogens. The adjusted relative risk of death or NDI was increased among children with LOM (aOR, 1.53; 95% CI, 1.04-2.25) and among those with LOS without LOM (aOR, 1.41; 95% CI, 1.29-1.54) compared with children with neither infection.Conclusions and RelevanceIn this cohort study, LP was performed with decreasing frequency, and the observed incidence of LOM also decreased. Both LOM and LOS were associated with increased risk of death or NDI; risk varied by LOM pathogen. The full association of LOM with outcomes of children born extremely preterm may be underestimated by current diagnostic practices.
Neurodevelopmental and Behavioral Outcomes in Extremely Premature Neonates With Ventriculomegaly in the Absence of Periventricular-Intraventricular Hemorrhage
Pappas, Athina, Adams‐Chapman, Ira , Shankaran, Seetha , McDonald, Scott A. , Stoll, Barbara J. , Laptook, Abbot R. , Meurs, Krisa P. Van , Hintz, Susan R. , Carlson, Martha, Walsh, Michele C. , Wyckoff, Myra H. , Das, Abhik , Higgins, Rosemary D. , Alexander, Barbara D. , Ambalavanan, Namasivayam , Gantz, Marie G. , Colaizy, Tarah T. , Bell, Edward F. , DeMauro, Sara B. , Payne, Allison H. , Lakshminrusimha, Satyan , Hibbs, Anna Maria , Yolton, Kimberly , Green, Charles E. , Parikh, Nehal A. , Yeates, Keith Owen , Brumbaugh, Jane E. , Das, Abhik , Carlo, Waldemar A.
JAMA Pediatrics | November 27, 2017 | Volume: 172 | Issue: 1 | Pages: 32
Metabolites and microbial composition of stool of women with fecal incontinence: Study design and methods
Arya, Lily A. , Richter, Holly E. , Jelovsek, Eric, Gantz, Marie G. , Cichowski, Sara , Zyczynski, Halina M. , Dyer, Keisha Y., Siddiqui, Nazema Y. , Carberry, Cassandra, Broeckling, Corey, Morrow, Casey D. , Kashyap, Purna , Meikle, Susie, Arya, Lily A.
Neurourology and Urodynamics | August 1, 2017 | Volume: 37 | Issue: 2 | Pages: 634-641
AimsThis paper aims to report the rationale, design, and the specific methodology of an ongoing nested observational study that will determine the association of the metabolite and microbial composition of stool with fecal incontinence (FI).MethodsEligible cases are participants with FI enrolled in the Controlling Anal Incontinence in women by Performing Anal Exercises with Biofeedback or Loperamide (CAPABLe) trial, a Pelvic Floor Disorders Network trial across eight clinical centers in the United States. Women of similar age without FI in the last year served as controls. All subject collected stool samples at the baseline and 24‐week visit at home using a standardized collection method. Samples were shipped to and stored at centralized laboratories.ResultsSpecimen collection commenced December 2014 and was completed in May 2016. Fecal water and DNA has been extracted and is currently being analyzed by targeted metabolic profiling for stool metabolites and 16S rRNA gene sequencing for stool microbiota.ConclusionsThis article describes the rationale and design of a study that could provide a paradigm shift for the treatment of FI in women.