Neonatal Research Network (NRN)

Overview

Formed in 1986 through NICHD’s Pregnancy and Perinatology Branch, the NRN is a collaborative network of neonatal intensive care units across the United States. It comprises 15 clinical centers and a data coordinating center.

Focused on newborns, particularly extremely preterm and low birth rate (ELBW) and very low birth weight (VLBW) infants, the NRN facilitates the advancement of neonatal care by establishing a network of academic centers that, by rigorous patient evaluation using common protocols, can study the required numbers of patients and can provide answers more rapidly than individual centers acting alone.

To fulfill this mission, the NRN has completed or is implementing multiple observational studies and interventional trials.

In 2022, NICHD initiated a new pre-application process for its multicenter clinical research networks, like the NRN, to capitalize on existing infrastructure and other resources, and to make those resources available to researchers outside the currently funded sites. Visit the Pre-Application Process for NICHD Multisite Clinical Research page to learn more.

Topic Areas

In addition to timely studies, such as those related to COVID-19 and Zika virus, the NRN studies address a range of topics, including:

  • Preterm birth complications and infant outcomes. These include data on extremely preterm infants that informed the development of the Extremely Preterm Birth Outcomes Tool, which gives physicians predictive estimates of infant mortality and morbidity using five key factors: gestational age, birth weight, sex, singleton/multiple birth, and whether the mother received corticosteroids before delivery.
  • Bronchopulmonary dysplasia (BPD). Also called chronic lung disease, BPD is a serious respiratory condition that affects premature infants. These babies generally have inflammation or scarring of the lungs and must be on some form of oxygen therapy via nasal prongs, a mask, or a breathing tube. NRN research discovered that a vitamin A regimen reduced biochemical evidence of vitamin deficiency and slightly decreased the risk of chronic lung disease in VLBW infants (PMID: 10379020).
  • Necrotizing enterocolitis (NEC). In NEC, the intestines lack oxygen or blood flow. It occurs primarily in VLBW and preterm infants, and can include isolated intestinal perforation, which leaks fluid into the abdominal cavity.
  • Anemia. Virtually all VLBW infants become anemic in early life, and approximately 90% receive one or more blood transfusions for a variety of reasons.
  • Birth asphyxia. Hypoxic-ischemic encephalopathy (HIE) is a rare but life-threatening condition characterized by brain injury due to a lack of oxygen at or shortly after birth. The NRN pioneered hypothermia to improve outcomes for infants with HIE and other conditions. These findings included:
    • Whole-body hypothermia is both a safe and effective therapy—infants with moderate or severe HIE who received hypothermia were more likely to survive to a corrected age of 18-22 months with less neurodevelopmental impairment (PMID: 16221780).
    • Among surviving children, those who received hypothermia were more likely to survive to 6 or 7 years of age and were no more likely than the routine care group to experience a physical or cognitive impairment (PMID: 22646631).
  • Sepsis
  • Congenital anomalies. Some areas of research include infants with trisomy conditions, dental and craniofacial conditions, and other anomalies.
  • Treatments for neonatal morbidities, such as retinopathy or prematurity and jaundice. NRN studies found that earlier jaundice treatment with phototherapy reduces brain injury in extremely premature infants (PMID: 18971491).

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