Tag Archive for: prenatal pediatrics

Adre Jacques duPlessis

Honor bestowed on Adré Jacques du Plessis, M.B.Ch.B.

Adre Jacques duPlessis

Dr. du Plessis joins a distinguished group of Children’s National physicians and scientists who hold an endowed chair.

Children’s National Hospital named Adré Jacques du Plessis, M.B.Ch.B., as The People of the United Arab Emirates Distinguished Professor of Prenatal Pediatrics.

Dr. du Plessis serves as director of the Zickler Family Prenatal Pediatrics Institute, division chief of Prenatal and Transitional Pediatrics and director of the Prenatal-Neonatal Neuroscience Program at Children’s National. In addition, Dr. du Plessis is a professor of pediatrics and neurology at George Washington University School of Medicine.

The big picture

Dr. du Plessis joins a distinguished group of Children’s National physicians and scientists who hold an endowed chair. Children’s National is grateful to generous donors who altogether have funded 49 professorships.

Professorships support groundbreaking work on behalf of children and their families and foster new discoveries and innovations in pediatric medicine. These prestigious appointments reflect the recipient’s achievements and a donor’s commitment to advancing and sustaining knowledge.

Why it matters

Dr. du Plessis is a leading international expert in the normal and abnormal development of the brain, as well as the mechanisms of injury to the immature brain. Under his leadership, the Zickler Family Prenatal Pediatrics Institute provides personalized specialty care to patients before, during and after their baby’s birth. His career-long research focus has been on the nervous system of the fetus and newborn, and the hazards for, and mechanisms of, brain injury and its prevention.

Moving the field forward

The Government of the United Arab Emirates (UAE) has established this distinguished professorship as part of its recent philanthropic commitment to Children’s National, which is set to further life-changing research breakthroughs and care for children worldwide. The UAE’s visionary generosity enables Dr. du Plessis and future holders of this professorship to launch bold new initiatives. The professorship will offer a platform to advance the field of prenatal, neonatal and maternal research and care while elevating our leadership and improving outcomes for children who need neonatal care.

Children’s National has been honored to treat patients from the UAE for more than 30 years, with more than 100 Emirati families traveling between the Emirates and Children’s National each year for advanced pediatric care and life-saving treatments.

The UAE’s long-standing philanthropic partnership with Children’s National has resulted in the 2009 establishment of the Sheikh Zayed Institute for Pediatric Surgical Innovation (SZI), the 2021 launch of the Children’s National Research and Innovation Campus, 82 U.S. patents and countless medical breakthroughs for kids and their families. Through this transformational partnership, the UAE and Children’s National are unlocking new possibilities for pediatric medicine and accomplishing what once was thought impossible. Children’s National remains deeply grateful to the UAE for its extraordinary support.

Visitors from the UAE at Children's National Hospital.

New philanthropic support from the United Arab Emirates furthers research breakthroughs and care

Visitors from the UAE at Children's National Hospital.

His Highness Sheikh Mohamed bin Zayed Al Nahyan, President of the United Arab Emirates (right) visited Children’s National in September 2024.

Continuing a 30-year partnership that has yielded 82 U.S. patents and countless medical breakthroughs for kids and their families, the Government of the United Arab Emirates (UAE) has strengthened its transformational commitment to Children’s National Hospital with a new $35 million donation focused on prenatal, neonatal and maternal health.

The announcement of the new gift comes after a recent visit to the hospital by His Highness Sheikh Mohamed bin Zayed Al Nahyan, President of the United Arab Emirates (UAE), who met with Emirati families and patients receiving care at Children’s National Hospital.

The investment is the latest chapter of a longstanding philanthropic partnership between the UAE and Children’s National. Each year, more than 100 Emirati families travel to Children’s National for advanced pediatric care and life-saving treatments.

This latest investment will bolster various strategic health initiatives, including within the hospital’s Center for Prenatal, Neonatal & Maternal Health Research and the Zickler Family Prenatal Pediatrics Institute.

Researchers in the Center for Prenatal, Neonatal & Maternal Health Research are focused on the role of perinatal factors — including maternal stress, anxiety and depression — on the developing brain of the child. Studies also are revealing the impact of congenital anomalies such as heart disease and acquired conditions such as maternal infection with COVID-19 or Zika virus. New approaches to prenatal and postnatal care promise to optimize long-term outcomes of many hospitalized babies.

“Children in the Washington, D.C., area and across the world benefit greatly from the breakthroughs that have emerged from the incredible decades-long partnership between the UAE and Children’s National,” said Michelle Riley-Brown, President and CEO of Children’s National. “I am deeply grateful for the UAE’s most recent gift. The contribution will positively impact children and families and support the teams of researchers and specialists who dedicate their lives to developing innovative medical care.”

Key milestones

The UAE helped to establish the Sheikh Zayed Institute for Pediatric Surgical Innovation at Children’s National in 2009. Today, the Sheikh Zayed Institute (SZI) has grown into a world-class, self-sustaining research center receiving more than 80% of its funding from grants and outside sources.

This platform for invention is advancing autonomous, robotic surgery. The institute’s researchers believe pediatric surgical outcomes will improve if the precision and delicacy of a robot are incorporated into procedures such as gallbladder removal. SZI is also propelling the use of artificial intelligence to improve pediatric medicine and expand health equity. One example is a deep learning algorithm that uses hand-held ultrasounds to detect early signs of rheumatic heart disease, which kills nearly 400,000 people worldwide each year.

“The lives and health of countless children and families in the Washington area, in the UAE and around the world have been transformed by our partnership,” said Yousef Al Otaiba, the UAE Ambassador to the United States. “Our continued support promises even more breakthrough innovations in pediatric medicine.”

The UAE also supported the opening of the Children’s National Research & Innovation Campus through a 2019 commitment. The campus represents the first pediatric innovation hub of its kind, where scientists, inventors, caregivers, patients’ families and health authorities come together to advance pediatric health.

The Children’s National Rare Disease Institute and Center for Genetic Medicine Research are two of the teams housed at the campus. Together, they are pioneering care for children in the Washington region and abroad as an international referral site for rare disorders. Two examples of their research endeavors include: next-generation genomic testing to better understand how differences in genetic material can affect human health and identifying biochemical analytes.

The UAE opened a medical office in Washington, D.C., in 1991. Since then, thousands of Emirati patients have visited Children’s National for life-changing care for conditions such as congenital heart disease, neurological disorders and cancer. The hospital is currently treating 40 Emirati patients.

“Having our child treated at Children’s National means accessing specialized pediatric care from a renowned institution dedicated to children’s health,” said Hamad Alnuaimi, an Emirati father of a Children’s National patient. “It provides us with confidence and reassurance that our son is receiving the best possible medical attention from experts who understand and prioritize the unique needs of children. For the UAE to have a strong relationship with Children’s National signifies a valuable connection that enhances pediatric healthcare in our country. This partnership allows us to benefit from advanced treatments, medical innovations, and expertise that might otherwise be inaccessible. It represents a commitment to improving the health and well-being of children through international collaboration.”

growth of the Children's National Spina Bifida Program

A look at the Children’s National Spina Bifida Program

The Spina Bifida Program at Children’s National Hospital, led by co-directors, Christina Ho, M.D., and Briony Varda, M.D., has seen impressive growth and there are plans to continue expanding the program. Drs. Ho and Varda share insights on the multidisciplinary care being provided, along with their plans for the future of the program.

Q: How would you describe the growth of the program?

A: The growth of the Spina Bifida Program has been remarkable! The graph below really shows it all (more than a 25% increase in patient visits in the past year). We currently hold multidisciplinary programs including providers from neurosurgery (Robert Keating, M.D.), orthopaedic surgery (Matthew Oetgen, M.D.), physical medicine and rehabilitation (Mi Ran Shin, M.D.), urology (Briony Varda, M.D. and Christina Ho, M.D.), and expanded to include bowel management (Celicia Little, N.P.), gynecology (Allison Mayhew, M.D.) for our adolescent patients, as well as a dedicated nurse, Nicole Allentuck, R.N., and program associate, Christine Scott.

We are extremely proud of how the program has grown, particularly through the past two years, with the advent of our adolescent clinic and having a dedicated supportive team that ensures we have significant re-engagement of patients who had previously been lost to care. We are also working with the Prenatal Pediatrics Institute at Children’s National to enhance our prenatal care for patients diagnosed with spina bifida.

growth of the Children's National Spina Bifida Program

Q: What advancements is the spina bifida program making that benefit patients?

A: We have developed a transition clinic for our adolescent spina bifida patients to help address goals of care, independence with care and readiness for transition to adult providers. Our program coordinator, Celicia Little, N.P., also oversees our bowel management program to provide specialized bowel management care for our patients. We have been working on educational information specific to different areas within spina bifida, including how to catheterize, common medications, bowel management and anticipatory guidance. This helps to provide longevity for our patients as well.  We are evaluating ways to decrease visits to the emergency department and ensure appropriate antibiotic usage with proper diagnoses of urinary infections in patients who perform CIC.  To further our goal of providing longitudinal care within our program, we have engaged gynecology colleagues to see patients within our adolescent clinic and begin promoting independence through perpetuated discussions (e.g., are they able to schedule their own physician appointments or grocery shop for themselves?) in preparation for adult transitional care. Additionally, we readily offer telehealth visits for convenience and in hopes of easing access to care.

Q: Looking ahead, what’s next for the Spina Bifida Program? How will we continue to measure success?

A: We are excited to continue expanding our Spina Bifida Program. We currently care for more than 500 patients within the Washington, D.C., Maryland and Virginia areas. We want to continue to include patient narratives through our research initiatives to inform quality of care, including decreasing E.D. utilization and needless antibiotic use. We also want to expand our adolescent program to include sexual healthcare as they transition to adult care with our adult collaborators within MedStar and GWU. We would like to provide more comprehensive care, improve access to care, and ensure patients and families have utilization of the armamentaria of medical resources available at Children’s National.

pregnant hispanic woman

Significant health disparities in detection of critical congenital heart disease

pregnant hispanic woman

Mothers who are Hispanic or who come from rural or low socioeconomic status neighborhoods are less likely to have their child’s critical heart condition diagnosed before birth, according to a new study in the journal Circulation.

Mothers who are Hispanic or who come from rural or low socioeconomic status neighborhoods are less likely to have their child’s critical heart condition diagnosed before birth, according to a new study in the journal Circulation.

This is the largest and most geographically diverse study of these challenges to date. The study compared patient data of more than 1,800 children from the United State and Canada diagnosed with two of the most common, and the most serious, critical congenital heart defects: hypoplastic left heart syndrome (HLHS), when the left side of the heart is not developed completely, and transposition of the great arteries (TGA), when the two main arteries that carry blood away from the heart are reversed.

“The earlier we diagnose a heart defect, especially a serious one such as HLHS or TGA, the sooner we can make a plan for how to safely deliver the infant and reduce the impacts of that heart defect on the rest of the body,” says Anita Krishnan, M.D., first author and cardiologist at Children’s National Hospital. “Early detection and diagnosis of these conditions is crucial to ensuring the best possible outcome for the child, especially in protecting the brain.”

Even when infants’ heart defects were detected before birth, babies from neighborhoods with lower socioeconomic status were detected later in gestation than others.

“The COVID-19 pandemic has brought the idea of significant disparities in health care to the forefront of our national attention,” says Dr. Krishnan. “Even though many health care providers have seen these inequities firsthand in their own clinical experience, it was still surprising to see the strength of the association between socioeconomic position and the care available to mothers.”

In both the United States and Canada, expectant mothers are first screened as part of routine prenatal care in the first trimester for early signs of congenital heart defects and other genetic disorders via blood screen and ultrasound. In the second trimester, a comprehensive ultrasound evaluation for structural anomalies is routine. If any issues are detected, the mother is referred for a fetal echocardiogram and counseling.

The authors suggest that decreased linkages between neighborhoods and people identified in the study and subspecialists could contribute to the disparities found in the study.

“Prenatal detection rates may improve if we are able to leverage outreach and telehealth to strengthen the relationships between these specialties and the groups we identified in the study,” Dr. Krishnan says.

The study included a total of 1,862 patients, including 1,171 patients with HLHS (91.8% prenatally diagnosed) and 691 with TGA (58% prenatally diagnosed). The study group included prenatally diagnosed fetuses with HLHS or TGA and postnatally diagnosed infants less than two months old with HLHS or TGA. Data was collected from institutions participating in the Fetal Heart Society, a non-profit 501(c) multicenter research collaborative with a mission to advance the field of fetal cardiovascular care and science. Mary Donofrio, M.D., director of Prenatal Cardiology at Children’s National, is society president and served as a senior author on this study.

Read the AHA’s press release: Prenatal detection of heart defects lower in rural, poor areas and among Hispanic women.