illustration of baby in utero

New research maps how opioid exposure may shape the newborn brain

illustration of baby in utero

New research from the Developing Brain Institute at Children’s National is helping scientists better understand how prenatal opioid exposure may shape early brain development.

The opioid crisis continues to affect families across the United States. One question researchers are working to answer is how opioid exposure during pregnancy may influence the developing brain. A new study led by scientists at the Developing Brain Institute at Children’s National Hospital offers one of the most comprehensive looks yet. Using advanced brain imaging, the team examined how brain networks are organized in newborns who were exposed to opioids before birth.

The study analyzed brain scans from 248 newborns across four medical centers in the United States. Some infants had prenatal opioid exposure, while others did not. By comparing the two groups, researchers were able to identify subtle differences in how regions of the newborn brain communicate.

What the study found

To study early brain development, the researchers used resting-state functional MRI, a technique that measures how different parts of the brain communicate while a person is at rest. Even in newborns, the brain already contains recognizable communication networks that support basic functions such as movement, sensation and early cognitive processes. These networks continue to mature rapidly during infancy and early childhood.

One of the most striking findings from the study was that the overall structure of these major brain networks remained intact in opioid-exposed newborns. But when researchers looked more closely at how specific regions were connected, they found important differences. The study also found that opioid-exposed newborns showed a pattern of both weaker and stronger connections across different brain circuits. Some areas involved in sensorimotor function and frontal brain regulation showed reduced connectivity. These circuits help coordinate movement, attention and self-regulation. At the same time, researchers observed stronger connectivity in several other regions, including areas involved in emotional processing, reward and sensory perception such as the amygdala, putamen and parts of the visual system. Rather than a loss of brain networks, the results point to shifts in how strongly certain regions communicate with one another. Scientists believe these changes may reflect how opioids interact with the developing brain during critical periods of growth.

Why this matters

Many previous imaging studies of opioid exposure in newborns have relied on relatively small groups of infants. Recruiting newborns for advanced brain imaging is challenging, and it is especially difficult to assemble well-matched comparison groups. This study draws on the ACT NOW Outcomes of Babies with Opioid Exposure (OBOE) study, a large multi-site research effort designed to better understand the long-term effects of prenatal opioid exposure.

Because the researchers were able to analyze one of the largest cohorts studied to date, they could perform a whole-brain analysis that examined connectivity across 93 brain regions. That broader approach helped reveal widespread but nuanced connectivity differences. The altered brain connectivity observed in the study may represent an early neural signature of prenatal opioid exposure. Researchers believe these changes could reflect a vulnerability that may contribute to developmental or behavioral challenges later in life. Previous studies have shown that children exposed to opioids during pregnancy may face increased risks of motor delays, attention challenges and difficulties with emotional regulation.

However, the authors emphasize that these findings represent an early step in understanding the biology behind those outcomes. Because the OBOE study is designed to follow children over time, future research will explore whether early brain connectivity patterns are linked to later development. If those links are confirmed, brain imaging could eventually help clinicians identify which infants may benefit from closer developmental monitoring or early support.

Leading the way

The Developing Brain Institute at Children’s National serves as the neuroimaging core for the OBOE study, bringing decades of expertise in imaging the developing brain. This work is part of a broader effort to identify early markers of risk and resilience in childhood development. By combining large-scale collaboration with cutting-edge neuroimaging, studies like this one are helping researchers better understand how the earliest stages of life influence brain development and how clinicians can intervene earlier to support healthier futures for children.

This research, Disrupted Brain Connectivity in Newborns Following Antenatal Opioid Exposure, was published in Biological Psychiatry: Cognitive Neuroscience and Neuroimaging. Authors from Children’s National Hospital include Josepheen De Asis-Cruz, MD, PhD; Jung-Hoon Kim, PhD; Kushal Kapse, MS; Yao Wu, PhD; and Catherine Limperopoulos, PhD, in collaboration with colleagues from institutions participating in the multi-site ACT NOW Outcomes of Babies with Opioid Exposure (OBOE) study.

brain scans

Fetal MRI study reveals links between neighborhood disadvantages and brain development

brain scans

New research from the Developing Brain Institute used fetal MRI to explore how neighborhood environments may influence brain development before birth.

New research from scientists at Children’s National Hospital suggests that the environments families live in may begin shaping brain development even before a baby is born. In a study published in the journal Cerebral Cortex, researchers from the Developing Brain Institute used fetal MRI to examine how neighborhood conditions are associated with brain growth during pregnancy.

The findings suggest that factors linked to neighborhood disadvantage may influence the trajectory of brain development in utero, particularly in regions involved in emotion, memory and stress regulation.

Mechanics of the study

Neighborhood conditions are known to affect health outcomes across the lifespan. Children growing up in disadvantaged communities face higher risks for a range of health and developmental challenges. But researchers have long wondered when these effects first begin. To explore this question, investigators studied 199 healthy pregnancies in the Washington, D.C., region. Using advanced fetal MRI imaging, the team analyzed 298 brain scans collected between 18 and 39 weeks of gestation.

Researchers then compared patterns of fetal brain growth with neighborhood-level measures from the CDC’s Social Vulnerability Index. This index reflects factors such as income, education, housing conditions and access to transportation. The goal was to understand whether broader community conditions are associated with differences in early brain development.

What the study found

The study found that higher levels of neighborhood disadvantage were associated with differences in fetal brain development over the course of pregnancy. Early in gestation, fetuses from more disadvantaged neighborhoods showed slightly larger total brain volumes. As pregnancy progressed, however, the pattern shifted. By the end of gestation, those same fetuses tended to show smaller overall brain volumes and differences in subcortical brain structures.

Many of the strongest effects were seen in limbic regions, which help regulate emotions, stress responses and memory. “These findings suggest that the developmental pathways linking neighborhood conditions and brain development may begin earlier than previously understood,” the authors wrote. The results align with previous research in children and adolescents showing that socioeconomic environments can influence brain structure and connectivity.

What this means

Because fetuses do not directly interact with their neighborhoods, the researchers believe the association likely occurs through maternal experiences during pregnancy. One possible pathway is maternal stress, which has been linked to hormonal changes that can affect fetal brain development. Other potential contributors include environmental exposures, nutrition and access to health resources. While the study cannot determine which factors drive the relationship, it highlights how broader community conditions may influence development before birth.

What’s Next

The research provides new insight into how social environments intersect with early brain development. Understanding when these differences emerge may help guide future public health strategies aimed at supporting families during pregnancy. “Our findings emphasize the importance of considering the communities mothers live in during pregnancy,” the authors wrote. By identifying when developmental trajectories begin to diverge, scientists hope to better understand where early interventions may have the greatest impact.

Read the full study “Prenatal experience of greater neighborhood disadvantage is associated with altered fetal volumetric brain growth in utero” in Cerebral Cortex here.

Authors from Children’s National include Kevin M. Cook, PhD; Josepheen De Asis-Cruz, PhD; Kushal Kapse; Kelsey Christoffel, MD; Caitlin McDermott; Nickie Andescavage, MD; and Catherine Limperopoulos, PhD.

US News 2025-26 Honor Roll badge

U.S. News & World Report voting

US News 2025-26 Honor Roll badgeChildren’s National is ranked one of the top 10 pediatric hospitals in the nation by U.S. News & World Report. Our faculty and staff are proud of the impact made on the lives of children and families in our community. Your participation in the U.S. News & World Report annual reputational survey validates the quality of care we provide and reflects the mutual respect and trust we share as healthcare professionals.

How to determine your voting eligibility

Voting for the U.S. News & World Report Best Children’s Hospitals rankings can be done only through Doximity.

To participate, physicians must:

  • Be board-certified and meet the eligibility criteria for the voting categories.
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View the full eligibility criteria

How to claim your Doximity profile to vote

  • You have to claim your profile on Doximity.com to participate in the online survey. If you have not yet claimed your Doximity profile, go to Doximity.com, and click “Find My Profile.”
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  • Verified Doximity members will receive an email inviting them to participate in the U.S. News survey.
  • For more information on how to claim your profile, visit Doximity.com

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Your Doximity profile must have up-to-date licenses, certifications and board documents.

  • Once you are logged in, your profile will automatically be in “Edit Mode.” You are able to add new items or edit existing information.
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Once registered, users wishing to participate in the online survey should:

  • Watch for an email from Doximity about the annual member survey.
  • Even if you don’t see the email, if you are a registered Doximity user, you can still vote by logging in to Doximity.com with your username and password during the voting period.
  • Once logged in, look for a U.S. News graphic or button on the homepage and click on it.
  • The survey asks users to name the hospitals that provide the best care in your respective specialty, without consideration to location or cost. Pediatric specialists will list 10 hospitals. The order in which you list the hospitals does not matter.

Please note: Children’s National Hospital is listed as “Children’s National Hospital Washington, DC” on the survey.

Visit Doximity’s FAQs if you have issues or questions about registration or claiming your profile.

How to cast your vote

In February 2026 when voting opens, all survey-eligible physicians will receive a notification on the Doximity app for Android or iOS. If you do not use the Doximity app, you will receive an email when voting opens.

  1. Log in to your Doximity account at doximity.com or via the mobile app.
  2. Click the Notifications icon or tap the “Submit your Nominations” button on the homepage. You can also search for “U.S. News Best Hospitals”
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The 2026 U.S. News & World Report Best Children’s Hospitals reputation voting will open in mid-February. Look for your Doximity notification to vote.

Cast your vote
mom wearing mask and holding baby

New insights into early brain development following in-utero COVID-19 exposure

mom wearing mask and holding baby

New research from Children’s National links in-utero COVID-19 exposure to subtle differences in newborn brain development and cognitive and emotional outcomes at age two.

Researchers studying prenatal exposure to SARS-CoV-2 found that it was linked to measurable differences in newborn brain structure and, by age two, lower cognitive scores and higher internalizing behaviors.

Led by the Developing Brain Institute at Children’s National Hospital, a new study in Brain, Behavior, and Immunity followed mother-baby pairs in the Washington, D.C., region and compared infants exposed to SARS-CoV-2 during pregnancy (2020–2022) with a normative pre-pandemic cohort (2016–2019). Researchers used newborn brain MRI scans and standardized toddler developmental assessments to better understand what in-utero exposure may mean as children grow.

The big picture

During past viral outbreaks, prenatal infections have been linked with later neurodevelopmental and mental health risks. The COVID-19 pandemic raised similar concerns, but the longer-term effects of in-utero exposure are still coming into focus.

In this study, researchers prospectively enrolled 142 mother baby pairs: 103 from a pre-pandemic cohort and 39 with confirmed maternal SARS-CoV-2 infection during pregnancy. Infants underwent quantitative brain MRI scans at about two weeks old during natural sleep and without sedation. When children were about 2 years old, they were assessed by trained pediatric developmental psychologists using the Bayley Scales of Infant and Toddler Development, Third Edition (BSID-III), alongside parent-reported social-emotional and behavioral measures using the Infant-Toddler Social and Emotional Assessment (ITSEA).

The newborn MRI findings showed that prenatal SARS-CoV-2 exposure was associated with differences in regional brain volumes, including cortical gray matter, subcortical gray matter, cerebral white matter and the left hippocampus, compared to infants from healthy pregnancies.

“At the newborn stage, we’re seeing differences in how specific brain regions are developing after in-utero exposure,” said Nickie Andescavage, MD, neonatologist at Children’s National and a senior author on the study. “Brain imaging allows us to detect these changes very early, before behavioral differences are visible.”

Two-year follow-up

At age two, toddlers exposed to SARS-CoV-2 in utero scored lower on cognitive measures and social-emotional measures compared with children in the pre-pandemic cohort. They also had higher scores on the internalizing domain of the ITSEA, a reflection of early anxiety symptoms.

The research team used mediation analyses to explore how early brain differences might relate to later outcomes. Their results suggest that differences in newborn cortical gray matter volumes statistically accounted for part of the association between prenatal exposure and lower toddler cognitive scores. In turn, lower cognitive scores statistically mediated part of the association between prenatal exposure and higher internalizing behaviors.

“Our goal was not just to identify differences, but to understand how early brain development after SARS-CoV-2 exposure might relate to later learning and behavioral outcomes,” said Susan Weiner, PhD, lead author of the study and a researcher at Children’s National. “These findings suggest that early changes in brain structure may help explain why we see differences in cognition and emotional development at toddler age.”

Why this matters for families and clinicians

For families, one of the hardest parts of the pandemic has been uncertainty about what it might mean for children born during that period. Most children exposed to SARS-CoV-2 in utero will not have severe developmental problems, and this study does not suggest outcomes are predetermined. But it does add to growing evidence that prenatal exposure may be associated with subtle differences that can be detected early.

The findings reinforce the importance of routine developmental screening and follow-up, especially for children born during the COVID era. Pediatric developmental surveillance is already a standard part of well-child care, and early identification of concerns can connect families with supportive services when they are most effective.

“The most important message is not alarm,” Andescavage said. “It’s awareness and follow-up. Early monitoring helps ensure children get support if and when they need it.”

What’s next

The authors note several limitations. The exposed cohort was relatively small, and the study population had high overall education levels, which may limit how broadly the findings apply across populations. The study also compared a pandemic cohort to a pre-pandemic cohort, making it difficult to fully separate the effects of viral exposure from broader pandemic-related stressors, even though maternal stress and anxiety were assessed.

Larger and more diverse longitudinal studies are now needed to determine whether these early differences persist, change or diminish as children reach school age and to identify factors that may protect or promote healthy development.

For now, the takeaway is practical and actionable: Children born during the COVID era, including those exposed to SARS-CoV-2 in utero, benefit from consistent developmental screening, and families should feel empowered to raise concerns early.

Read the full open access study, “The COVID generation: the neurodevelopmental consequences of in-utero COVID-19 exposure,” in Brain, Behavior, and Immunity. Additional authors from Children’s National include Yao Wu, PhD,  Jacob Jenhao Cheng, PhD, Melissa O’Connell Ligget, PhD, Cassianna McCants, PsyD, Esther Adegbulugbe, MS, Anna Mears, Diedtra Henderson and Catherine Limperopoulos, PhD.

2025 with a lightbulb instead of a zero

The best of 2025 from Innovation District

2025 with a lightbulb instead of a zero

In 2025, Innovation District readers gravitated toward stories that explored how research and clinical innovation are reshaping pediatric care in real time. This year’s most popular articles highlighted advances in complex surgical care, evidence-based treatments for chronic and neuropsychiatric conditions and emerging technologies — from wearable data to artificial intelligence — that are changing how clinicians diagnose, treat and support children and families. Read on for our list of the most popular articles we published on Innovation District in 2025.

1. Life-changing care: How Children’s National tackles pediatric cervical spine injuries

The Cervical Spine program at Children’s National Hospital is responsible for treating a range of conditions, including trauma, congenital abnormalities and tumors. These conditions can lead to instability or misalignment of the cervical spine. “There are unique challenges in pediatric cases due to anatomical differences. The cervical spines of children are more at risk for injury because of their developmental stage and structural characteristics,” says Matthew Oetgen, MD, MBA, chief of Orthopaedic Surgery and Sports Medicine at Children’s National.
(2 min. read)

2. Pioneering evidence-based treatments for substance addictions

Increasing evidence-based treatment is a key component of the Addictions Program at Children’s National Hospital, created in 2022 and led by Sivabalaji Kaliamurthy, MD. “We really want to focus on intervening in an evidence-based manner in the primary care setting because that is where most of our patients are going to first access care outside of the emergency room,” explains Dr. Kaliamurthy.
(3 min. read)

3. Breaking barriers in growth disorder treatment for families

For many children with short stature and other rare genetic growth disorders, there have been no next steps after usual treatment options prove ineffective. Researchers at Children’s National Hospital are digging deeper to find the root genetic causes of short stature disorders and creating novel, nuanced treatment options that have the opportunity to change how the field approaches these cases.
(4 min. read)

4. The link between metabolic acidosis and cardiovascular disease in children with CKD

Denver D. Brown, MD, nephrologist at Children’s National, is looking at whether untreated metabolic acidosis could potentially contribute to cardiovascular outcomes in children with chronic kidney disease (CKD). Here, she explains her motivation, findings and future directions for this critical research.
(3 min. read)

5. Therapy approach shows promise for PANS/PANDAS

A multidisciplinary therapy model developed at Children’s National shows promise for children with PANS and PANDAS, significantly reducing symptoms through structured cognitive-behavioral therapy and family-centered care. The approach could offer a new standard for treating these rare, complex neuropsychiatric disorders.
(2 min. read)

6. Wearable tech data shows promise in ADHD detection

A study from Children’s National reveals that common wearable devices like Fitbits may hold the key to improving how we identify Attention-Deficit/Hyperactivity Disorder (ADHD) in adolescents. By analyzing patterns in heart rate, activity levels and energy expenditure, researchers were able to predict ADHD diagnoses with striking accuracy, offering a glimpse into a future where objective, real-time data supports earlier and more personalized mental healthcare.
(2 min. read)

7. Novel pediatric pacemaker shows safety, effectiveness for fragile infants in multi-center study

A novel implantable pacemaker designed specifically for infants has demonstrated safety and effectiveness in stabilizing heart rhythms for at least two years. The multi-center study of 29 infants showed stable pacing, normal electrical parameters and expected battery life, offering a viable alternative to standard-size devices for the smallest children.
(2 min. read)

8. Socioeconomic disadvantage associated with higher long-term mortality for children after heart surgery

Children who had heart surgery and come from less advantaged neighborhoods in the Washington, D.C., region are much more likely to die in the long term than those from neighborhoods with more wealth and opportunity. The finding was part of a presentation titled, Socioeconomic Disadvantage Is Associated with Higher Long-Term Mortality After Cardiac Surgery, by Jennifer Klein, MD, MPH, cardiologist at Children’s National Hospital, during the Society of Thoracic Surgeons Annual Meeting in Los Angeles.
(2 min. read)

9. Children’s National brings AI into the RHD early diagnosis equation

Experts from Children’s National traveled to Uganda to continue work on a pilot program applying artificial intelligence (AI) to the diagnosis of rheumatic heart disease (RHD). The team created a tool that uses AI to predict RHD by identifying leaky heart valves on handheld ultrasound devices, then prompts a referral for a full echocardiogram.
(2 min. read)

10. Fighting food insecurity with fresh produce and education

Food insecurity is rising in Washington, D.C. and it’s hitting families with children the hardest. That’s why Children’s National Hospital created the Family Lifestyle Program (FLiP) – a multi-layered intervention, which offers Patient Navigation (FLiP-PN) and a Produce Prescription Intervention (FLiPRx). FLiP is a Food Is Medicine, clinical-community initiative that helps families get access to fresh food, build healthy habits and lower their risk of diet-related diseases like diabetes and obesity.
(3 min. read)

collage of news outlet logos

Children’s National in the News: 2025

collage of news outlet logosIn 2025, Children’s National Hospital was featured in major national news outlets for pioneering advances in pediatric care, groundbreaking clinical research and powerful human stories of healing and hope. From gene therapy for sickle cell disease and innovative pacemakers for newborns to breakthrough transplants, cancer trials and emerging mental health concerns like AI psychosis, these stories highlight the hospital’s leadership across the full spectrum of pediatric medicine. The following ten highlights showcase the patients, families and experts behind this impact, as reported by outlets including NBC News, The Washington Post, Good Morning America, USA Today, Healio, ABC News and ESPN.

1. Gene therapy treatment gives new hope to sickle cell patients

Children’s National patient Wedam, 19, begins the first steps for intensive gene therapy for sickle cell disease, discussing his skepticism while his mother expresses her joy and gratitude for the treatment. (NBC News)

2. Little pacemakers ‘reliable’ in stabilizing newborns needing pacing

Charles Berul, MD, pediatric electrophysiologist and emeritus chief of Cardiology, discusses his study highlighting the safety and efficacy of an innovative smaller pacemaker designed for newborns with critical congenital heart disease. (Healio)

3. Why this clinical trial is offering some young cancer patients hope

Catherine Bollard, MBChB, MD, senior vice president and chief research officer, and the NexTGen team are poised to recruit patients for a new clinical trial that will take on an old, implacable foe: children’s solid tumors. (The Washington Post)

4. 11-year-old receives living donor heart valve to replace artificial one in breakthrough surgery

Yves d’Udekem, MD, PhD, chief of Cardiac Surgery, talked to Good Morning America about how an 11-year-old’s groundbreaking partial heart transplant will change his life and the lives of other children in need of valve replacements. (Good Morning America)

5. 9-year-old fights brain cancer with magic in her heart

The Lilabean Foundation along with Brian Rood, MD, medical director of the Brain Tumor Institute, talked about how patients like Kasey Zachman are the motivation behind finding a cure for brain cancer. (ABC News)

6. How Little League helps father-son duo recover from kidney transplant

USA Today Sports spoke with Gavin Brown and his parents, as well as Yi Shi, MD, a pediatric nephrologist at Children’s National Hospital, about their kidney transplant journey. (USA Today)

7. Jayden Daniels surprises Children’s National patient

After Jayden Daniels visited Commanders fan Sarah Addison at Children’s National Hospital while she was being treated for myeloid leukemia, they quickly became friends. (ESPN)

8. At D.C. children’s hospital, opera singers offer light, hope and healing

International opera stars performed for children, their families and employees at Children’s National Hospital. (The Washington Post)

9. ‘Gift of life:’ Tiny heart transplant saves life of Maryland baby

A baby boy in Maryland is back home after being given a second chance at life, just before his first birthday. The boy’s mother and his surgeon, Manan Desai, MD, share the remarkable story of a moment that changed all of their lives. (NBC4)

10. AI psychosis: Kids left delusional and paranoid over conversations with chatbots

Ashley Maxie-Moreman, PhD, clinical psychologist, spoke to ABC7 about what AI psychosis is and what parents need to know. (ABC7)

doctor and little girl holding a model of a heart

A roadmap to uncover the causes of congenital anomalies

doctor and little girl holding a model of a heart

A new white paper in Developmental Biology outlines a roadmap to uncover the causes of congenital anomalies through better genomic analysis, functional research and patient partnerships.

Congenital anomalies affect more than 6% of live births worldwide. In the United States, about one in every 33 babies is born with one of these conditions. They are a leading cause of infant mortality, childhood hospitalizations and lifelong disability. Yet despite their impact, congenital anomalies remain underrecognized and underfunded, and for many families, unexplained.

That gap between burden and understanding is the focus of a new white paper published in Developmental Biology as part of a special issue on congenital anomalies. The paper brings together five lead authors, more than 60 contributing scientists and clinicians, and endorsements from major scientific societies. Irene Zohn, PhD, principal investigator in the Center for Precision Medicine and Genomics Research at Children’s National Hospital, is among the authors helping shape this field-wide call to action.

The message is simple. We have the tools to identify the causes of many more congenital anomalies, but progress depends on investing, collaborating more effectively and treating patients and families as research partners.

Why so many families still lack answers

Advances in genome sequencing have transformed the search for genetic causes of disease. For some families, sequencing has provided long-awaited answers. For many others, the search continues.

More than half of individuals with congenital anomalies still do not receive a definitive genetic explanation. Even when sequencing is performed, results often include variants of uncertain significance, genetic changes that cannot yet be clearly linked to disease. Families may spend years navigating tests and referrals without answers, often described as the “diagnostic odyssey”. The white paper argues that this reflects system-level gaps rather than a lack of scientific potential.

Two priorities to move the field forward

The authors outline a framework centered on two key investments. First, they call for expanded and improved genomic analysis. This includes broader access to genome sequencing, better analytic tools and stronger data sharing across institutions. It also requires consistent terminology to accurately measure the true scope of congenital anomalies and recognize the magnitude of the problem.

Second, the paper emphasizes the need for mechanistic research. Identifying a genetic variant is only the first step. Researchers must also understand how that variant disrupts development and whether the consequences can be prevented or treated. This requires sustained support for functional studies using cell models, patient-derived tissues and animal systems. Together, these approaches can shorten the diagnostic journey, improve confidence in genetic findings, and accelerate the development of new therapies.

Putting patients and families at the center

A defining feature of the roadmap is its focus on patient partnership. Families should be treated as active participants in research, including through the return of results and clear communication about uncertainties. Genomic data should also be reanalyzed over time, since findings that are unclear today may become meaningful as science advances. Building systems that support this process is essential to improving care.

A pivotal moment for the field

Congenital anomalies are not rare when considered together. They represent a significant public health challenge with lifelong consequences for children and families. Science is advancing rapidly, but progress depends on aligning investment, infrastructure and collaboration with the scale of the problem. This white paper argues that the field is at a turning point. With focused support for genomic diagnosis, functional research and patient-centered partnerships, researchers and clinicians can deliver answers and improve outcomes for children who have waited too long.

You can read the full article, “Challenges and opportunities for understanding the genetic causes of congenital anomalies,” in Developmental Biology here.

US News badges

Children’s National Hospital once again ranked among the nation’s best by U.S. News & World Report

US News badgesChildren’s National Hospital in Washington, D.C., was ranked as a top hospital in the nation by the U.S. News & World Report 2025-26 Best Children’s Hospitals annual rankings. This marks the ninth straight year Children’s National has made the Honor Roll list. The Honor Roll is a distinction awarded to only 10 children’s hospitals nationwide.

For the fifteenth straight year, Children’s National ranked in 10 specialty services and is the highest U.S. News ranked children’s hospital in Washington, D.C., Maryland and Virginia. Last year, U.S. News introduced pediatric & adolescent behavioral health as a service line in its rankings. While there are no ordinal rankings for behavioral health, the Children’s National program was named one of the top 50 programs in the country for the second year in a row.

“To be named among the nation’s top children’s hospitals for nine years in a row is a reflection of the extraordinary expertise, innovation and heart that our teams bring to every child and family we serve,” said Michelle Riley-Brown, MHA, FACHE, president and chief executive officer of Children’s National. “Our leadership in specialties like neurology, cancer, and diabetes and endocrinology underscores the national impact of our work, and we remain focused on setting new standards in pediatric care.”

The annual rankings are the most comprehensive source of quality-related information on U.S. pediatric hospitals and recognizes the nation’s top 50 pediatric hospitals based on a scoring system developed by U.S. News.

“Being a top-ranked pediatric hospital means more than just excelling in a single specialty — it means being a pillar of outstanding care for your entire region,” said Ben Harder, chief of health analysis and managing editor at U.S. News. “Our rankings acknowledge these hospitals for their comprehensive excellence, helping families find the very best care conveniently located within their state and community.”

The bulk of the score for each specialty service is based on quality and outcomes data. The process includes a survey of relevant specialists across the country, who are asked to list hospitals they believe provide the best care for patients with the most complex conditions.

The Children’s National specialty services that U.S. News ranked in the top 10 nationally are:

The other six specialties ranked among the top 50 are Behavioral Health, Cardiology and Heart Surgery, Gastroenterology and GI Surgery, Neonatology, Pulmonology and Lung Surgery, and Urology.

AAP 2025

Children’s National Hospital at the 2025 American Academy of Pediatrics meeting

AAP 2025Children’s National Hospital affiliates will participate in this year’s American Academy of Pediatrics National Conference & Exhibition, taking place in Denver, Colorado, from September 26-30. Below is a schedule of sessions led by professionals from Children’s National:

Allison Markowsky, MD, MSHS, FAAP, attending physician and associate chief for Community Hospital Medicine programs
S2433: What’s Trending in the Newborn Nursery: Controversies and Evidence
Saturday, September 27, 2025
5:30-6:30 PM EDT/EST 

Dennis Ren, MD, pediatric emergency medicine physician
H0226: Section on Emergency Medicine Program: Day 2
PEM Hot Topic, EmergiQuiz, PEMPix and State of the Section Awards
Saturday, September 27, 2025
10:30 AM-7:30 PM EDT/EST

Natasha Shur, MD, medical geneticist
S2324: Genetic Testing Boot Camp
Saturday, September 27, 2025
4:00-5:00 PM EDT/EST

To view the full schedule along with options to join sessions virtually, please visit the AAP conference website.

illustration of brain with brainwaves

Transarterial embolization offers hope for infants with hemimegalencephaly

illustration of brain with brainwaves

A new study from Children’s National Hospital reveals how a minimally invasive procedure is transforming care for infants with hemimegalencephaly and medically refractory seizures, offering seizure relief with fewer surgical risks.

Until recently, families of infants with hemimegalencephaly and medically refractory seizures had few treatment options, almost all involved major brain surgery such as hemispherectomy, to remove or disconnect the affected portion of the brain. These procedures, while sometimes effective, carry high risks in very young infants due to the fragility of their developing brains and invasive nature of the surgery.

Now, specialists from the Hemimegalencephaly Program at Children’s National Hospital have pioneered a minimally invasive alternative. Leveraging the combined expertise of a multidisciplinary team — spanning neurology, neurointerventional radiology, prenatal pediatrics, neonatology, neurogenetics and neurodevelopmental pediatrics, neuropsychology and neurosurgery — they have developed a technique that induces controlled, targeted strokes in the affected hemisphere using transarterial embolization (TAE). This approach mimics the effect of surgery by reducing seizure activity, without the need for open brain procedures.

This novel strategy is the focus of a new study led by Monica Pearl, MD, director of the Neurointerventional Radiology Program. The research represents the largest retrospective review of its kind, examining 41 TAE procedures performed over an 11-year span in 13 infants under three months of age.

The results are promising: 73% of patients achieved Engel Class I seizure outcomes at follow-up, suggesting that with careful technique and patient selection, TAE may provide meaningful seizure control with fewer perioperative risks than traditional surgery. The study also highlights the technical complexity of the procedure, early complications and the critical role of evolving protocols in ensuring patient safety.

Authors from Children’s National include Monica Pearl, MD, Tayyba Anwar, MD, Shani Israel, BS, Lindsay Ruffini, CPNP, CPNP-AC, CPNP-PC, Panagiotis Kratimenos, MD, PhD, Kyle Spagnolo, DO, Wei-Liang Chen, MD, Madison Berl, PhD, William D. Gaillard, MD, Tammy N. Tsuchida, MD, PhD and Chima Oluigbo, MD

To learn more about the clinical outcomes and evolving protocols behind this approach, you can read the full study, Transarterial embolization for infants under 3 months of age with refractory seizures due to hemimegalencephaly: complication analysis and evolution of treatment strategy, in the Journal of Neurointerventional Surgery.

Poster session at REI Week 2025

REI Week 2025 empowers the future in pediatric research and innovation

Children’s National Hospital hosted its fifteenth annual Research, Education and Innovation Week from March 31–April 4, 2025, bringing together clinicians, scientists, educators and innovators from across the institution to celebrate discovery and collaboration. This year’s theme, “Empowering the Future in Pediatric Research and Innovation with Equity, Technology and a Global Reach,” served as a call to action for advancing science that improves child health both locally and around the world.

Each day of the week-long event featured thought-provoking lectures — now available to watch — dynamic panel discussions, interactive workshops and vibrant poster sessions, all highlighting the diverse and interdisciplinary work taking place across Children’s National.

Centering the patient and the planet

REI Week began on Monday with a powerful keynote lecture from Lynn R. Goldman, MD, MS, MPH, Michael and Lori Milken dean of the Milken Institute School of Public Health at the George Washington University. In her talk, “Children: Uniquely vulnerable to climate-related threats,” Dr. Goldman underscored the urgent need to protect children from the environmental hazards of a changing climate and to integrate climate science into pediatric care and advocacy.

At mid-morning, Mary-Anne “Annie” Hartley, MD, PhD, MPH, director of the LiGHT Laboratory at École Polytechnique Fédérale de Lausanne, introduced the “MOOVE” platform — Massive Open Online Validation and Evaluation of clinical LLMs. Her talk demonstrated how artificial intelligence, when rigorously validated, has the potential to transform clinical decision-making and global health equity.

Monday’s final keynote, “Zinc and childhood diarrhea,” was presented by Christopher Duggan, MD, MPH, director of the Division of Nutrition at Harvard Medical School. Dr. Duggan highlighted the global health impact of zinc supplementation in reducing childhood mortality — a reminder that simple, evidence-based interventions can save millions of lives.

In that first day, the first poster session of the week showcased projects in adolescent medicine, global health, infectious diseases, oncology and more. The session reflected the full breadth of research taking place across Children’s National.

Ambroise Wonkam, MD, PhD, professor of genetic medicine at Johns Hopkins University, then delivered Tuesday’s Global Health Keynote Lecture, “Harnessing our common African genomes to improve health and equity globally.” His work affirmed that inclusive genomics is key to building a healthier world.

Later, the Global Health Initiative event and GCAF Faculty Seminar encouraged attendees to pursue collaborative opportunities at home and abroad, reflecting the growing global footprint of Children’s National research programs.

Transforming education and care delivery

On Wednesday, Larrie Greenberg, MD, professor emeritus of pediatrics, kicked off the day with a Grand Rounds keynote on educational transformation: “Shouldn’t teachers be more collaborative with their learners?” He followed with a CAPE workshop exploring the effectiveness of case-based learning.

The Nursing Sponsored Keynote Lecture by Vincent Guilamo-Ramos, PhD, MPH, LCSW, ANP-BC, PMHNP-BC, FAAN, explored “Redesigning the U.S. broken health system.” He offered an urgent and inspiring call to reimagine pediatric care by addressing social determinants of health.

In the Jill Joseph Grand Rounds Lecture, Deena J. Chisolm, PhD, director of the Center for Child Health Equity at Nationwide Children’s Hospital, challenged attendees to move beyond dialogue into action in her talk, “Health equity: A scream to a whisper?,” reminding researchers and clinicians that advocacy and equity must be foundational to care.

The day continued with a poster session spotlighting medical education, neonatology, urology and neuroscience, among other fields.

Posters and pathways to progress

Throughout the week, poster sessions highlighted cutting-edge work across dozens of pediatric disciplines. These sessions gave attendees the opportunity to engage directly with investigators and reflect on the shared mission of discovery across multiple disciplines, including:

Honoring excellence across Children’s National

The REI Week 2025 Awards Ceremony celebrated outstanding contributions in research, mentorship, education and innovation. The winners in each category were:

POSTER SESSION AWARDS

Basic & Translational Research

Faculty:  Benjamin Liu, PhD

“Genetic Conservation and Diversity of SARS-CoV-2 Envelope Gene Across Variants of Concern”

Faculty:  Steve Hui, PhD
“Brain Metabolites in Neonates of Mothers with COVID-19 Infection During Pregnancy”

Faculty: Raj Shekhar, PhD
“StrepApp: Deep Learning-Based Identification of Group A Streptococcal (GAS) Pharyngitis”

Post docs/Fellows/Residents: Dae-young Kim, PhD
“mhGPT: A Lightweight Domain-Specific Language Model for Mental Health Analysis”

Post docs/Fellows/Residents: Leandros Boukas, MD, PhD
“De Novo Variant Identification From Duo Long-Read Sequencing: Improving Equitable Variant Interpretation for Diverse Family Structures”

Staff: Naseem Maghzian
“Adoptive T Lymphocyte Administration for Chronic Norovirus Treatment in Immunocompromised Hosts (ATLANTIC)”

Graduate Students: Abigail Haffey
“Synergistic Integration of TCR and CAR T Cell Platforms for Enhanced Adoptive Immunotherapy in Brain Tumors”

High School/Undergraduate Students: Medha Pappula
“An ADHD Diagnostic Interface Based on EEG Spectrograms and Deep Learning Techniques”

Clinical Research

Faculty: Folasade Ogunlesi, MD
“Poor Air Quality in Sub-Saharan Africa is Associated with Increase Health Care Utilization for Pain in Sickle Cell   Disease Patients”

Faculty: Ayman Saleh, MD
“Growth Parameters and Treatment Approaches in Pediatric ADHD: Examining Differences Across Race”

Post docs/Fellows/Residents: Nicholas Dimenstein, MD, MPH
“Pre-Exposure Prophylaxis (PrEP) Eligibility in the Pediatric Emergency Department”

Staff: Tayla Smith, MPH
“The Public Health Impact of State-Level Abortion and    Firearm Laws on Health Outcomes”

Graduate Students: Natalie Ewing
“Patterns of Bacteriuria and Antimicrobial Resistance in Patients Presenting for Primary Cloacal Repair: Is Assisted Bladder Emptying Associated with Bacteriuria?”

Graduate Students: Manuela Iglesias, MS
“Exploring the Relationship Between Child Opportunity Index and Bayley-III Scores in Young Children”

High School/Undergraduate Students: Nicholas Lohman
“Preliminary Findings: The Efficacy, Feasibility and Acceptability of Group Videoconference Cognitive Behavioral Therapy with Exposure and Response Prevention for Treating Obsessive-Compulsive Disorder Among Children and Young People”

Community-Based Research

Faculty: Sharon Shih, PhD
“Assessing Pediatric Behavioral Health Access in DC using Secret Shopper Methodology”

Post docs/Fellows/Residents: Georgios Sanidas, MD
“Arrested Neuronal Maturation and Development in the Cerebellum of Preterm Infants”

Staff: Sanam Parwani

“Intersectionality of Gender and Sexuality Diversity in Autistic and Non-Autistic Individuals”

Graduate Student: Margaret Dearey
“Assessing the Burden of Period Poverty for Youth and Adolescents in Washington, DC: A Pilot Study”

Quality and Performance Improvement

Faculty: Nichole L. McCollum, MD
“A Quality Improvement Study to Increase   Nurse Initiated Care from Triage and Improve Timeliness to Care”

Post docs/Fellows/Residents:  Hannah Rodriguez, MD
“Reducing Unnecessary Antibiotic Use in a Level IV NICU”

Staff: Amber K. Shojaie, OTD, OTR/L
“Implementing Dynamic Axilla Splints in a Large Burn Patient”

MENTORSHIP AWARDS

Basic Science Research

Conrad Russell Y. Cruz, MD, PhD

Clinical Research

Rana Hamdy, MD, MPH, MSCE

Bench to Bedside Research

Ioannis Koutroulis, MD, PhD, MBA

ELDA ARCE TEACHING SCHOLAR AWARD

Priti D. Bhansali, MD, MEd

Heather Ann Walsh, PhD, RN

SUZANNE FEETHAM NURSING RESEARCH SUPPORT AWARD

Eileen P. Engh, PhD RN 
“Rare Disease Organization Lifecycle” Role in Helping Parents with Everyday Life Information Seeking and Connection (RDO-HELIX)

EXPLORATIONS IN GLOBAL HEALTH PILOT AWARDS

Launchpad Awards

Mi Ran Shin, MD, MPH
“Establishing Interdisciplinary Rehabilitation for Birth and Burn Injuries in Ethiopia”

Susan Harvey, MSN, CPNP-AC
“Implementation of Sickle Cell Pilot Program in Ndhiwa Sub County, Kenya”

Meleah Boyle, PhD, MPH
“Understanding and Addressing Environmental Sustainability to Protect the Health of the Children’s National and Global Communities”

Eiman Abdulrahman, MD
“Research Capacity Building to Improve Pediatric Emergency and Critical Care in Ethiopia”

Pilot Awards

Alexander Andrews, MD
“EEG as a Diagnostic and Prognostic Marker in Severe Pediatric Malaria, Blantyre Malawi”

Daniel Donoho, MD & Timothy Singer, MD
“Feasibility Study of a Novel Artificial Intelligence-Based Educational Platform to Improve Neurosurgical Operative Skills in Tanzania”

Hasan Syed, MD
“Bridging the Gap an Educational Needs Assessment for Pediatric Neurosurgery Training in Pakistan”

Sofia Perazzo, MD & Lamia Soghier, MD, MEd, MBA
“QI Mentorship to Improve Pediatric Screening and Follow-up in Rural Argentina”

Benjamin Liu, PhD
“AI-Empowered Real-Time Sequencing Assay for Rapid Detection of Schistosomiasis in Senegal”

Rae Mittal, MD
“Assessment and Enhancement of Proficiency in Emergency Child Neurology Topics for Post-Graduate Emergency Medicine Trainees in India”

Innovation Day ignites bold thinking

Thursday, REI Week shifted to the Children’s National Research & Innovation Campus for Innovation Day, a celebration of how bold ideas and collaborative culture can accelerate progress in pediatric medicine.

Brandy Salmon, PhD, associate vice president of Innovation and Partnerships at Virginia Tech, opened the day with “The Alchemy of Innovation,” focusing on how institutions can build a culture that fuels transformative partnerships.

A multidisciplinary panel discussion moderated by Nathan Kuppermann, MD, MPH, and Catherine Bollard, MBChB, MD, featured Nehal Mehta, MD, Julia Finkel, MD, Kevin Cleary, PhD, Ioannis Koutroulis, MD, PhD, MBA, Francesca Joseph, MD and Patrick Hanley, PhD, who shared how innovation can be advanced and promoted, especially as a core institutional priority.

A shared vision for the future

REI Week 2025 reaffirmed the values that define Children’s National: a commitment to excellence, collaboration and equity in pediatric research and care. As discoveries continue to emerge from our hospital and our research campuses, the connections built and ideas sparked during this week will help shape the future of pediatric health — locally and globally.

By elevating voices from the bedside to the bench, with the support of the executive sponsors Nathan Kuppermann, MD, MBChB, Catherine Bollard, MBChB, MD, Kerstin Hildebrandt, MSHS, Linda Talley, MS, RN, NE-BC and David Wessel, MD, REI Week demonstrated that we must embrace the community in all aspects of our work. Because we know that there are answers we can only get from the patients that we serve—and we need to be their voice.

Research, Education & Innovation Week will be back next year on April 13-17, 2026.

  • Posters at the REI Week 2025 Monday, March 31 poster session.

    Posters at the REI Week 2025 Monday, March 31 poster session.

  • Panelists discuss innovation during REI Week 2025.

    Panelists discuss innovation during REI Week 2025.

  • Global Health Initiative community engagement event during REI Week 2025.

    Global Health Initiative community engagement event during REI Week 2025.

  • Chris Rees presents his REI Week 2025 lecture.

    Chris Rees presents his REI Week 2025 lecture.

  • Nathan Kuppermann listens to a presenter during the REI Week 2025 Tuesday, April 1, poster session.

    Nathan Kuppermann listens to a presenter during the REI Week 2025 Tuesday, April 1, poster session.

  • Michelle Riley-Brown, Nathan Kuppermann, Catherine Bollard and Naomi Luban on stage during the REI Week 2025 awards ceremony.

    Michelle Riley-Brown, Nathan Kuppermann, Catherine Bollard and Naomi Luban on stage during the REI Week 2025 awards ceremony.

  • Brandy Salmon presents on innovation programs at Virginia Tech during the REI Week 2025 Innovation Day.

    Brandy Salmon presents on innovation programs at Virginia Tech during the REI Week 2025 Innovation Day.

  • Catherine Bollard listens to a presenter during the REI Week 2025 Monday, March 21 poster session.

    Catherine Bollard listens to a presenter during the REI Week 2025 Monday, March 21 poster session.

  • Ambroise Wonkman poses for a picture with Children’s National staff.

    Ambroise Wonkman poses for a picture with Children’s National staff.

  • Tanzeem Choudhury presenting during REI Week 2025.

    Tanzeem Choudhury presenting during REI Week 2025.
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brain scan of newborn

New study finds prenatal opioid exposure linked to smaller newborn brain volumes

brain scans of newbornA new study out of the Center for Prenatal, Neonatal & Maternal Health Research, directed by Catherine Limperopoulos, PhD, led by Yao Wu, PhD and Stephanie Merhar, MD, MS, out of Cincinnati Children’s Hospital Medical Center, sought answers to the question: “Do brain volumes differ in opioid-exposed vs. unexposed newborns?” In one of the largest studies of this kind, researchers found that prenatal exposure to opioids is associated with smaller brain volumes in newborns. These findings from the landmark Outcomes of Babies with Opioid Exposure (OBOE) study build on, reinforce smaller studies, and achieve a better understanding of the impacts of prenatal opioid exposure (POE).

Dive Deeper

The Advancing Clinical Trials in Neonatal Opioid Withdrawal (ACT-NOW)’s OBOE study is a multi-site observational study of newborns with prenatal opioid exposure and a control group of unexposed newborns from four different sites in the United States – Case Western Reserve University, Cincinnati Children’s Hospital Medical Center, University of Alabama at Birmingham, and Children’s Hospital of Philadelphia.

In a study involving 173 newborns who were exposed to opioids during pregnancy and 96 newborns not exposed to opioids prenatally showed smaller brain sizes in several key areas. Specifically, these exposed babies had smaller total brain volumes, as shown through MRI, as well as reduced volumes in important parts of the brain, including the cortex (outer layer of the brain), deep gray matter (areas that control movement and emotions), white matter (which helps transmit signals in the brain), cerebellum (responsible for coordination and movement), brainstem (controls basic functions like breathing), and the amygdala (involved in emotions and memory).

Further details showed that newborns exposed to medication for opioid use disorder (MOUD) during pregnancy with methadone, had smaller white matter volumes, while those exposed to MOUD with buprenorphine had smaller volumes specifically in the right amygdala. Additionally, newborns who were exposed to opioids plus additional substances such as THC and gabapentin had smaller volumes in even more brain areas compared to those who were only exposed to opioids.

What’s Next

The OBOE study sets the groundwork for further research into the long-term impact of opioid exposure during pregnancy. Additional work is necessary to expand on these findings and how they relate to functions in childhood – including exploring the way these reduced brain volumes may impact cognitive, behavioral, and motor impairments. The study raises important questions about how current guidelines for MOUD during pregnancy – specifically with methadone and buprenorphine – might evolve considering these findings. This study highlights the need for further research to assess the long-term effects of MOUD regimens on both maternal and infant outcomes.

This significant study underscores the importance of multi-disciplinary collaboration in opioid exposure research, effective regulation, and policy interventions – involving healthcare providers, researchers, policymakers, and affected families – to best mitigate the consequences and improve the health outcomes of children affected by prenatal opioid exposure.

You can read the full study, Antenatal Opioid Exposure and Global and Regional Brain Volumes in Newborns, and its companion editorial, Following the Developing Brain Affected by Opioid Exposure, in the Journal of the American Medical Association.

Additional authors from Children’s National include Kushal Kapse, BS, MS, and Josepheen De Asis-Cruz, MD, PhD. Other authors include Carla M. Bann, PhD, Jamie E. Newman, PhD4, Nicole Mack, MS, Sara B. De Mauro, MD, MSCE, Namasivayam Ambalavanan, MD, Jonathan M. Davis, MD, Scott A. Lorch, MD, MSCE5, Deanne Wilson-Costello, MD, Brenda B. Poindexter, MD and Myriam Peralta-Carcelen, MD.

Children's National Hospital's 2023-2024 Academic Annual Report on a tablet

Children’s National delivers on the promise in 2024

Children's National Hospital's 2023-2024 Academic Annual Report on a tablet

The Children’s National 2023-2024 Academic Annual Report show on a tablet.

Children’s National Hospital has released its 2023-2024 Academic Annual Report, showcasing a year of transformative progress in pediatric medicine. The report highlights achievements across its research centers, institutes and Innovation Ventures, underscoring the hospital’s role as a leader in advancing child health through innovation and collaboration.

“This year’s report reflects the remarkable progress we have made in advancing the frontiers of pediatric medicine,” said Nathan Kuppermann, MD, MPH, Chief Academic Officer and Chair of Pediatrics. “It highlights groundbreaking work across our research centers, institutes, and Innovation Ventures, showcasing the collaborative spirit that drives our mission forward. These achievements underscore our shared commitment to delivering transformative research and the best possible outcomes for children and families.”

Delivering across centers

The report captures the contributions of each of Children’s National’s research centers, each pushing the boundaries of pediatric healthcare:

  • Center for Cancer & Immunology Research (CCIR): Delivering on the promise of cell and gene therapies, offering innovative treatments for pediatric cancers and immune disorders.
  • Center for Genetic Medicine Research (CGMR): Advancing pediatric genetic medicine through interdisciplinary efforts, addressing complex genetic conditions with cutting-edge science.
  • Center for Neuroscience Research (CNR): A year of growth in scientific excellence, advancing the understanding of brain development and neurological conditions.
  • Center for Prenatal, Neonatal & Maternal Health Research (CPHNMR): Revolutionizing neonatal care with its pioneering infant brain health neuromonitoring program.
  • Center for Translational Research (CTR): Facilitating groundbreaking work by new K awardees and driving translational research to bridge the gap between discovery and clinical care.
  • Sheikh Zayed Institute for Pediatric Surgical Innovation (SZI): Leading the way in advanced research projects in pediatric surgery, pushing technological boundaries to improve outcomes for children worldwide.

Taking the lead in innovation through collaboration

Innovation Ventures at Children’s National is advancing pediatric health security, addressing unique challenges with transformative solutions. Meanwhile, the Children’s National Research & Innovation Campus (CNRIC) continues to thrive as a hub for discovery and collaboration, hosting conferences on topics like artificial intelligence in healthcare, cell and gene therapy, and pediatric epilepsy research.

A vision for the future

The report also highlights Children’s National’s focus on integrating cutting-edge technologies like artificial intelligence into its research and clinical practices, as well as addressing global health challenges such as the effects of climate change on children’s health. These efforts reflect the hospital’s commitment to improving outcomes for children everywhere through innovation, teamwork, and forward-thinking leadership.

The 2023-2024 Academic Annual Report serves as a testament to the dedication and expertise of the Children’s National community, showcasing how collaboration and innovation are shaping the future of pediatric healthcare.

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.

collage of news logos

Children’s National in the News: 2024

collage of news logosIn 2024, Children’s National Hospital continued to make remarkable strides across diverse areas of pediatric medicine, from groundbreaking technological innovations to critical health advocacy. The following compilation showcases ten significant stories that demonstrate the breadth and depth of the hospital’s impact, as featured in major national news outlets including NBC Nightly News, CNN, The Washington Post, The New York Times, NPR, The Today Show, Healio, and POLITICO. Delve into our 2024 news highlights for more.

1. World’s smallest pacemaker gives new hope to babies with heart defects

Charles Berul, M.D., and a patient family talk about the pill-sized pacemaker that saved the life of Abby, an infant born with deadly heart defects. (NBC Nightly News)

2. ‘A $10 death trip’: Fentanyl is killing teens. Meet one fighting for his life

Sivabalaji Kaliamurthy, M.D., addiction psychiatrist and director of the Addictions Program, spoke to CNN about the impact of drug addiction on teen health and the lack of resources available to treat opioid use disorder. (CNN)

3. Health panel urges interventions for children and teens with high BMI

Susma Vaidya, M.D., M.P.H., associate medical director of the IDEAL Clinic, shared her concerns about childhood obesity treatment recommendations issued today by a leading panel of independent U.S. health experts. (The Washington Post)

4. An Rx for food? Doctor’s offices offer groceries to those in need

Shideh Majidi, M.D., M.S.C.S., and Emily Frymark, clinical dietitian, spoke about how the food pharmacy, created in partnership with the Capital Area Food Bank, benefits patients with diabetes and other chronic conditions. (The Washington Post)

5. First patient begins newly approved sickle cell gene therapy

Kendric Cromer, a 12-year-old boy being treated at Children’s National Hospital, became the first person in the world with sickle cell disease to begin a commercially approved gene therapy that may cure the condition. “This is a big effort,” says David Jacobsohn, M.D., ScM, M.B.A. (The New York Times)

6. ‘We created this problem’: A pediatric surgeon on how gun violence affects children

Mikael Petrosyan, M.D., associate chief of General and Thoracic Surgery, discusses the stress medical staff face when treating young victims of gun violence. (NPR)

7. 7th grade boy rings bell after final round of chemotherapy

Landon, an 11-year-old patient, rang the bell at Children’s National Hospital with family, friends, doctors and nurses cheering after finishing his final round of chemotherapy. (The Today Show)

8. Study: One in three adolescents experience ‘period poverty’

Monika Goyal, M.D., M.S.C.E., pediatric emergency medicine specialist and co-director of the Center for Translational Research, emphasized the need for awareness in addressing period poverty in teenagers and young adults. (Healio)

9. The AI assurance labs are coming

Kolaleh Eskandanian, Ph.D., M.B.A., P.M.P., vice president and chief innovation officer, participates in a panel discussion covering AI data collection, associated risks, reliance and other topics related to artificial intelligence. (POLITICO)

10. First day of a ‘new life’ for a boy with sickle cell

Children’s National patient Kendric Cromer, 12, became one of the first children ever to be treated with a newly approved gene therapy that will free him from the sickle cell disease that has stolen his childhood. (The New York Times)

2024 with a lightbulb instead of a zero

The best of 2024 from Innovation District

2024 with a lightbulb instead of a zero2024 marked another groundbreaking year for Children’s National Hospital, showcasing remarkable advances across the spectrum of pediatric medicine, research and healthcare innovation. From pioneering surgical procedures to breakthrough artificial intelligence applications, the institution continued to push the boundaries of what’s possible in children’s healthcare. Read on for our list of the most popular articles we published on Innovation District in 2024.

1. Prenatal COVID exposure associated with changes in newborn brain

A study led by researchers at Children’s National Hospital showed that babies born during the COVID-19 pandemic have differences in the size of certain structures in the brain, compared to infants born before the pandemic. The findings suggest that exposure to the coronavirus and being pregnant during the pandemic could play a role in shaping infant brain development.
(3 min. read)

2. Children’s National Hospital again ranked among the best in the nation by U.S. News & World Report

Children’s National Hospital was ranked as a top hospital in the nation by the U.S. News & World Report 2024-25 Best Children’s Hospitals annual rankings. This marks the eighth straight year Children’s National has made the Honor Roll list. The Honor Roll is a distinction awarded to only 10 children’s hospitals nationwide.
(2 min. read)

3. Children’s National performs first ever HIFU procedure on patient with cerebral palsy

In January 2023, a team of multidisciplinary doctors performed the first case in the world of using bilateral high intensity focused ultrasound (HIFU) pallidotomy on Jesus, a 22-year-old patient with dyskinetic cerebral palsy. The procedure is part of a clinical trial led by Chima Oluigbo, M.D., pediatric neurosurgeon at Children’s National Hospital.
(3 min. read)

4. Novel ultrasound device gets FDA breakthrough designation with Children’s National support

A novel ultrasound device developed by Bloom Standard received the Food and Drug Administration’s valued breakthrough device designation with the help of Children’s National Hospital. The device that enables autonomous, hands-free ultrasound scans to be performed anywhere, by any user.
(2 min. read)

5. First-of-its-kind pilot study on the impacts of Lyme disease in pregnancy and infant development

Understanding the effects of Lyme disease on the developing fetal brain is essential to ensure timely prenatal and postnatal treatments to protect the fetus and newborn. In response to this need, Children’s National Hospital is leading a pilot study to establish the groundwork needed for a larger study to determine the effect of in utero exposure to Lyme disease on pregnancy and early childhood neurodevelopmental outcomes.
(3 min. read)

6. Earliest hybrid HLHS heart surgery kids thrive 5 years later

Five years ago, Cayden was born 6 weeks early weighing less than four pounds and at risk of dying from her critical congenital heart disease. Today, she’s a happy five-year-old. Early diagnosis of her hypoplastic right ventricle, double inlet left ventricle and critical coarctation of the aorta allowed for the team at Children’s National Hospital to create a careful plan for safe delivery and to offer an innovative hybrid HLHS surgical approach at the hospital within 24 hours after she was born.
(1 min. read)

7. Wayne J. Franklin, M.D., F.A.C.C., named senior vice president of the Children’s National Heart Center

Children’s National Hospital appointed Wayne J. Franklin, M.D., F.A.C.C., as the new senior vice president (SVP) of the Children’s National Heart Center. In this role, Dr. Franklin oversees the full spectrum of heart care services including cardiac imaging and diagnostics, interventional cardiology, electrophysiology, cardiac anesthesia, cardiac surgery and cardiac intensive care.
(2 min. read)

8. Artificial – and accelerated – intelligence: endless applications to expand health equity

By pioneering artificial intelligence (AI) innovation programs at Children’s National Hospital, Marius George Linguraru, D.Phil., M.A., M.Sc., and the AI experts he leads are ensuring patients and families benefit from a coming wave of technological advances. The team is teaching AI to interpret complex data that could otherwise overwhelm clinicians.
(4 min. read)

9. Evidence review: Maternal mental conditions drive climbing death rate in U.S.

Painting a sobering picture, a research team led by Children’s National Hospital culled years of data demonstrating that maternal mental illness is an under-recognized contributor to the death of new mothers. They called for urgent action to address this public health crisis.
(3 min. read)

10. Nathan Kuppermann, M.D., M.P.H., named chief academic officer and chair of Pediatrics

Children’s National Hospital appointed Nathan Kuppermann, M.D., M.P.H., as its new executive vice president, chief academic officer and chair of Pediatrics. In this role, Dr. Kuppermann oversees research, education and innovation for the Children’s National Research Institute as well as academic and administrative leadership in the Department of Pediatrics at George Washington University School of Medicine & Health Services.
(2 min. read)

11. First global clinical trial achieves promising results for hypochondroplasia

Researchers from Children’s National Hospital presented findings from the first clinical trial of the medication vosoritide for children with hypochondroplasia – a rare genetic growth disorder. During the phase 2 trial, researchers found vosoritide increased the growth rate in children with hypochondroplasia, allowing them to grow on average an extra 1.8 cm per year.
(2 min. read)

12. Pioneering research center aims to revolutionize prenatal and neonatal health

Since its establishment in July 2023, the Center for Prenatal, Neonatal & Maternal Health Research at Children’s National Hospital has gained recognition through high-impact scientific publications, featuring noteworthy studies exploring the early phases of human development.
(3 min. read)

Mary Donofrio, M.D., medical director of Prenatal Cardiology at Children’s National Hospital

Fetal detection, risk stratified care algorithms give infants with CHD their best chance to thrive

Mary Donofrio, M.D., medical director of Prenatal Cardiology at Children’s National Hospital

Mary Donofrio, MD, medical director of Prenatal Cardiology at Children’s National, and other dedicated pediatric cardiologists working in this evolving specialty have spent most of the last two decades defining the field.

Congenital heart disease (CHD) can be detected in utero with precision and accuracy. With advanced technology, identification of a problem happens earlier than ever, including identifying details that predict whether a baby may be dangerously sick at birth. This gives fetal and pediatric cardiologists time to make plans for delivery and specialized care immediately after birth. These critical first moments can be the key to survival for infants with the most complicated defects.

Mary Donofrio, MD, medical director of Prenatal Cardiology at Children’s National Hospital, and other dedicated pediatric cardiologists working in this evolving specialty have spent most of the last two decades defining the field and demonstrating the importance of making sure every child with a congenital heart defect is diagnosed as early as possible to give them the best chance for a healthy life.

Children’s National leads the way

Children’s National performs more than 4,000 fetal ultrasounds each year to detect and manage the unborn child with congenital heart disease, making it one of the most experienced centers in the United States at finding these conditions and planning for their care.

For more than 20 years, every fetus diagnosed with congenital heart disease at Children’s National following an obstetrician referral has their anticipated level of delivery room care assigned by a fetal cardiologist. Protocols were created at Children’s National and validated to establish specialized delivery room management for each patient. The management plan includes specifics about the time and place of delivery and which delivery room staff members are required for stabilization and care after birth based on the severity of the condition.

The outcomes from this approach were published in a landmark 2013 study showing the impact on improving outcomes for infants with the most serious forms of congenital heart disease. Since then, these protocols have become part of more extensive fetal cardiology care guidelines that are in use both at Children’s National and around the world.

“The guidelines we wrote include recommendations about who should get a fetal echo, how to do a fetal echo, how to manage babies in utero including when a fetal intervention might be necessary, and finally how to decide the level of cardiology care that should be present in the delivery room,” according to Donofrio, who served as lead author.

In Washington, D.C., approximately 60 to 75% of congenital heart defects are diagnosed before a baby is born, giving doctors and other care providers critical days, weeks and months to plan how best to protect the fragile infant during their transition into the world from the safe haven of their mother’s body.

What’s next

Fetal imaging guidelines tell obstetricians which expecting mothers should be referred for a fetal ultrasound given a higher level of risk for CHD over the population risk. However, most women do not have any risk factors that will trigger additional testing beyond obstetrical screening. Also, many families even if referred are far from a center that is qualified to perform a fetal echocardiogram to detect these conditions.

Research at Children’s National, led by Anita Krishan, MD, and Dr. Donofrio in collaboration with the Fetal Heart Society, an international research collaborative, showed that in the U.S., factors such as socio-economic status, ethnicity and geography are important barriers to detection of severe congenital heart diseases such as hypoplastic left heart syndrome and transposition of the great arteries.

In a follow-up study by Jennifer Klein, MD, and Dr. Krishnan, distance was not the only barrier to detecting CHD, however. Geo-mapping technology using zip codes allowed the team at Children’s National to pinpoint “hot spots” where detection is decreased, even in places where care should be available. The Heart Center team is hoping to work with providers in these neighborhoods to improve access to care and help educate local clinic providers about how to image and when to refer for further testing.

Donofrio and colleagues are also working to develop ways to improve the diagnosis of fetal heart disease in places that are far from the Heart Center. This includes exploring more portable diagnostic tools and applying telehealth strategies to connect fetal heart experts with local care providers to make an action plan, before a baby arrives potentially in distress. In addition, a phone-based application is under development to help sonographers to identify abnormal images in real time during routine scans in remote locations. Improved detection rates have also opened the doors to powerful new studies investigating how maternal health and stress impacts brain development in fetuses with congenital heart disease. Ongoing research looks at ways to better support expecting mothers, with the goal of helping moms cope with stress during pregnancy so her baby has the best chance possible to be born healthy and strong.

Donofrio says she won’t stop until in utero detection of congenital heart disease is 100%. “Where you live, your neighborhood, your life experience or how far you live from the Heart Center, should not decrease our ability to do everything possible to care for every baby and achieve the best outcome possible,” she says.

Illustration of low brain efficiency

Neighborhood disadvantage alters brain networks in unborn babies

Illustration of high and low brain efficiencyGrowing up in a disadvantaged neighborhood changes a child’s brain even before birth. These new findings, in the latest edition of The Journal of Pediatrics, underscore the need to support young families from a baby’s earliest days.

According to this new research from the Center for Prenatal, Neonatal & Maternal Health Research at Children’s National Hospital, exposure to neighborhood disadvantage lessens the functional integration of neural networks in the fetal brain, as seen on functional MRIs of healthy babies. The center compared the brains of 68 healthy babies on 79 scans. Researchers then mapped details about neural activity to a “social vulnerability index” from the Centers for Disease Control and Prevention, which indicates proximity to environmental stressors.

“We specifically looked at brain architecture to see how easily information flows between different regions,” said Kevin Cook, Ph.D., research faculty at the center and the manuscript’s first author. “To do this, we used graph theory, which borrows concepts from social network theory. It’s widely applied in computer science to understand how information flows within groups, and neuroscience has adapted it to study how information travels within the brain.”

What we found

Dr. Cook said researchers focused on the three metrics:

  • Path length, which measures how many stops information needs to make along its way through the brain.
  • Global efficiency, which measures the overall efficiency of the entire brain’s network.
  • Small-world propensity, which describes how the brain’s network is organized and indicates how well the brain is organized into smaller, efficient networks.

As social vulnerability increased, the research team found global efficiency decreased, meaning the brain’s neural network was less efficient. The path lengths were also longer in children with greater neighborhood disadvantage, reinforcing the global efficiency findings.

The fine print

The under-development and over-development of fetal brains may contribute to neurological disorders, such as autism, epilepsy and other conditions of interest to researchers. Yet science’s understanding of how the brain matures in utero is still limited.

In this study, researchers found a notable difference related to age. At the youngest gestational ages, path lengths are longer, and both global efficiency and small world propensity are lower. As the fetus gets closer to term, path length and global efficiency show rapid maturation and less advantaged fetuses catch up to their peers who have greater advantages.

Researchers saw the same findings for small-world propensity, but the maturation didn’t stop. These unborn babies overshot their peers and had greater small-world propensity, suggesting their brains are divided into a greater number of smaller networks than their advantaged peers.

“We believe that length and global efficiency are on a trend to overshoot,” Dr. Cook said. “These findings are notable because they agree with what we know about older children and adolescents. Greater disadvantage is associated with hyper- or over-maturation of the brain. Our findings suggest that this may be starting even before birth.”

What’s ahead

While still early, this research improves the understanding of how environmental complexities can impact an unborn baby. Catherine Limperopoulos, Ph.D., director of the research center, which opened in 2023, said this work will be foundational as they continue to study the impact of a child’s environment on development.

“These findings have important implications for understanding how status and disadvantage may have a cumulative effect on fetal brain development,” Dr. Limperopoulos said. “We must study and consider how to conceptualize the impact of socioenvironmental disadvantage in communities to better care for children and work to improve outcomes.”

Read the full study – “Greater Neighborhood Disadvantage Is Associated with Alterations in Fetal Functional Brain Network Structure” – in The Journal of Pediatrics.

2024-25 US News Badges

Children’s National again ranked among the best in the nation by U.S. News & World Report

2024-25 US News BadgesChildren’s National Hospital in Washington, D.C., was ranked as a top hospital in the nation by the U.S. News & World Report 2024-25 Best Children’s Hospitals annual rankings. This marks the eighth straight year Children’s National has made the Honor Roll list. The Honor Roll is a distinction awarded to only 10 children’s hospitals nationwide.

This year, U.S. News ended ordinal rankings on its Honor Roll. Instead of assigning a numerical rank from 1 to 10, all hospitals on the Honor Roll will be recognized as having attained the highest standards of care in the nation.

In addition, Children’s National tied for #1 pediatric hospital in the Mid-Atlantic region, which includes New York, New Jersey, Delaware, Pennsylvania, the District of Columbia, West Virginia and Virginia. It’s also best in the Mid-Atlantic in Neonatology.

For the fourteenth straight year, Children’s National ranked in 10 specialty services. New this year, U.S. News included behavioral health as a service line in the rankings. Since it’s the first year, there are no ordinal rankings for behavioral health, but the Children’s National program was named one of the top 50 programs in the country.

“In my first year here, I witnessed what makes Children’s National so special — our commitment to collaboration, empowering one another, and charting a bold path forward for pediatric care,” said Michelle Riley-Brown, MHA, FACHE, president and chief executive officer of Children’s National. “I’m proud U.S. News again recognized Children’s National as one of the top in the nation and the highest-ranked pediatric hospital in D.C., Maryland and Virginia. Together, we’ll continue to push the boundaries of care, research and innovation to make a difference for those who matter most — the kids.”

The annual rankings are the most comprehensive source of quality-related information on U.S. pediatric hospitals and recognizes the nation’s top 50 pediatric hospitals based on a scoring system developed by U.S. News.

“For nearly two decades, U.S. News has published Best Children’s Hospitals to empower the parents and caregivers of children with complex medical needs,” said Ben Harder, chief of health analysis and managing editor at U.S. News. “Children’s hospitals appearing on the U.S. News Honor Roll have a track record of delivering unparalleled specialized care.”

The bulk of the score for each specialty service is based on quality and outcomes data. The process includes a survey of relevant specialists across the country, who are asked to list hospitals they believe provide the best care for patients with the most complex conditions.

The Children’s National specialty services that U.S. News ranked in the top 10 nationally are:

The other four specialties ranked among the top 50 are Behavioral Health, Cardiology and Heart Surgery, Pulmonology and Lung Surgery, and Urology.

Kolaleh Eskandanian, Ph.D., M.B.A., during her recent appearance at POLITICO.

In the news: The future of patient care and access

Kolaleh Eskandanian, Ph.D., M.B.A., during her recent appearance at POLITICO.

“It is a market failure that we are dealing with – a lack of incentives leading to a stagnation in innovation with respect to small markets, such as pediatrics. Children’s National Hospital and our partners in other children’s hospitals in the country play a critical role in making noise and sending a message that children should not be an afterthought.” 

Hear more from Kolaleh Eskandanian, Ph.D., M.B.A., during her recent appearance at POLITICO. As vice president and chief innovation officer at Children’s National and Alliance for Pediatric Device Innovation principal investigator, Dr. Eskandanian shared her approach to engaging with the Food and Drug Administration (FDA) to advance artificial intelligence (AI) and machine learning technologies for pediatric healthcare. To date, she noted, the FDA has authorized 950 healthcare-related technologies enabled with AI and machine learning.