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Neonatal-Perinatal Medicine

Dedicated to providing the highest level of expertise in the care of women with high-risk pregnancies and in diagnosing and treating diseases and disorders of the newborn infant.

The Division of Neonatal-Perinatal Medicine provides comprehensive care for premature and full-term infants with a complex of neonatal problems. The ICN is a major referral center for term infants with respiratory failure and persistent pulmonary hypertension, perinatal asphyxia, extracorporeal membrane oxygenation (ECMO) and complex surgical problems, especially those with congenital diaphragmatic hernia where the survival for uncomplicated cases is greater than 90%. Special services offered in our nursery include high frequency ventilation, nitric oxide, hypothermia for perinatal asphyxia, and comprehensive neonatal health care. We also provide long-term neurodevelopmental follow-up for high-risk infants who are discharged from the intensive care nursery. The Division of Neonatal-Perinatal Medicine is a member of the National Institute of Child Health and Human Development (NICHD) Neonatal Research Network, a consortium of the leading neonatal intensive care units in the country that perform cutting-edge, collaborative clinical research.

The Division benchmarks patient care outcomes with this group of 16 of the leading intensive care nurseries in the country. Our low birth weight mortality and rate of broncho-pulmonary dysplasia and retinopathy of prematurity are consistently among the lowest.

The Division of Neonatal-Perinatal Medicine offers a NICHD sponsored fellowship program for pediatricians interested in advanced training in neonatal basic or clinical research. The Division houses the Jean & George Brumley Jr., Neonatal-Perinatal Research Institute which includes over 80 investigators at Duke interested in developmental biology and problems of the neonate and fetus.

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Treatments

Our expertise includes a continuum of care:

  • Critically ill newborns
  • Premature infants
  • Low birth weight infants
  • Complex surgical conditions
  • Perinatal asphyxia
  • Sepsis and septic shock
  • Newborns with congenital malformations
  • Respiratory failure in newborns
  • Congenital diaphramatic hernia

We offer:

  • High frequency ventilation for respiratory failure
  • Nitric oxide for pulmonary hypertension
  • Total body cooling for perinatal asphyxia
  • ECMO

Our Division provides comprehensive coverage for nurseries at Duke Hospital, Durham Regional and Alamance Regional Hospital:

  • Duke Intensive Care Nursery Our 50-bed neonatal intensive care unit provides care for more than 800 infants each year.
  • Duke Transitional Care Nursery This "step-down" unit helps transition infants from the ICN to home.
  • Neurodevelopmental Follow-Up Clinic This clinic provides comprehensive follow-up and assessment of our at-risk patients.
  • Duke Special Infant Care Nursery Our multidisciplinary medical and neurodevelopmental clinic provides follow-up care for high risk infants.
  • Durham Regional Hospital Special Care Nursery This nursery, staffed by Duke neonatologists, provides care for acutely ill and convalescing infants at our nearby Durham Regional Hospital.
  • Alamance Regional Medical Center Special Care Nursery This is our newest nursery, located 35 miles from Duke Hospital and staffed by Duke neonatologists.
  • Special Infant Care Clinic (SICC) This is a multidisciplinary comprehensive medical and neurodevelopmental follow-up clinic that is unique in its holistic approach to not only assessing development but providing nutritional, feeding, physical, and speech therapy for our patients. It assures that medical conditions are properly cared for and that recommendations are transmitted to primary care physicians and appointments for community services are utilized.
  • Neonatal-Infant Palliative Care Program (NIPCP)
    This family-centered program is offered for newborns and infants diagnosed with serious life-threatening conditions or overwhelming illnesses that are no longer responding to curative care.

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Physicians and Staff

Physicians

Name Areas of Special Interest
Patricia L. Ashley, MD, PhD Convalescent care of chronically ill neonates; acute care of mild to moderately ill newborns
Kamlesh V. Athavale, MD, MBBS Prematurity, bronchopulmonary dysplasia, neonatal ventilation
Richard L. Auten, MD Critically ill newborns, newborns with congenital malformations, severe respiratory failure, ECMO, high-frequency ventilation, nitric oxide
Margarita Bidegain, MD, MHS-CL High-risk neonatal care, prenatal, neonatal and pediatric palliative care
C. Michael Cotten, MD, MHS Optimizing care for newborns with evidence-based practice; special interest in infectious disease in low birth-weight infants, perinatal asphyxia, congenital diaphragmatic hernia, and the genomic approach to neonatal diseases
Jeffrey M. Ferranti, MD, MS Medical informatics, computerized patient-safety initiatives, quality improvement metrics, electronic research data exchange, medical-data standards and interoperability, neonatal critical care, CPOE, electronic medical records
Ronald N. Goldberg, MD Care of the low birth-weight infant, perinatal asphyxia, persistent pulmonary hypertension, congenital diaphragmatic hernia
Ricki F. Goldstein, MD Neonatal intensive care, neuro-developmental follow-up of high-risk infants
Susan D. Izatt, MD Intensive and transitional care of the ill newborn, neonatal skin, resident education
Robert W. Lenfestey, MD Pediatric pharmacology, neuroprotection of very low birth-weight infants
William F. Malcolm, MD Duke Transitional Care Nursery; convalescent and follow-up care of high-risk infants
Hugo A. Navarro, MD Care of the critically ill neonate with special interest in respiratory disorders
Silvia Y. Rho, MD General pediatrics including hospital medicine and newborn care
P. Brian Smith, MD, MHS Nosocomial infections in preterm neonates, drug safety and efficacy in neonates
Alyssa M. Stephany, MD Improving communication with referring providers and primary care providers; clinical education of residents, medical students, and other medical providers; neurodevelopment of premature and high-risk infants; quality improvement
David T. Tanaka, MD High-risk neonatal care, financial process analysis
Yui-Lin Tang, MD, MHS High-risk neonatal care, developmental care
James L. Wynn, MD Care of premature and critically ill infants, neonatal sepsis, immunology and immunomodulation, physician teaching and development

Research Faculty

Name Areas of Special Interest
Richard L. Auten, MD Mechanisms by which oxidative stress disrupts postnatal lung development in premature newborns.
Margarita Bidegain, MD, MHS Palliative care.
C. Michael Cotten, MD, MHS
 Use of cord blood therapy for perinatal asphyxia, use of genomic studies to diagnose and guide neonatal therapy.
Jeffrey Ferranti, MD, MS Use of medical informatics, computerized patient safety initiatives.
Ronald Goldberg, MD
 Perinatal asphyxia, use of stem cell/cord blood therapy for perinatal asphyxia.
Mary Hutson, PhD Growth factor signalling and cardiac development.
Margaret Kirby, PhD Etiology and pathogenesis of congential heart defects.
Chay Kuo, MD, PhD
 Neurodevelopmental research of neural stem cells.
William Malcolm, MD
 Diagnosis and management of gastroesophageal reflux.
David Tanaka, MD Health care economics.

Neonatal-Perinatal Research Unit Staff

Name Position
C. Michael Cotten, MD, MHS
 Medical Director
Kimberley Fisher, PhD, FNP-BC, IBCLC
 Director of Operations

NICHD Neonatal Research Network Staff

Name Position
Malissa Dunn, RRT
 Clinical Research Nurse
Katherine Foy, RN
 Clinical Research Coordinator, Neonatal Research Network
Sandra Grimes, RN, BSN Coordinator of Industry and Investigator Research
Charles Vajdl Clinical Trials Assistant

Staff

Name Position
Jennifer McLamb
 Patient Services
Emily Patterson
 Patient Services

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Clinic Hours and Location

Duke Children's Hospital & Health Center
2301 Erwin Road
Durham, NC 27710
Tel: 919-668-4000

Durham Regional Hospital
3643 Roxboro Road
Durham, NC 27704
Tel: 919-470-4000

Alamance Regional Medical Center
1240 Huffman Mill Road
Burlington, NC 27215
Tel: 336-538-7000

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Appointments and Contact Information

Referrals 24/7: 800-MED-DUKE (800-633-3853) or call the Intensive Care Nursery directly and ask to speak to the fellow or attending on call: 919-681-5551

Urgent calls during business hours: 919-681-5551

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