Network


Latest external collaboration on country level. Dive into details by clicking on the dots.

Hotspot


Dive into the research topics where Raye Ann deRegnier is active.

Publication


Featured researches published by Raye Ann deRegnier.


Behavioral Neuroscience | 2000

Neurocognitive sequelae of infants of diabetic mothers

Charles A. Nelson; Sandi S. Wewerka; Kathleen M. Thomas; Stephanie Tribby-Walbridge; Raye Ann deRegnier; Michael K. Georgieff

On the basis of animal models, it was hypothesized that infants of diabetic mothers (IDMs) would be at risk for suffering damage to the hippocampus primarily because of fetal iron deficiency, chronic hypoxia, and hypoglycemia. This, in turn, may result in impairments in recognition memory at a young age. To test this model, the memory of 6-month-old IDMs and control infants was evaluated with electrophysiological (event-related potential [ERP]) and behavioral (looking time) measures. At 12 months, the Bayley Scales of Infant Development was administered. Our ERP measures showed robust evidence consistent with memory deficits in the IDMs. In contrast, the looking time measures and the Bayley exam failed to distinguish between the groups. From these results it was concluded that the ERP, but not the behavioral, measures are able to detect, in an at-risk population, deficits in recognition memory that are thought to be mediated by damage to the hippocampus.


Pediatrics | 1999

Randomized, controlled trial of low-dose inhaled nitric oxide in the treatment of term and near-term infants with respiratory failure and pulmonary hypertension.

David N. Cornfield; Roy C. Maynard; Raye Ann deRegnier; Sixto F. Guiang; Joel E. Barbato; Carlos Milla

Recent reports indicate that inhaled nitric oxide (iNO) causes selective pulmonary vasodilation, increases arterial oxygen tension, and may decrease the use of extracorporeal membrane oxygenation (ECMO) in infants with persistent pulmonary hypertension of the newborn (PPHN). Despite these reports, the optimal dose and timing of iNO administration in PPHN remains unclear. Objectives. To test the hypotheses that in PPHN 1) iNO at 2 parts per million (ppm) is effective at acutely increasing oxygenation as measured by oxygenation index (OI); 2) early use of 2 ppm of iNO is more effective than control (0 ppm) in preventing clinical deterioration and need for iNO at 20 ppm; and 3) for those infants who fail the initial treatment protocol (0 or 2 ppm) iNO at 20 ppm is effective at acutely decreasing OI. Study Design. A randomized, controlled trial of iNO in 3 nurseries in a single metropolitan area. Thirty-eight children, average gestational age of 37.3 weeks and average age <1 day were enrolled. Thirty-five of 38 infants had echocardiographic evidence of pulmonary hypertension. On enrollment, median OI in the control group, iNO at 0 ppm, (n = 23) was 33.1, compared with 36.9 in the 2-ppm iNO group (n = 15). Results. Initial treatment with iNO at 2 ppm for an average of 1 hour was not associated with a significant decrease in OI. Twenty of 23 (87%) control patients and 14 of 15 (92%) of the low-dose iNO group demonstrated clinical deterioration and were treated with iNO at 20 ppm. In the control group, treatment with iNO at 20 ppm decreased the median OI from 42.6 to 23.8, whereas in the 2-ppm iNO group with a change in iNO from 2 to 20 ppm, the median OI did not change (42.6 to 42.0). Five of 15 patients in the low-dose nitric oxide group required ECMO and 2 died, compared with 7 of 23 requiring ECMO and 5 deaths in the control group. Conclusion. In infants with PPHN, iNO 1): at 2 ppm does not acutely improve oxygenation or prevent clinical deterioration, but does attenuate the rate of clinical deterioration; and 2) at 20 ppm acutely improves oxygenation in infants initially treated with 0 ppm, but not in infants previously treated with iNO at 2 ppm. Initial treatment with a subtherapeutic dose of iNO may diminish the clinical response to 20 ppm of iNO and have adverse clinical sequelae.


Obstetrics & Gynecology | 2010

Providing Advice to Parents for Women at Acutely High Risk of Periviable Delivery

William A. Grobman; Karen Kavanaugh; Teresa T. Moro; Raye Ann deRegnier; Teresa A. Savage

OBJECTIVE: To better understand preferred approaches that health care professionals could use when caring for parents who are at risk of giving birth to an extremely premature infant. METHODS: Women who were at high risk of having a periviable birth were recruited from three tertiary care hospitals with level 3 neonatal intensive care units. These women, as well as their partners, physicians, and nurses underwent structured interviews both before and after delivery. Interviews were analyzed for advice that was provided to health care professionals who could be involved in the future counseling of antenatal patients at high risk of periviable delivery. RESULTS: Forty women, 14 fathers, and 52 health care providers participated in the interview process. Two main themes were identified—namely, the fundamental importance of information provision and support. Nevertheless, although all participants agreed about the importance of these actions, several areas of discordance among participants were noted. Nearly one third of parents emphasized the importance of “hope”; 60% and 45% recommended the provision of supplementary written and Internet materials, respectively. In contrast, most health care providers expressed the importance of “objectivity,” and only 15% and 5% thought written or Internet materials, respectively, were desirable, given the concern that supplementary information sources could be misleading. CONCLUSION: Both patients and providers agree about the centrality of information provision and emotional support for women at risk of periviable delivery. This study not only elucidates preferred approaches and methods by which this information and support could be optimized, but also shows pitfalls that, if not avoided, may impair the relationship between provider and patient. LEVEL OF EVIDENCE: II


Seminars in Perinatology | 2008

Neurophysiologic Evaluation of Brain Function in Extremely Premature Newborn Infants

Raye Ann deRegnier

In extremely preterm infants, neonatal brain injury and interruption of the normal maturation of the brain result in functional impairments that appear to manifest in later life. The roots of these impairments may be evaluated in the newborn infant using neurophysiologic techniques, such as evoked potentials and event-related potentials. This paper will review the use of neurophysiologic techniques as a marker of maturational processes in the preterm and newborn brain and as a method of monitoring the development of sensory and cognitive function in preterm infants, focusing on auditory perception, discrimination, and memory. The effects of risk conditions will be reviewed.


Experimental Neurology | 2004

Electrographic imaging of recognition memory in 34-38 week gestation intrauterine growth restricted newborns

Linda S. Black; Raye Ann deRegnier; Jeffrey D. Long; Michael K. Georgieff; Charles A. Nelson

Electrophysiological imaging of recognition memory using event-related potentials (ERPs) in intrauterine growth-restricted (IUGR) newborns allows assessment of recognition memory before the onset of multiple confounding variables. Animal models that reproduce the physiologic components associated with IUGR have demonstrated adverse effects on the hippocampus, a structure that is essential to normal memory processing. Previous electrophysiologic studies have demonstrated shortened auditory-evoked potential (AEP) and visual-evoked potential (VEP) latencies in IUGR infants suggesting accelerated neural maturation in response to the adverse in-utero environment. The hypothesis of the current study was that newborns with IUGR and head-sparing would demonstrate altered auditory recognition memory when compared to controls and that the configuration of the alteration would evidence advanced maturation but still be different from that of typically grown newborns. Twelve IUGR newborns born at 34-38 weeks gestation with head-sparing and 16 age-matched control newborns were tested with both a speech/nonspeech paradigm to assess auditory sensory processing and a novel (strangers voice) and familiar (mothers voice) paradigm to assess recognition memory. In the recognition memory experiment, a three-way interaction of condition, lead, and group was identified for the lateral leads T4, CM3, and CM4 with the response to the mother being of much greater area in the IUGR cohort than in the controls. This ERP configuration has previously been reported for the midline leads in term newborns. The findings indicate that IUGR newborns with head-sparing have electrophysiologic evidence of accelerated maturation of cognitive processing suggesting an atypical process of maturation that may not support typical cognitive development.


BMC Pediatrics | 2007

Survival and major neurodevelopmental impairment in extremely low gestational age newborns born 1990–2000: a retrospective cohort study

Lisa K. Washburn; Robert G. Dillard; Donald J. Goldstein; Kurt L Klinepeter; Raye Ann deRegnier; Thomas M. O'Shea

BackgroundIt is important to determine if rates of survival and major neurodevelopmental impairment in extremely low gestational age newborns (ELGANs; infants born at 23–27 weeks gestation) are changing over time.MethodsStudy infants were born at 23 to 27 weeks of gestation without congenital anomalies at a tertiary medical center between July 1, 1990 and June 30, 2000, to mothers residing in a thirteen-county region in North Carolina. Outcomes at one year adjusted age were compared for two epochs of birth: epoch 1, July 1, 1990 to June 30, 1995; epoch 2, July 1, 1995 to June 30, 2000. Major neurodevelopmental impairment was defined as cerebral palsy, Bayley Scales of Infant Development Mental Developmental Index more than two standard deviations below the mean, or blindness.ResultsSurvival of ELGANs, as a percentage of live births, was 67% [95% confidence interval: (61, 72)] in epoch 1 and 71% (65, 75) in epoch 2. Major neurodevelopmental impairment was present in 20% (15, 27) of survivors in epoch 1 and 14% (10, 20) in epoch 2. When adjusted for gestational age, survival increased [odds ratio 1.5 (1.0, 2.2), p = .03] and major neurodevelopmental impairment decreased [odds ratio 0.54 (0.31, 0.93), p = .02] from epoch 1 to epoch 2.ConclusionThe probability of survival increased while that of major neurodevelopmental impairment decreased during the 1990s in this regionally based sample of ELGANs.


Developmental Neuropsychology | 2012

Auditory Recognition Memory in 2-Month-Old Infants as Assessed by Event-Related Potentials

Xiaoqin Mai; Lin Xu; Mingyan Li; Jie Shao; Zhengyan Zhao; Raye Ann deRegnier; Charles A. Nelson; Betsy Lozoff

Previous studies of auditory recognition memory in sleeping newborns reported 2 event-related potential (ERP) components, P2 and negative slow wave (NSW), reflecting voice discrimination and detection of novelty, respectively. In the present study, using high-density recording arrays, ERPs were acquired from 26 2-month-old awake infants as they were presented with a familiar and unfamiliar voice (i.e., mother and stranger) with equal probability. In addition to P2 and NSW, we observed a positive slow wave (PSW) over the right temporo-parietal scalp, indicating memory updating. Our study suggests that infants appear to have the capacity to encode novel stimuli as early as 2 months of age.


American Journal of Obstetrics and Gynecology | 2016

Periviable birth: Interim update

Jeffrey L. Ecker; Anjali J Kaimal; Brian M. Mercer; Sean C. Blackwell; Raye Ann deRegnier; Ruth M. Farrell; William A. Grobman; Jamie L. Resnik; Anthony Sciscione

Approximately 0.5% of all births occur before the third trimester of pregnancy, and these very early deliveries result in the majority of neonatal deaths and more than 40% of infant deaths. A recent executive summary of proceedings from a joint workshop defined periviable birth as delivery occurring from 20 0/7 weeks to 25 6/7 weeks of gestation. When delivery is anticipated near the limit of viability, families and health care teams are faced with complex and ethically challenging decisions. Multiple factors have been found to be associated with short-term and long-term outcomes of periviable births in addition to gestational age at birth. These include, but are not limited to, nonmodifiable factors (eg, fetal sex, weight, plurality), potentially modifiable antepartum and intrapartum factors (eg, location of delivery, intent to intervene by cesarean delivery or induction for delivery, administration of antenatal corticosteroids and magnesium sulfate), and postnatal management (eg, starting or withholding and continuing or withdrawing intensive care after birth). Antepartum and intrapartum management options vary depending upon the specific circumstances but may include short-term tocolytic therapy for preterm labor to allow time for administration of antenatal steroids, antibiotics to prolong latency after preterm premature rupture of membranes or for intrapartum group B streptococci prophylaxis, and delivery, including cesarean delivery, for concern regarding fetal well-being or fetal malpresentation. Whenever possible, periviable births for which maternal or neonatal intervention is planned should occur in centers that offer expertise in maternal and neonatal care and the needed infrastructure, including intensive care units, to support such services. This document describes newborn outcomes after periviable birth, provides current evidence and recommendations regarding interventions in this setting, and provides an outline for family counseling with the goal of incorporating informed patient preferences. Its intent is to provide support and guidance regarding decisions, including declining and accepting interventions and therapies, based on individual circumstances and patient values.


American Journal of Obstetrics and Gynecology | 2015

#3: Periviable birth

Jeffrey L. Ecker; Anjali J Kaimal; Brian M. Mercer; Sean C. Blackwell; Raye Ann deRegnier; Ruth M. Farrell; William A. Grobman; Jamie L. Resnik; Anthony Sciscione

Approximately 0.5% of all births occur before the third trimester of pregnancy, and these very early deliveries result in the majority of neonatal deaths and more than 40% of infant deaths. A recent executive summary of proceedings from a joint workshop defined periviable birth as delivery occurring from 20 0/7 weeks to 25 6/7 weeks of gestation. When delivery is anticipated near the limit of viability, families and health care teams are faced with complex and ethically challenging decisions. Multiple factors have been found to be associated with short-term and long-term outcomes of periviable births in addition to gestational age at birth. These include, but are not limited to, nonmodifiable factors (eg, fetal sex, weight, plurality), potentially modifiable antepartum and intrapartum factors (eg, location of delivery, intent to intervene by cesarean delivery or induction for delivery, administration of antenatal corticosteroids and magnesium sulfate), and postnatal management (eg, starting or withholding and continuing or withdrawing intensive care after birth). Antepartum and intrapartum management options vary depending upon the specific circumstances but may include short-term tocolytic therapy for preterm labor to allow time for administration of antenatal steroids, antibiotics to prolong latency after preterm premature rupture of membranes or for intrapartum group B streptococci prophylaxis, and delivery, including cesarean delivery, for concern regarding fetal well-being or fetal malpresentation. Whenever possible, periviable births for which maternal or neonatal intervention is planned should occur in centers that offer expertise in maternal and neonatal care and the needed infrastructure, including intensive care units, to support such services. This document describes newborn outcomes after periviable birth, provides current evidence and recommendations regarding interventions in this setting, and provides an outline for family counseling with the goal of incorporating informed patient preferences. Its intent is to provide support and guidance regarding decisions, including declining and accepting interventions and therapies, based on individual circumstances and patient values.


Labmedicine | 2007

Diagnosis of Iron Deficiency in Infants

John L. Beard; Raye Ann deRegnier; Malika D. Shaw; Raghavendra Rao; Michael K. Georgieff

The assessment of iron deficiency anemia in infants is a clinical challenge because of the high requirements for iron to support expansion of the blood volume during rapid growth and development. Infants are endowed with only adequate storage iron to support this iron requirement for the first 4 to 6 months of life and premature infants even less than that. Hemoglobin is a measure of anemia but is not specific to iron deficiency, which requires the additional measurement of ferritin, soluble transferrin receptor, and protoporphyrin levels to assess iron nutrition. Premature infants that receive transfusion or erythropoietin therapy are special diagnostic challenge. An accurate classification of iron status requires multiple biomarkers of iron storage and transport adequacy and in the absence of standardized assay material for several tests, becomes quite problematic.

Collaboration


Dive into the Raye Ann deRegnier's collaboration.

Top Co-Authors

Avatar
Top Co-Authors

Avatar
Top Co-Authors

Avatar
Top Co-Authors

Avatar
Top Co-Authors

Avatar
Top Co-Authors

Avatar
Top Co-Authors

Avatar

Anthony Sciscione

Christiana Care Health System

View shared research outputs
Top Co-Authors

Avatar

Brian M. Mercer

Case Western Reserve University

View shared research outputs
Top Co-Authors

Avatar
Top Co-Authors

Avatar
Researchain Logo
Decentralizing Knowledge