Beyond the NICU: Longitudinal Research Unlocks Pathways to Better Outcomes in High Risk Infants
October 05, 2025
UH Innovations in Research
University Hospitals Rainbow Babies & Children’s is recognized globally for its leadership in neonatology, consistently ranked among the top U.S. programs for both clinical excellence and innovative research. With over a century of advancements in neonatal care, UH Rainbow integrates multidisciplinary expertise with a rigorous translational research framework to drive improved outcomes for preterm and critically ill infants.
A founding member of the National Institutes of Health (NIH) Neonatal Research Network, UH Rainbow plays a pivotal role in national and international studies that are redefining standards in neonatal medicine. Our investigators make significant contributions to the evolution of clinical protocols in areas such as neonatal respiratory failure, neurodevelopmental outcomes, and neonatal abstinence syndrome, exemplifying a bench-to-bedside approach.
Anna Maria Hibbs, MD, leads longitudinal studies evaluating the downstream effects of neonatal interventions on school-age children, including asthma pathogenesis, sleep-disordered breathing, and neurocognitive function. At Rainbow, Dr. Hibbs is leading “Pragmatic Research on Diuretic Management in Early Bronchopulmonary Dysplasia,” a multiple principal investigator (MPI) study to increase the evidence base for using diuretics in the treatment of BPD. These drugs are frequently used to treat infants at risk of developing BPD, despite limited evidence on their benefit.
Dr. Hibbs is also PI for “Post-Vent, the Sequelae: Personalized Prognostic Modeling for Consequences of Neonatal Intermittent Hypoxemia (IH) in Preterm Infants at Pre-school Age,” a collaboration between five NRN centers to examine oxygenation and control of breathing patterns and their impact on long-term respiratory outcomes.
Cynthia Bearer, MD, PhD, investigates the molecular pathways by which environmental exposures affect neonatal brain development, with a focus on identifying actionable neuroprotective interventions. Currently, her laboratory is focused on the effects of ethanol and bilirubin on brain development and how these neurotoxins inhibit the function of lipid rafts. These specialized micro domains of the plasma membrane are critical for cell-to-cell signaling in cerebellar and brain stem function, including respiratory control.
Deanne Wilson-Costello, MD, focuses on long-term neurodevelopmental outcomes in opioid-exposed infants, informing care strategies for a growing high-risk population. Dr. Wilson-Costello is the PI of a NIH-funded multi-site study using Magnetic Resonance Fingerprinting (MRF) to identify brain imaging biomarkers that predict developmental delays in opioid-exposed infants. She aims to integrate MRF with AI technologies to develop a non-invasive motion-robust imaging method that accurately maps infant brain development, to enable earlier identification of at-risk infants, particularly those affected by opioid exposure, and guide targeted early interventions.
Stephanie Ford, MD, examines how prenatal alcohol exposure impacts cardiac morphogenesis, contributing to mechanistic understanding of congenital heart disease (CHD). She is presently studying how prenatal alcohol exposure induces changes at times critical to human heart development, using hearts of quail and mouse embryos as a model to identify where within the anatomy of the heart gene expression is changing in response to alcohol and whether compounds administered during pivotal periods of embryonic heart development could ultimately be used to prevent CHDs.
Thomas Raffay, MD, investigates neonatal inflammatory signaling pathways to inform the development of targeted therapies. His lab has identified a potential new therapeutic candidate for the lung, airway, and cardiovascular issues that develop because of bronchopulmonary dysplasia, and is developing a potential therapy. Supported by an NIH R01 $2.3 million grant, Dr. Raffay is building upon a near decade of pre-clinical research, which showed that neonatal hyperoxia, a condition found in the NICU, causes the beneficial bronchodilator and antioxidant GSNO to be catabolized in the lungs by the enzyme GSNO reductase (GSNOR). Dr. Raffay’s research has shown that editing out the GSNOR enzyme reduces complications associated with BPD and found that airway hyper-reactivity, often experienced by BPD patients, can be reversed with inhaled GSNO, or a GSNOR inhibitor.
Peter MacFarlane, PhD, focuses on respiratory control and ventilatory support, advancing precision strategies for infants with cardiorespiratory instability. Ongoing studies in his laboratory strive to elucidate the pathophysiological consequences of apnea of prematurity (chronic intermittent hypoxia), supplemental oxygen therapy (hyperoxia), antenatal inflammation (amnionitis), neonatal inflammation (sepsis), and continuous oxygen de-saturation (sustained hypoxia). His lab is advancing understanding around the etiology of sudden infant death syndrome; dietary (metabolism and nutrition) regulation of genes important for respiratory neural development and airway hyper-reactivity and pulmonary development following neonatal hyperoxia and continuous positive airway pressure.
Samudragupta Bora, PhD, leads a research program on high-risk infant neurodevelopment, focusing on developing innovative care models for neurodevelopmental follow-up in resource-limited settings, to reduce disparities and improve long-term outcomes. He is leading groundbreaking child development research across sub-Saharan Africa, specifically in Ghana and Zimbabwe, to improve neonatal follow-up care for newborns discharged from NICUs. He is partnering with local clinicians, global experts, a Cleveland-based health tech start-up and families with lived experience.
The collaborative multidisciplinary discoveries unfolding across UH Rainbow Babies vastly expand the realm of what is clinically possible to optimize clinical outcomes, providing hope and transforming lives.