This is an application to participate in a Multicenter Neonatal Network to conduct collaborative search involving various issues in neonatology. The applicant, Women & Infants is the teaching hospital for obstetric, gynecology and neonatology for Brown University of Medicine. The institution has a full range of perinatal services that provide tertiary care to the mothers and infants in the state of Rhode Island and Southeastern Massachusetts. The Division of Neonatology has five full time board certified and/or board eligible neonatologists, an NIH funded fellowship in neonatology, and is part of a rotation for a 39-member pediatric residency program. The Division of Maternal Fetal Medicine has four full time perinatologists, a fellowship approved by the American College of Obstetrics and Gynecology and is part of a rotation for the 20-member Obstetric and Gynecology Residency Program. Both divisions are staffed by experienced nurses, respiratory therapists, social service and other relevant ancillary services. Women & Infants Hospital has just moved to a new $48-million dollar building in 1986, adjacent to the major teaching hospital for the Brown Medical School, Rhode Island Hospital. The Neonatal Intensive Care Unit is a 60-bed facility with modern equipment and resources. Maternal Fetal Medicine has a 16 bed labor and delivery unit and a full compliment of modern equipment and facilities to care for high risk pregnant women. The institution has an annual delivery rate of approximately 9,500, maternal transport of 600 and neonatal transport of 150. Total admissions of low birth weight infants (< 1500 g) for the calendar year 1989 was 223 with a survival rate of 82%. The facility serves as the only tertiary care center for the Southeastern New England region. The Division of Neonatology and Maternal Fetal Medicine has past records of collaboration both in clinical care, teaching and research. The latter is best exemplified by the participation in a collaborative research as a diabetes research center funded by NICHD during the past 14 years. The Principal Investigator has extensive experience in collaborative research in the past; the mission and goal, treatment philosophy and institutional flexibilities are such that collaborative clinical research can be done with good productivity.
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