This Week in Baby + Parent Health: UTI tests, a NEC drug, appointment times and more
5 deeper dives and a few quick hits — what matters, what to do, and why it’s not all bad.
Hi! I’m Dr. Vicky — a board-certified pediatrics and NICU doctor — and these are the news stories I’d pop into the group chat.
Let me know in the comments if there’s a story you want me to unpack more next time.
⚡️ Infants born to mothers with pre-eclampsia are at higher risk of kidney disease
A new study in Kidney International found that babies whose mothers had pre-eclampsia had an increased risk (26%) of developing kidney disease before age 1. They also had a higher risk of developing kidney disease after age 25 (including a 3x higher risk of diabetic kidney disease). Pre-eclampsia, a hypertensive disease of pregnancy, can necessitate preterm delivery for the safety of the mother. Prematurity interrupts normal kidney cell (nephron) development and can itself cause kidney disease. This study adds to our knowledge by showing that even in term babies, there is a higher risk of renal disease from pre-eclampsia.
✅ What you can do
📋 Your pediatrician may not be thinking of screening for renal disease if your baby is term and otherwise healthy, regardless of maternal history of pre-eclampsia. This study is a good chance to discuss the risk/benefit of additional screening with them.
🧠 Machine learning helps identify postpartum depression
A paper in the American Journal of Psychiatry reported on efforts to develop a machine learning model for screening for postpartum depression at time of discharge. Postpartum depression is highly prevalent (in this cohort of patients without pre-existing depression, 10%, which is in line with other studies’ estimates). It is a great success to identify this potentially debilitating condition earlier, so parents can get treatment and support. I don’t see this study as an unmitigated machine learning success, though, the way it’s being reported. First, the Edinburgh Postnatal Depression Scale plays a role in their model, and already exists and does a reasonable job. Second, their study population was not especially diverse (mostly White, mostly college educated and privately insured). But the real sticky point is: the problem isn’t a lack of screening tools, it’s a lack of actual screening being done, and how to follow up screening information. Referrals can leave parents waiting for months to get help.
✅ What you can do
🔎 Glance over the Edinburgh Scale. If any of these ring a bell (prenatally, postnatally, whenever!) talk to your provider or a trusted confidante. Getting help can take months - so let’s get you on a waitlist or enrolled as soon as possible.
💊 A drug for NEC may be in the pipeline
A drug candidate for NEC is being developed by Infinant Health. NEC, or necrotizing enterocolitis, is a true scourge in neonatology. It is a dangerous and sometimes fatal condition in which the gut can sicken and become necrotic, sometimes requiring surgical resection, and can have severe long-term consequences for both nutrition and development. Infinant Health, formerly known as Evolve Biosystems, is working on a drug candidate, INF108, to reduce NEC. I suspect this drug is a relative of Evolve Biosystems’s probiotic Evivo. Probiotics are extensively used in older populations and abroad; in the US, American Academy of Pediatrics most recent policy discouraged their use in preterm infants. There were serious safety concerns (including illness and death) in infants exposed to contaminated probiotics spurring this policy. But if a probiotic is manufactured and regulated as a drug, it may be safer and thus more broadly used.
✅ What you can do
🍼 If your baby is preterm, especially <32 weeks, NEC is definitely a risk (though it can present at older ages). The best thing you can do for your baby to prevent NEC is maximize breastmilk intake (ideally your milk, but second best is donor milk). Ask your provider if they use probiotics in their NICU - many abroad do, fewer in the US.
🔬 Urine dipsticks can be used to diagnose UTI in febrile babies 2-6 months
Infants are at risk of severe illness from UTIs, and checking for UTI is a standard part of evaluating fevers in young infants. Typically, diagnosis is made via culture (gold standard, painful, requires a catheter sample), which can take time to grow. Thus, preliminary diagnoses have been typically made using urinalysis (someone looks at the kind and number of cells in the urine under a microscope). This study is excellent - it showed that urine dipstick, an easy-peasy to obtain test (painless! nearly immediate results) is sensitive for diagnosing UTIs in this population. This means less waiting in the cesspool that is the ED for urinalysis microscopy results, and faster treatment initiation.
✅ What you can do
💧 If your baby (2-6 months old) is being worked up for a UTI, ask if your provider offers urine dipstick testing. Fast and painless, and now with proof of appropriate diagnostic sensitivity.
🕒 It’s not in your head: wait times for appointments are longer than ever
A survey of 1391 medical offices in 15 metropolitan areas looking at appointment times in six specialties (cardiology, dermatology, ob-gyn, family medicine, orthopedic surgery and gastroenterology) showed appointments are increasingly unavailable. Of course, anyone who’s tried to book an appointment already knew this, but putting a number to the delay…both hurts more and is useful confirmation.Wait times are up nearly 20% from 2022. For ob-gyn appointments, an annual checkup took an average of 42 days to schedule (up by nearly 80% since 2004 and by 33% since 2022).
✅ What you can do
📅 Same thing I am trying to do (my annual had to be booked 6 weeks in advance this year): book as far ahead as possible. It’s brutal out there.
⚡️ Quick Hits
👀 Moves
RFK Jr. does not recommend COVID vaccines for kids + pregnant people. ACOG does not agree. I’m with ACOG.
HHS cancelled a $766M contract with Moderna aimed at developing a vaccine against avian flu.
The CDC team that aggregates and disseminates contraception guidelines was eliminated.
🔮 Possibly Good News (Stay Tuned)
England will make a gonorrhea vaccine available starting August 1st. Great news given the recent increase in multi-drug resistant gonorrhea. In addition to being profoundly unpleasant to have (though some remain asymptomatic), gonorrhea can impair fertility and cause a severe, vision-threatening infection in infants.
Researchers at University of South Australia are developing a tool for improved diagnosis of ovarian cancer, which is often missed until very late in the disease course.
Pfizer’s drug Braftovi reduced the risk of death by 51% for patients with colorectal cancer compared to standard chemotherapy.
Very interesting about the promise of an NEC drug…I am very optimistic about the new wave of probiotic pharma potential for GI and GU microbiome modulation