The Incubator

Send us a textThis week on The Incubator Podcast, Ben and Daphna review several recent studies in neonatal care. They start with a JAMA trial comparing expectant versus active PDA management in preterm infants, noting a survival signal favoring expectant care and discussing how this fits within current practice. They then review outcomes of 21-week gestation infants from the University of Iowa, focusing on resuscitation strategies and survival at the limits of viability.The conversation continues with the ICAF trial, examining whether extending caffeine therapy through 41 weeks postmenstrual age meaningfully reduces intermittent hypoxia and for which infants this may matter. A large national cohort study on antenatal corticosteroids between 21 and 24 weeks gestation is also discussed, highlighting practice variation and implications for counseling.The episode closes with a Neo News segment on legal liability in the NICU following a recent $32 million NEC settlement. Ben, Daphna, and Eli consider informed consent around nutritional care and how evolving legal pressures may influence communication and clinical decision making.This compilation brings together research and policy discussions from the week in a single long-form episode.Support the showAs always, feel free to send us questions, comments, or suggestions to our email: [email protected]. You can also contact the show through Instagram or Twitter, @nicupodcast. Or contact Ben and Daphna directly via their Twitter profiles: @drnicu and @doctordaphnamd. The papers discussed in today's episode are listed and timestamped on the webpage linked below. Enjoy!

Send us a textIn this episode of Neo News, Ben, Daphna, and Eli tackle the complex and emotionally charged landscape of legal liability in the NICU. Following a recent $32 million settlement involving necrotizing enterocolitis (NEC) and cow's milk-based formula, the team debates the future of informed consent for routine nutritional care. They explore how legal precedents may force neonatologists to replace bedside counseling with transactional forms, potentially eroding trust and complicating evidence-based practice. Join us as we discuss how to balance transparency, parental autonomy, and the reality of risk in the pursuit of better outcomes for our tiniest patients.----WTNH News 8. (2025, December 15). Parents, attorneys emphasizing importance of informed consent to NICUs following baby’s death at Yale New Haven Hospital. WTNH. https://www.wtnh.com/news/connecticut/new-haven/parents-attorneys-emphasizing-importance-of-informed-consent-to-nicus-following-babys-death-at-yale-new-haven-hospital/Support the showAs always, feel free to send us questions, comments, or suggestions to our email: [email protected]. You can also contact the show through Instagram or Twitter, @nicupodcast. Or contact Ben and Daphna directly via their Twitter profiles: @drnicu and @doctordaphnamd. The papers discussed in today's episode are listed and timestamped on the webpage linked below. Enjoy!

Send us a textIn this Journal Club episode, Ben and Daphna review a large national cohort study examining the association between antenatal corticosteroid exposure and survival in extremely preterm infants born between 21 and 24 weeks’ gestation. They discuss biologic plausibility, practice variation, and the challenges of interpreting retrospective data, while focusing on how these findings may inform counseling and shared decision-making at the margins of viability.----The Effects of Antenatal Corticosteroids on Extremely Premature Neonates Born between 21 and 24 Weeks. Yao R, Tritch N, Vedhanayagam K, Ali N, Reimche-Vu H, Gedestad I, Karageuzian S, Contag S.Am J Perinatol. 2025 Nov 6. doi: 10.1055/a-2722-8107. Online ahead of print. PMID: 41086871Support the showAs always, feel free to send us questions, comments, or suggestions to our email: [email protected]. You can also contact the show through Instagram or Twitter, @nicupodcast. Or contact Ben and Daphna directly via their Twitter profiles: @drnicu and @doctordaphnamd. The papers discussed in today's episode are listed and timestamped on the webpage linked below. Enjoy!

Send us a textBen and Daphna review the ICAF randomized clinical trial evaluating extended caffeine therapy in preterm infants and its impact on intermittent hypoxia through 41 weeks postmenstrual age. They discuss the study design, oximetry outcomes across multiple saturation thresholds, inflammatory biomarkers including TNF-α, and clinically relevant safety signals such as oxygen restart rates, length of stay, and weight gain. The conversation focuses on what intermittent hypoxia may mean for ongoing risk, and whether a targeted subgroup of infants might benefit from extending caffeine beyond traditional stopping points.----Intermittent hypoxia and caffeine in infants born preterm: the ICAF Randomized Clinical Trial. Eichenwald E, Corwin M, McEntire B, Knoblach S, Limperopoulos C, Kapse K, Kerr S, Heeren TC, Ikponmwonba C, Hunt CE; ICAF Study Group.Arch Dis Child Fetal Neonatal Ed. 2025 Nov 24:fetalneonatal-2025-329230. doi: 10.1136/archdischild-2025-329230. Online ahead of print.PMID: 41285561Support the showAs always, feel free to send us questions, comments, or suggestions to our email: [email protected]. You can also contact the show through Instagram or Twitter, @nicupodcast. Or contact Ben and Daphna directly via their Twitter profiles: @drnicu and @doctordaphnamd. The papers discussed in today's episode are listed and timestamped on the webpage linked below. Enjoy!

Send us a textIn this Journal Club episode, Ben and Daphna review a salient study from JAMA Network Open examining outcomes of infants born at 21 weeks’ gestation at the University of Iowa. They walk through resuscitation practices, early physiologic challenges, survival trends, and short-term developmental outcomes, while placing the data in the broader context of shifting limits of viability. The discussion highlights both cautious optimism and the many unanswered questions that remain as neonatology continues to push the boundaries of what is possible.----Outcomes of Infants Born at 21 Weeks' Gestational Age. Hyland RM, Mat HD, Boly TJ, Thomas BJ, Stanford AH, Harmon HM, Bermick JR, Davila RC, Colaizy TT, Dagle JM, Klein JM, Greiner AL, Bell EF, McNamara PJ; University of Iowa Neonatology Program.JAMA Netw Open. 2025 Dec 1;8(12):e2548211. doi:10.1001/jamanetworkopen.2025.48211.PMID: 41385227 Free PMC article.Support the showAs always, feel free to send us questions, comments, or suggestions to our email: [email protected]. You can also contact the show through Instagram or Twitter, @nicupodcast. Or contact Ben and Daphna directly via their Twitter profiles: @drnicu and @doctordaphnamd. The papers discussed in today's episode are listed and timestamped on the webpage linked below. Enjoy!