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Dean of CSON Speaks on Newborn Health in NICUs

Katherine Gregory, dean of the Connell School of Nursing, has spent a lot of time in neonatal intensive care units (NICU) throughout her extensive nursing career. NICUs, she said, have significantly improved over the years.

“It’s very different in the NICU 25 years ago as it is today,” Gregory said. “I could see that we were successfully helping more and more babies survive, which is wonderful.”

On Tuesday, Gregory spoke at an event titled Babies, Biomes, and Boston: A Journey in Leadership. She detailed her research on the gut health of premature babies and her background as a clinician and nurse prior to joining the Boston College community in July of 2021. 

“But I do want you to know that the microbiome plays a huge role in how we digest our food and metabolize our medicines … and it’s been really important to my research, because it plays a critical role in the development and the training of the immune system … most notably through the gut in early life,” she said.

Gregory then explained the root issue that nurses see in the NICU when dealing with preterm babies—an inflammatory bowel disease that doesn’t present very clearly with clinical signs and symptoms.

“So, when we think about gut health in the preterm baby, we think about necrotizing enterocolitis, or NEC,” Gregory said. “Very simply, NEC is the thing that keeps us up at night in the NICU.”

There is no exact way to test for NEC, and given the fact there aren’t any specific symptoms of NEC, it’s hard for nurses to even know what to test for when preterms are sick, according to Gregory. 

“[NEC] is still one of the only things we lack a blood test for and we need to rely on X-rays for diagnosis,” Gregory said. “Believe it or not, the use of an X-ray is a pretty crude and rudimentary thing to diagnose a GI disease.”

Gregory said that NEC is also a leading cause of death among preterms in the first week following birth, only falling behind lack of oxygen due to lung disease.

“But, after that first week … as the graph indicates, NEC is the leading cause of mortality,” Gregory said.

The main reason Gregory attended graduate school was to study NEC, she said. She wanted to understand this disease as it had been devastating watching the babies she worked with grow, but  then later contract the disease.

“And this is the reason I returned to graduate school,” she said. “And from the nursing perspective, I could see that we needed some new tools in our toolbox.”

While there is still much progress to be made, according to Gregory, through studying the urine of babies, nurses are now able to identify a signifier that NEC could be approaching.

“So I should note that our lab has done some really good work,” she said. “In addition to studying poopy diapers, we also study baby pee, and so we have had good luck in identifying a biomarker of NEC in urine and it’s called intestinal fatty acid binding protein and we found it to be higher in [urine] three to seven days before the disease is diagnosed.”

Working in Boston has taught Gregory a lot about collaboration and mentorship in the nursing world, she said. She is excited to continue her professional career at CSON. 

“So, my goal in serving the Connell School and Boston College is that as your dean, every day you will get my best,” she said. “I am sure that it will not always be perfect. I am 100 percent sure that it will not always be perfect, but it will be my best and I will be committed to leading with empathy to being a good communicator and building collaborations and mentorship to support all members of our community.”

Featured Image by Nicole Vagra / Heights Staff

November 7, 2021