Michael W. Kuzniewicz, MD, MPH

People

Expansion of Division of Research Perinatal Research Unit (EXPPRU)

Dedicated quantitative analytic support for obstetrics has not been available in Kaiser Permanente Northern California. An unusual opportunity has appeared: as a result of a project to develop a predictive model for obstetric complications, considerable development work has been conducted by a Division of Research (DOR) team. If linked to an ongoing program, the DOR Perinatal Research Unit, this development work could permit our region to enhance its ability to conduct sophisticated quantitative quality-assurance and utilization management in obstetrics. This study will explore the opportunity to expand the extraordinarily successful Perinatal Research Unit so that it could monitor obstetrics, not just neonatology. In addition to the funds requested here, TPMG has committed to providing MD time.
Investigator: Kuzniewicz, Michael
Funder: Kaiser Permanente Program Offices

Improving Post-Discharge Bilirubin Management in Newborns

There is variation and overuse in bilirubin testing among newborns. Multiple repeat testing occurs despite most newborns being at low risk for reaching bilirubin levels that would require phototherapy. Among the Kaiser Permanente birth population, 45 percent have two or more tests and 10 percent four or more tests. While the tests themselves are relatively inexpensive, the burden on families is significant, given the need to bring their newborns into outpatient clinics for repeat testing and the stress of worrying about hyperbilirubinemia. Evidence-based approaches for repeat testing are lacking. The aims of this study are to develop total serum bilirubin nomograms based upon gestational age, develop predictive models for reaching bilirubin levels above the 95th percentile during the first week of life to guide clinicians on the need and timing of post-discharge bilirubin testing, and assess the utility of bilirubin screening at less than 24 hours of age.
Investigator: Kuzniewicz, Michael
Funder: Northern California Community Benefit Programs

Medical Burden Associated with Preterm Labor and Preterm Birth in Kaiser Northern California

The aims of this study are to: 1) Characterize women in the Northern California Kaiser Permanente Medical Care Program (KPMCP) who received a diagnosis of preterm labor (PTL) between January 2001 and December 2010 and compare them to women without PTL who deliver at term. 2) Compare maternal and infant outcomes of pregnancies complicated by preterm labor versus those unaffected by PTL. 3) Evaluate the incremental cost of preterm delivery by week of gestational age. 4) Compare the maternal costs of pregnancies with PTL and without PTL.
Investigator: Kuzniewicz, Michael
Funder: GlaxoSmithKline PLC

A Quantitative, Risk-Based Approach to the Management of Neonatal Early-Onset Sepsis

Author(s): Kuzniewicz MW; Puopolo KM; Fischer A; Walsh EM; Li S; Newman TB; Kipnis P; Escobar GJ

JAMA Pediatr. 2017 Feb 20.

PubMed abstract

Development and Implementation of an Early-Onset Sepsis Calculator to Guide Antibiotic Management in Late Preterm and Term Neonates

Author(s): Kuzniewicz MW1; Walsh EM; Li S; Fischer A; Escobar GJ;

​​Jt Comm J Qual Patient Saf. 2016 May;42(5):232-9.

PubMed abstract

Incidence, Etiology, and Outcomes of Hazardous Hyperbilirubinemia in Newborns

Author(s): Kuzniewicz MW; Wickremasinghe AC; Wu YW; McCulloch CE; Walsh EM; Wi S; Newman TB

Pediatrics. 2014 Sep;134(3):504-9. Epub 2014-08-04.

PubMed abstract

Impact of universal bilirubin screening on severe hyperbilirubinemia and phototherapy use

Author(s): Kuzniewicz MW; Escobar GJ; Newman TB

Pediatrics. 2009 Oct;124(4):1031-9. Epub 2009 Sep 28.

PubMed abstract

Incremental Cost of Prematurity by Week of Gestational Age

Author(s): Walsh EM; Li SX; Black LK; Kuzniewicz M

AJP Rep. 2019 Jan;9(1):e76-e83. Epub 2019-03-19.

PubMed abstract

Antenatal and Intrapartum Risk Factors for Hypoxic-Ischemic Encephalopathy in a US Birth Cohort

Author(s): Parker SJ; Kuzniewicz M; Niki H; Wu YW

J Pediatr. 2018 Sep 27.

PubMed abstract

Childhood Seizures After Phototherapy

Author(s): Newman TB; Wu YW; Kuzniewicz MW; Grimes BA; McCulloch CE

Pediatrics. 2018 Sep 24.

PubMed abstract

Hyperbilirubinemia, Phototherapy, and Childhood Asthma

Author(s): Kuzniewicz MW; Niki H; Walsh EM; McCulloch CE; Newman TB

Pediatrics. 2018 Sep 12.

PubMed abstract

Comparison of Collaborative Versus Single-Site Quality Improvement to Reduce NICU Length of Stay

Author(s): Lee HC; Kuzniewicz M; Sharek PJ; et al.

Pediatrics. 2018 Jun 13.

PubMed abstract

Efficacy of Subthreshold Newborn Phototherapy During the Birth Hospitalization in Preventing Readmission for Phototherapy

Author(s): Wickremasinghe AC; Kuzniewicz MW; McCulloch CE; Newman TB

JAMA Pediatr. 2018 Feb 26.

PubMed abstract

Accuracy of international classification of diseases, ninth revision, codes for postpartum hemorrhage among women undergoing cesarean delivery

Author(s): Butwick AJ; Walsh EM; Kuzniewicz M; Li SX; Escobar GJ

Transfusion. 2018 Jan 26.

PubMed abstract

Health Care Utilization in the First Month after Birth and Its Relationship to Newborn Weight Loss and Method of Feeding

Author(s): Flaherman V; Schaefer EW; Kuzniewicz MW; Li S; Walsh E; Paul IM

Acad Pediatr. 2017 Nov 27.

PubMed abstract

Outcomes of Admissions for Preterm Labor

Author(s): Kuzniewicz MW; Black L; Walsh EM; Li SX; Greenberg M

AJP Rep. 2017 Apr;7(2):e106-e113. Epub 2017-06-22.

PubMed abstract

A Quantitative, Risk-Based Approach to the Management of Neonatal Early-Onset Sepsis

Author(s): Kuzniewicz MW; Puopolo KM; Fischer A; Walsh EM; Li S; Newman TB; Kipnis P; Escobar GJ

JAMA Pediatr. 2017 Feb 20.

PubMed abstract

A Clinical Prediction Rule for Rebound Hyperbilirubinemia Following Inpatient Phototherapy

Author(s): Chang PW; Kuzniewicz MW; McCulloch CE; Newman TB

Pediatrics. 2017 Feb 14.

PubMed abstract

Newborn Weight Loss During Birth Hospitalization and Breastfeeding Outcomes Through Age 1 Month

Author(s): Flaherman VJ; Schaefer EW; Kuzniewicz MK; Li S; Walsh E; Paul IM

J Hum Lact. 2017 Feb;33(1):225-230. Epub 2017-01-20.

PubMed abstract

Weight Change Nomograms for the First Month After Birth

Author(s): Paul IM; Schaefer EW; Miller JR; Kuzniewicz MW; Li SX; Walsh EM; Flaherman VJ

Pediatrics. 2016 Dec;138(6). Epub 2016-11-09.

PubMed abstract

Phototherapy and Risk of Type 1 Diabetes

Author(s): Newman TB; Wickremasinghe AC; Walsh EM; Grimes BA; McCulloch CE; Kuzniewicz MW

Pediatrics. 2016 Nov;138(5). Epub 2016-10-19.

PubMed abstract

Risk of Autism Associated With Hyperbilirubinemia and Phototherapy

Author(s): Wu YW; Kuzniewicz MW; Croen L; Walsh EM; McCulloch CE; Newman TB

Pediatrics. 2016 Sep 26.

PubMed abstract

Retrospective Cohort Study of Phototherapy and Childhood Cancer in Northern California

Author(s): Newman TB; Wickremasinghe AC; Walsh EM; Grimes BA; McCulloch CE; Kuzniewicz MW

Pediatrics. 2016 May 23.

PubMed abstract

Neonatal Phototherapy and Infantile Cancer

Author(s): Wickremasinghe AC; Kuzniewicz MW; Grimes BA; McCulloch CE; Newman TB

Pediatrics. 2016 May 23.

PubMed abstract

Development and Implementation of an Early-Onset Sepsis Calculator to Guide Antibiotic Management in Late Preterm and Term Neonates

Author(s): Kuzniewicz MW1; Walsh EM; Li S; Fischer A; Escobar GJ;

​​Jt Comm J Qual Patient Saf. 2016 May;42(5):232-9.

PubMed abstract

External Validation of Early Weight Loss Nomograms for Exclusively Breastfed Newborns

Author(s): Schaefer EW; Flaherman VJ; Kuzniewicz MW; Li SX; Walsh EM; Paul IM

Breastfeed Med. 2015 Nov 13.

PubMed abstract

Incidence of Dravet Syndrome in a US Population

Author(s): Wu YW; Sullivan J; McDaniel SS; Meisler MH; Walsh EM; Li SX; Kuzniewicz MW

Pediatrics. 2015 Oct 5.

PubMed abstract

Risk of Sensorineural Hearing Loss and Bilirubin Exchange Transfusion Thresholds

Author(s): Wickremasinghe AC; Risley RJ; Kuzniewicz MW; Wu YW; Walsh EM; Wi S; McCulloch CE; Newman TB

Pediatrics. 2015 Sep;136(3):505-12. Epub 2015-08-17.

PubMed abstract

Differentiating Sepsis From Adverse Events After Immunization in the Neonatal Intensive Care Unit: How Is a Physician to Know?

Author(s): Kuzniewicz MW; Klein NP

JAMA Pediatr. 2015 Aug;169(8):718-9.

PubMed abstract

Early weight loss nomograms for formula fed newborns

Author(s): Miller JR; Flaherman VJ; Schaefer EW; Kuzniewicz MW; Li SX; Walsh EM; Paul IM

Hosp Pediatr. 2015 May;5(5):263-8.

PubMed abstract

Follow-up of extreme neonatal hyperbilirubinemia: more reassuring results from Denmark

Author(s): Newman TB; Kuzniewicz MW

Dev Med Child Neurol. 2015 Apr;57(4):314-5. Epub 2014-10-28.

PubMed abstract

A Randomized Clinical Trial of Therapeutic Hypothermia Mode during Transport for Neonatal Encephalopathy

Author(s): Akula VP; Joe P; Thusu K; Davis AS; Tamaresis JS; Kim S; Shimotake TK; Butler S; Honold J; Kuzniewicz M; DeSandre G; Bennett M; Gould J; Wallenstein MB; Van Meurs K

J Pediatr. 2015 Apr;166(4):856-61.e1-2. Epub 2015-02-12.

PubMed abstract

Gestational Thyrotoxicosis, Antithyroid Drug Use and Neonatal Outcomes within an Integrated Healthcare Delivery System

Author(s): Lo JC; Rivkees S; Chandra M; Gonzalez JR; Korelitz JJ; Kuzniewicz MW

Thyroid. 2015 Mar 6.

PubMed abstract

Risk for Cerebral Palsy in Infants With Total Serum Bilirubin Levels at or Above the Exchange Transfusion Threshold: A Population-Based Study

Author(s): Wu YW; Kuzniewicz MW; Wickremasinghe AC; Walsh EM; Wi S; McCulloch CE; Newman TB

JAMA Pediatr. 2015 Mar;169(3):239-46.

PubMed abstract

Early weight loss nomograms for exclusively breastfed newborns

Author(s): Flaherman VJ; Schaefer EW; Kuzniewicz MW; Li SX; Walsh EM; Paul IM

Pediatrics. 2015 Jan;135(1):e16-23. Epub 2014-12-01.

PubMed abstract

Neonatal Neurocritical Care Service Is Associated With Decreased Administration of Seizure Medication

Author(s): Wietstock SO; Bonifacio SL; McCulloch CE; Kuzniewicz MW; Glass HC

J Child Neurol. 2014 Nov 7.

PubMed abstract

Incidence, Etiology, and Outcomes of Hazardous Hyperbilirubinemia in Newborns

Author(s): Kuzniewicz MW; Wickremasinghe AC; Wu YW; McCulloch CE; Walsh EM; Wi S; Newman TB

Pediatrics. 2014 Sep;134(3):504-9. Epub 2014-08-04.

PubMed abstract

Prevalence and Neonatal Factors Associated with Autism Spectrum Disorders in Preterm Infants

Author(s): Kuzniewicz MW; Wi S; Qian Y; Walsh EM; Armstrong MA; Croen LA

J Pediatr. 2014 Jan;164(1):20-5. Epub 2013-10-22.

PubMed abstract

Invited Commentary: Does Neonatal Hyperbilirubinemia Cause Asthma?

Author(s): Kuzniewicz MW; Wickremasinghe AC; Newman TB

Am J Epidemiol. 2013 Dec 15;178(12):1698-701. Epub 2013-10-31.

PubMed abstract

Hospital readmissions and emergency department visits in moderate preterm, late preterm, and early term infants

Author(s): Kuzniewicz MW; Parker SJ; Schnake-Mahl A; Escobar GJ

Clin Perinatol. 2013 Dec;40(4):753-75. Epub 2013-09-20.

PubMed abstract

Black Race Is Not Protective Against Hazardous Bilirubin Levels

Author(s): Wickremasinghe AC; Kuzniewicz MW; Newman TB

J Pediatr. 2013 May;162(5):1068-9. Epub 2013 Feb 10.

PubMed abstract

Increased risk for respiratory distress among white, male, late preterm and term infants

Author(s): Anadkat JS; Kuzniewicz MW; Chaudhari BP; Cole FS; Hamvas A

J Perinatol. 2012 Oct;32(10):780-5. Epub 2012 Jan 5.

PubMed abstract

Impact of universal bilirubin screening on severe hyperbilirubinemia and phototherapy use

Author(s): Kuzniewicz MW; Escobar GJ; Newman TB

Pediatrics. 2009 Oct;124(4):1031-9. Epub 2009 Sep 28.

PubMed abstract

No association between hyperbilirubinemia and attention-deficit disorder

Author(s): Kuzniewicz M; Escobar GJ; Newman TB

Pediatrics. 2009 Feb;123(2):e367-8.

PubMed abstract

Risk factors for severe hyperbilirubinemia among infants with borderline bilirubin levels: a nested case-control study

Author(s): Kuzniewicz MW; Escobar GJ; Wi S; Liljestrand P; McCulloch C; Newman TB

J Pediatr. 2008 Aug;153(2):234-40. Epub 2008 Mar 21.

PubMed abstract

Incorporation of physiological trend and interaction effects in neonatal severity of illness scores: an experiment using a variant of the Richardson score

Author(s): Kuzniewicz M; Draper D; Escobar GJ

Intensive Care Med. 2007 Sep;33(9):1602-8. Epub 2007 Jun 19.

PubMed abstract