Toby Debra Yanowitz, MD, MS
- Associate Professor of Pediatrics and Clinical and Translational Science
- Associate Investigator, Magee-Womens Research Institute and Foundation
- Director, UPMC Newborn Medicine Database
- Analytics Director, Neonatal Neuro-Intensive Care Unit, UPMC Newborn Medicine Program
Yanowitz graduated from Princeton University in 1987 with a BA in Molecular Biology and received her MD from the Albert Einstein College of Medicine 1991. She completed her pediatric residency at Children’s Hospital of Philadelphia in 1994 and her Perinatal-Neonatal Medicine Fellowship at Brown University’s Women and Infant’s Hospital in 1997. Yanowitz was certified by the American Board of Pediatrics in October of 1994 and by the Sub-board in Perinatal/Neonatal Medicine in November of 1997. Yanowitz returned to school in 2007 and, in December of 2008, she received a Master’s of Science in Epidemiology from the University of Pittsburgh’s Graduate School of Public Health.
As director of the Newborn Medicine Database and Analytics, Yanowitz oversees the Neonatal Databases at both UPMC Magee-Womens Hospital and UPMC Children’s Hospital of Pittsburgh. In this capacity, she serves as Magee's Physician Representative to the Vermont Oxford Network, contributing data to the Very Low Birth Weight Infant Database, the Expanded Database, and the Neonatal Encephalopathy Registry. She oversees Children's comprehensive neonatal database which is part of the Children’s Hospitals Consortium (CHHC) and serves on multi-center working groups through the CHNC, including being a member of the Hypoxic-Ischemic Encephalopathy focus group and chairing the Surgical NEC focus group. As director of Newborn Medicine Clinical Consensus Committee of UPMC, Yanowitz supervises multidisciplinary working groups that strive to improve clinical care in the UPMC NICUs through condition-specific quality improvement projects (examples include oxygen saturation limits for preterm babies, treatment of patent ductus arteriosus, Additionally, as director of the Neonatal Neuro-Critical Care Units of Magee and Children's , Yanowitz has brought Neuro expertise to the NICUs through clinically relevant education including bedside teaching rounds and weekly neuroradiology rounds and clinical care guidelines including the management of neonatal seizures, therapeutic hypothermia for babies with neonatal encephalopathy and protocols for screening cranial ultrasounds for premature infants.
Yanowitz has many peer-reviewed publications, related to her clinical research endeavors, a Master's thesis and an invited editorial. Her early clinical research explored the contribution of hemodynamic disturbances to the pathophysiology of chorioamnionitis-associated neonatal brain injury. Her landmark paper "Hemodynamic Disturbances in Premature Infants Born After Chorioamnionitis: Association with Cord Blood Cytokine Concentrations" (Pediatr Res. 51(3): 310-316, 2002) has been quoted in >90 research articles (See Appended “Citation Report”) and by Joseph J. Volpe in his authoritative text "Neurology of the Newborn". She mentored Neonatal Fellows on Doppler studies in the premature infant. One such study, "Blood Transfusion Alters the Superior Mesenteric Artery Blood Flow Velocity Response to Feeding in Premature Infants" [Am J Perinatol 25(12), 2008], has received national recognition as a pivotal paper detailing mesenteric blood flow velocity disturbances that may contribute to TRAGI (transfusion-associated acute gut injury) or necrotizing enterocolitis in premature infants.
Yanowitz has also serviced as site-PI for numerous multi-center clinical trials, including the multi-national Olympic Medical-sponsored "Cool Cap" trial [Selective head cooling with mild systemic hypothermia after neonatal encephalopathy: multicenter randomized trial. The Lancet electronic pages, 365 (9457) Jan 29, 2005] which demonstrated safety and efficacy of therapeutic hypothermia for newborns with hypoxic-ischemic encephalopathy. This therapy is now a standard of care. Next, Yanowitz became site-PI for a randomized trial of feeding versus remaining nil per os (NPO) during medical treatment for a patent ductus arteriosus (PDA) which demonstrated the safety of feeding babies during PDA treatment, allowing them to achieve full enteral nutrition at an earlier age). She was National Principal Investigator for an ancillary study exploring the mesenteric blood flow velocity changes associated with feeding or not feeding during PDA treatment groups, and how these blood flow velocity changes may predict feeding intolerance or necrotizing enterocolitis. Currently, she is Site-PI for the “HEAL” study (High-Dose Erythropoietin for Asphyxia and Encephalopathy) and the PreMOD study (Premature Infants Receiving Milking of Delayed Cord Clamping: a randomized non-inferiority Trial).
In keeping with her interests, Yanowitz mentors many students, residents and fellows on clinical research related to the newborn brain and transitional hemodynamics.
Professional and Scientific Society Memberships
- Alpha Omega Alpha, 1991-Present
- American Academy of Pediatrics, 1994-Present
- Perinatal Section, 1999-Present
- American Medical Association, 1994-1997
- American Federation for Medical Research, 2000-Present
- Midwest Society for Pediatric Research, 2003-Present
- Society for Pediatric Research, 2003-Present
- Perinatal Research Society, 2008-Present
- Association for Clinical and Translational Science, 2017-Present
Education & Training
- BA, Molecular Biology, Princeton University, 1987
- MD, Albert Einstein College of Medicine, 1991
- Residency in Pediatrics, Children's Hospital of Philadelphia, 1991-1994
- Fellowship in Neonatology, Women and Infants Hospital of Rhode Island, 1994-1997
- MS, Epidemiology, University of Pittsburgh, 2008
Yanowitz, Toby D; Reese, Jeff; Gillam-Krakauer, Maria; Cochran Caitlin M; Jegatheesan, Priya; Lau, John; Tran, Vy Thao; Walsh Michele; Carey, William A; Fujii, Alan; Fabio, Anthony; Clyman Ronald. Superior Mesenteric Artery Blood Flow Velocities Following Medical Treatment of a Patent Ductus Arteriosus. J Pediatr. 2014 Mar; 164 (3): 661-3.
Murthy, Karna; Yanowitz, Toby D; DiGeronimo Robert; Dykes, Francis D; Zaniletti, Isabella; Sharma, Jotisha; Sullivan Kevin M; Mipuri Julie; Evans, Jaqueline R; Wadhawan Rajan; Piazza Anthony; Adams-Chapman Ira; Asselin Jeanette M: Short Billie L; Padula Michael A: Durand David J: Pallotto Jean; Reber Kristina M. Short-Term Outcomes for Preterm Infants with Surgical Necrotizing Enterocolitis. J Perinatol. 2014 Oct 14; 34: 736-40.
Scholl, Jonathan E and Yanowitz, Toby D. Pulmonary Hemorrhage in Very Low Birth Weight Infants: A Case-Control Analysis. J Pediatr. 2015 Apr; 166(4): 1083-4.
Dizon Maria LV, Rao Rakesh, Hamrick Shannon E, Zaniletti Isabella, DiGeronimo Robert, Natarajan Girija, Kaiser Jeffrey R, Flibotte John, Lee Kyong-Soon, Smith Danielle, Yanowitz Toby D, Mathur Amit, Massaro An. Practice variation in anti-epileptic drug use for neonatal hypoxic-ischemic encephalopathy among regional NICUs. BMC Pediatr. 2019 Feb 27;19(1):67.
Yanowitz, Toby D; Sullivan, Kevin M; Piazza, Anthony J; Brozanski, Beverly S; Zaniletti, Isabella; Sharma, Jotishna; DiGeronimo, Robert; Nayak, Sujir P; Wadhawan, Rajan; Reber, Kristina; Murthy Karna. Does the Initial Surgery for Necrotizing Enterocolitis Matter? Comparative Outcomes for Laparotomy vs. Peritoneal Drain as Initial Surgery for Necrotizing Enterocolitis in Infants <1000 gm Birth Weight. Pediatr Surgery. 2019 April; 54(4): 712-717.
Rao, Rakesh; Lee, Kyong-Soon; Zaniletti, Isabella; Yanowitz, Toby D; DiGeronimo, Robert; Dizon, Maria LV; Hamrick, Shannon E; Natarajan, Girija; Peeples, Eric S; Murthy, Karna; Mathur, Amit; Massaro, An. Antimicrobial Therapy utilization in Neonates with Hypoxic-Ischemia Encephalopathy: A Report from the Children’s Hospital Neonatal Database. J Perinatology. 2019 October 14; https://doi.org/10.1038/s41372-019-0527-2.
Katheria, Anup; Reister, Frank; Essers, Jochen; Mendler, Marc; Hummler Helmut; Subramaniam, Akila; Carlo, Waldemar; Tita, Alan; Truong, Giang; Davis-Nelson, Shareece; Schmölzer, Georg; Chari, Radha; Kaempf, Joseph; Tomlinson, Mark; Yanowitz, Toby; Beck, Stacy; Simhan, Hyagriv; Dempsey, Eugene; O’Donoghue, Keelin; Bhat, Shazia; Hoffman, Matthew; Faksh, Arij; Arnell, Kathy; Rich, Wade; Finer, Neil; Vaucher, Yvonne; Khanna, Paritosh; Meyers, Mariana; Varner, Michael; Allman, Phillip; Szychowsk, Jeff; Cutter, Gary. Association of umbilical cord milking vs delayed umbilical cord clamping with death or severe intraventricular hemorrhage among preterm infants. JAMA 2019 Nov; 322919):1877-1886 doi:10.1001/jama.2019.16004.
Academic and Research Interests
- Multicenter clinical trials, especially those related to the neurologic outcome of preterm and term babies
- Prevention and treatment of necrotizing enterocolitis among premature infants