Does Early Experience Improve Preterm Neurodevelopment?

早期经验能否改善早产神经发育？

• 批准号: 7264515
• 负责人: HEIDELISE ALS
• 金额: $ 43万
• 依托单位: BOSTON CHILDREN'S HOSPITAL
• 依托单位国家: 美国
• 财政年份: 2006
• 资助国家: 美国
• 起止时间: 2006-08-01 至 2011-05-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7264515
• 关键词: 8 year old; Accounting; Age; Behavior; Behavior Therapy; Birth; Birth Weight; Brain; Caring; Child; Child Development; Cognitive; Condition; Control Groups; Cross-Sectional Studies; Development; Effectiveness; Failure; Frequencies; Gestational Age; Goals; Growth; Head circumference; Infant; Intervention; Intervention Studies; Investigation; Knowledge; Learning; Learning Disabilities; Magnetic Resonance Imaging; Measures; Medical; Modeling; Neonatal Intensive Care Units; Numbers; Outcome; Parents; Performance; Physical Function; Premature Infant; Problem behavior; Public Health; Purpose; Randomized; Recruitment Activity; Regression Analysis; Relative (related person); Research; Risk; Sample Size; Sampling; School-Age Population; Schools; Socioeconomic Status; Standards of Weights and Measures; Structure; Students; System; Tail; Testing; Time; Tissues; Week; Weight; base; cognitive function; cohort; cost; early experience; frontal lobe; improved; innovation; neurodevelopment; peer; psychosocial; size; treatment effect; white matter

DESCRIPTION (provided by applicant): About fifty percent of prematurely born infants develop learning/behavior problems and school failure. The study will test the primary hypotheses, that preterm infants (PT) randomized to developmental care in the Newborn Intensive Care Unit (NICU) will be superior in cognitive performance at school age when compared to their peers, who did not receive the intervention. Fifty-two [26 control (C); 26 experimental (E)] infants born at a gestational age (GA) of 28-33 week (w) will be studied at 8 years(y) corrected age (CA). A sample of 26 fullterm-born (FT) healthy 8y-olds will provide an additional control group for descriptive purposes. Three secondary hypotheses will be tested: The PT-E group will be superior to the PT-C, 1) in academic performance; 2) in long distance cortical connectivity of frontal and occipital brain systems (EEC coherence), and 3) in frontal cortical white matter volumes (MRI). The FT group will be superior to both PT groups. Child physical and psychosocial functioning will be explored descriptively. The primary independent variable will be treatment group (PT-control, PT-experimental). Additionally tested will be GA, growth percentile (weight and head circumference) at birth, parent socioeconomic status, and parent cognitive function, all expected to influence outcome. The PT sample will be described by previously collected medical and demographic measures at birth, and by behavior and brain function at 2wCA and 9mCA. For testing the primary (school age cognitive function) and the two secondary dependent variables (frontal coherence and frontal white matter volume), stepwise multiple linear regression analysis will be used; the five independent variables will be entered into the models. Main effects and two and three-way interaction terms will be evaluated with goodness-of-fit assessed using adjusted R-squared. A sample size of 26 subjects per PT group will provide 80% statistical power (beta=0.20; alpha=0.05, 2-tailed) to detect a 12 point or higher mean difference in the cognitive measure, assuming a pooled standard deviation of 15 points (effect size sigma = 12/15 = 0.8) based on a two-sample Student t-test. The study will provide, for the first time, evidence at school age of the effectiveness of a much needed, low cost, early behavioral intervention. The expected reduction in learning and school failure for the increasing numbers of preterm-born children in the nation's schools, would give the study and the intervention, significant national public health importance.,

描述（由申请人提供）：大约百分之五十的早产婴儿会出现学习/行为问题和学业失败。该研究将检验主要假设，即被随机分配到新生儿重症监护病房 (NICU) 进行发育护理的早产儿 (PT) 在学龄时的认知表现将优于未接受干预的同龄人。五十二【26控制（C）； 26 实验 (E)] 胎龄 (GA) 为 28-33 周 (w) 出生的婴儿将在 8 岁 (y) 校正年龄 (CA) 时进行研究。 26 名足月出生 (FT) 健康 8 岁儿童的样本将提供一个额外的对照组用于描述目的。将测试三个次要假设： PT-E 组将优于 PT-C，1）学业成绩； 2) 额叶和枕叶大脑系统的长距离皮质连接（EEC 一致性），以及 3) 额叶皮质白质体积 (MRI)。 FT 组将优于两个 PT 组。将描述性地探讨儿童的身体和心理社会功能。主要自变量是治疗组（PT 对照、PT 实验）。此外还测试了 GA、出生时生长百分位（体重和头围）、父母的社会经济地位和父母的认知功能，所有这些都预计会影响结果。 PT 样本将通过先前收集的出生时医学和人口统计指标以及 2wCA 和 9mCA 时的行为和大脑功能来描述。为了测试主要（学龄认知功能）和两个次要因变量（额叶一致性和额叶白质体积），将使用逐步多元线性回归分析；五个自变量将被输入到模型中。主效应以及二向和三向交互作用项将通过使用调整 R 平方评估的拟合优度进行评估。每个 PT 组 26 名受试者的样本量将提供 80% 的统计功效（β=0.20；α=0.05，2 尾）来检测认知测量中 12 点或更高的平均差异（假设汇总标准差为 15 点） （效应量 sigma = 12/15 = 0.8）基于两个样本学生 t 检验。该研究将首次提供学龄儿童急需的低成本早期行为干预的有效性证据。预计全国学校中越来越多的早产儿的学习和学业失败将会减少，这将使这项研究和干预措施对国家公共卫生具有重要意义。