Adolescent Outcomes of <1000 gram Birth Weight Children

出生体重 <1000 克儿童的青春期结局

基本信息

批准号：
7368083
负责人：
MAUREEN HACK
金额：
$ 46.97万
依托单位：
CASE WESTERN RESERVE UNIVERSITY
依托单位国家：
美国
项目类别：
财政年份：
2007
资助国家：
美国
起止时间：
2007-03-01 至 2011-02-28
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/7368083
关键词：
Academic achievement Adolescence Adolescent Adolescent Development Age Age-Years Anxiety Attention deficit hyperactivity disorder Behavior Biological Biological Factors Birth Birth Weight Brain Brain Injuries Child Childhood Chronic Chronic Disease Cognitive Comparative Study Condition Data Depressed mood Development Ethnic Origin Evaluation Extremely Low Birth Weight Infant Family Funding Gender Growth Health Health Status Healthcare Knowledge Learning Matched Group Measures Mediating Mediator of activation protein Medical Mental Depression Modeling Neonatal Intensive Care Neuropsychology Numbers Obesity Outcome Perinatal Policies Rate Recruitment Activity Relative (related person)Request for Applications Request for Proposals Research Research Personnel Risk Risk-Taking School-Age Population Schools Services Social Change Social Functioning Social isolation Stress Survival Rate Survivors Symptoms Testing Time United States Weight maintenance regimen base biopsychosocial cohort developmental disease follow-up lung injury neonatal morbidity neurodevelopment peer prevent programs psychologic psychosocial therapy design

项目摘要

DESCRIPTION (provided by applicant): This application requests support to continue our examination of the effects of of extremely low birth weight (ELBW,<1kg) on outcomes. We have prospectively followed 219 ELBW born 1992-1995 since birth. A school matched group of 176 normal birth weight (NBW) controls were recruited at age 8 years. Results of the study at 8 years reveal very high rates of chronic conditions and special health care needs as well as cognitive and neuropsychologic deficits that have implications for learning and behavior. These result in increased family stress and burden. The children have since entered adolescence, a period of extraordinary biological, psychological and social change that pose special challenges to ELBW children. The major objective of this application is to extend the longitudinal follow up to age 14 years in order to examine the continuing impact of ELBW and the critical changes in health,development and behavior that may occur during adolescence. We present a developmental biopsychosocial framework which considers the sequelae of ELBW on outcomes of adolescence when compared to NBW children. Higher perinatal risk (mainly brain and lung injury) is predicted to result in poorer academic achievement, behavior and psychosocial adjustment. The model examines interpersonal contexts including family, peer and school relationships as mediators of perinatal risk, as well as the moderating effects of sociodemographic and intrapersonal factors such as gender and ethnicity. We also plan to examine the longitudinal changes in outcomes and their relationship to the contextual variables. We hypothesize that a) ELBW children will continue to have poorer outcomes than NBW children in health, neuropsychologic and academic function, and behavior; and negative impact on the family, b) The high rates of chronic disorders and special health care needs of the ELBW group will increase during adolescence; c) Effects of ELBW relative to NBW that will emerge will include increase in social isolation, symptoms of anxiety and depression, and diminished risk taking. The ELBW group represents the only such children followed to school age in the USA who were born in the 1990's. The findings will inform interventions designed to lessen or prevent adverse outcomes. Our data will also provide important information needed for the planning and provision of services for ELBW children who survive neonatal intensive care.

描述（由申请人提供）：本申请请求支持，以继续我们检查极低出生体重（ELBW，<1kg）对结果的影响。自 1992-1995 年出生以来，我们对 219 名 ELBW 进行了前瞻性跟踪。在 8 岁时招募了 176 名正常出生体重 (NBW) 对照组的学校匹配组。 8 年的研究结果显示，慢性病和特殊医疗保健需求以及对学习和行为有影响的认知和神经心理缺陷的发生率非常高。这些都会导致家庭压力和负担增加。自此，孩子们进入了青春期，这是一个生理、心理和社会发生巨大变化的时期，给 ELBW 儿童带来了特殊的挑战。该应用的主要目标是将纵向随访延长至 14 岁，以检查 ELBW 的持续影响以及青春期期间可能发生的健康、发育和行为的关键变化。我们提出了一个发育生物心理社会框架，该框架考虑了与 NBW 儿童相比，ELBW 对青春期结局的后遗症。较高的围产期风险（主要是脑损伤和肺损伤）预计会导致学业成绩、行为和社会心理适应较差。该模型研究了人际环境，包括家庭、同伴和学校关系作为围产期风险的中介因素，以及社会人口和个人因素（如性别和种族）的调节作用。我们还计划检查结果的纵向变化及其与背景变量的关系。我们假设 a) ELBW 儿童在健康、神经心理和学业功能以及行为方面的结果将继续比 NBW 儿童差； b) 青少年时期，ELBW 群体的慢性疾病发病率较高，特殊医疗保健需求将会增加； c) ELBW 相对于 NBW 的影响将包括增加社会孤立、焦虑和抑郁症状以及减少冒险行为。 ELBW 群体代表了美国唯一的 20 世纪 90 年代出生的学龄儿童。研究结果将为旨在减少或预防不良后果的干预措施提供信息。我们的数据还将提供为在新生儿重症监护中存活下来的 ELBW 儿童规划和提供服务所需的重要信息。