Does Early Experience Improve Preterm Neurodevelopment?

早期经验能否改善早产神经发育？

• 批准号: 7847566
• 负责人: HEIDELISE ALS
• 金额: $ 44.75万
• 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 2013-05-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7847566
• 关键词: 8 year old; Accounting; Age; Behavior; Behavior Therapy; Birth; Birth Weight; Brain; Caring; Child; Child Development; Cognitive; Control Groups; Cross-Sectional Studies; Development; Effectiveness; Failure; Frequencies; Gestational Age; Goals; Growth; Head circumference; Infant; Intervention; Intervention Studies; Investigation; Knowledge; Learning; Learning Disabilities; Linear Regressions; Magnetic Resonance Imaging; Measures; Medical; Modeling; Neonatal Intensive Care Units; Outcome; Parents; Performance; Physical Function; Premature Infant; Primary Schools; Problem behavior; Public Health; Randomized; Recruitment Activity; Regression Analysis; Relative (related person); Research; Sample Size; Sampling; School-Age Population; Schools; Socioeconomic Status; Structure; Students; System; Tail; Testing; Time; Tissues; Weight; base; cognitive function; cohort; cost; early experience; frontal lobe; high risk; improved; innovation; neurodevelopment; peer; psychosocial; 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）：约有50％的过早出生的婴儿培养学习/行为问题和学校失败。这项研究将检验主要假设，即早产儿（PT）与新生儿重症监护病房（NICU）随机分配为发育护理（NICU）将在学龄前年龄与同龄人相比，他们没有接受干预。五十二个[26对照（c）; 26在8岁（y）校正年龄（CA）的胎龄（GA）时出生的28-33周（GA）的婴儿（ga）。 26个成年（FT）健康8岁的样本将提供一个额外的对照组，以进行描述。将检验三个次要假设：PT-E组将优于PT-C，1）学业表现； 2）在额叶和枕脑系统的长距离皮质连通性中（EEC相干），3）在额叶皮质白质体积（MRI）中。 FT组将优于两个PT组。儿童身体和社会心理功能将进行描述探索。主要独立变量将是治疗组（PT-Control，PT-实验性）。另外，经过测试的是GA，出生时的生长百分位数（体重和头圆），父母的社会经济状况和父母的认知功能，所有这些都预计会影响预后。 PT样本将通过先前收集的医学和人口统计指标来描述，以及2WCA和9MCA的行为和大脑功能。为了测试初级（学校年龄认知函数）和两个次要因变量（额叶相干性和额叶白质体积），将使用逐步的多线性回归分析；五个自变量将输入模型。主要效果以及两个和三向交互项将通过使用调整后的R平方评估的拟合优点进行评估。每分PT组的26个受试者的样本量将提供80％的统计功率（beta = 0.20; alpha = 0.05，2尾），以检测认知度量中的12点或更高的平均差异，假设基于两样式的学生test test tampame test tept test twiptiative sigma的汇总标准偏差（效应尺寸Sigma = 12/15 = 0.8）。该研究将首次提供学期证据，表明急需，低成本，早期行为干预的有效性。预计，在美国学校中越来越多的早产儿童数量的学习和学校失败会减少，这将提供这项研究和干预措施，这是国家公共卫生的重要重要性。