Neonatal Neurobehavior and Outcomes in Very Preterm Infants

极早产儿的新生儿神经行为和结局

基本信息

批准号：
8729535
负责人：
Barry M. Lester
金额：
$ 70.72万
依托单位：
WOMEN AND INFANTS HOSPITAL-RHODE ISLAND
依托单位国家：
美国
项目类别：
财政年份：
2013
资助国家：
美国
起止时间：
2013-09-03 至 2018-08-31
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/8729535
关键词：
Accounting Acute Adaptive Behaviors Address Adult Age Autistic Disorder Behavioral Brain Brain Injuries Cerebral Palsy Child Behavior Checklist Chronic Disease Chronic lung disease Classification Cognitive Data Development Early Intervention Environment Environmental Risk Factor Evaluation Gestational Age Goals Hospitalization Hypoxia Impaired cognition Impairment Individual Infant Infection Inflammatory Intervention Lead Measures Medical Methods Modeling Motor Necrotizing Enterocolitis Neonatal Neonatal Intensive Care Units Neurodevelopmental Impairment Neurologic Operative Surgical Procedures Outcome Oxygen Therapy Care Play Population Premature Infant Prevalence Preventive Intervention Problem behavior Public Health Research Infrastructure Resources Respiratory Tract Infections Retinopathy of Prematurity Risk Role Schools Sepsis Severities Site Stress System Toddler Vermont base behavioral impairment caregiving clinically significant experience follow-up high risk indexing infant outcome neurobehavior neurobehavioral public health relevance social

项目摘要

DESCRIPTION (provided by applicant): Infants born <30 wks postmenstrual age (PMA) experience the potentially devastating brain injuries associated with immaturity, hypoxic insults, and inflammatory exposures. These infants are at high risk for developing neuromotor, cognitive, and behavioral impairments that persist through adulthood. However, for the majority of infants, there is no reliable method during their stay in the Neonatal Intensive Care Unit (NICU) to distinguish infants who will go on to develop later impairments from those who will not. There is increasing evidence that neonatal neurobehavioral assessments may predict developmental outcome in at risk and preterm populations. The overarching goal of this study is to determine which infants born <30 wks PMA are at greatest risk for impaired development using a neurobehavioral assessment (the NICU Network Neurobehavioral Scale or NNNS) and a medical risk score. The ability to identify infants at greatest risk addresses a major public health problem and could lead to targeted interventions to reduce or ameliorate later deficits, and more effectively allocate limited resources. We plan to administer the NNNS to 1060 infants born <30 wks PMA during their NICU stay at 7 sites participating in the Vermont-Oxford Network (VON). This will enable us to benefit from the VON infrastructure and medical information collected during neonatal hospitalization, including structural brain abnormalities, infections, an respiratory illnesses. Neurodevelopmental follow-up at 23 +2 months adjusted age will include the Bayley-III, Child Behavior Checklist, Modified Checklist for Autism in Toddlers, and prevalence of cerebral palsy. Our Aims are to determine: 1) if abnormalities on the NNNS will identify infants with impairment at 23 months 2) the association between the cumulative medical risk index, and NNNS scores at 36 wks PMA (or at discharge from the NICU) in infants born <30 wks PMA and 3) the role of post-discharge caregiving environment factors in explaining associations between medical conditions, NNNS scores and 23 month outcomes.

描述（由申请人提供）：出生<30周后月经年龄（PMA）的婴儿经历了与不成熟，低氧损伤和炎症暴露有关的潜在毁灭性脑损伤。这些婴儿面临着持续到成年的神经运动，认知和行为障碍的高风险。但是，对于大多数婴儿而言，在新生儿重症监护病房（NICU）逗留期间没有可靠的方法来区分那些将继续发展后来的障碍与那些不会的损害的婴儿。越来越多的证据表明，新生儿神经行为评估可以预测风险和早产群体的发展结果。这项研究的总体目标是确定哪些婴儿<30周PMA的婴儿使用神经行为评估（NICU网络神经行为量表或NNNS）和医疗风险评分最大的发育风险最大。识别最大风险的婴儿的能力解决了一个重大的公共卫生问题，并可能导致有针对性的干预措施减少或改善以后的赤字，并更有效地分配有限的资源。我们计划在NICU呆在佛蒙特州 - 牛津网络（VON）的7个地点期间，为1060名婴儿<30周PMA管理NNN。这将使我们能够从新生儿住院期间收集的von基础设施和医疗信息中受益，包括结构性脑部异常，感染和呼吸道疾病。调整年龄的23 +2个月的神经发育随访将包括Bayley-III，儿童行为清单，修改后的幼儿自闭症清单以及大脑麻痹的患病率。我们的目的是确定：1）如果NNN的异常情况会在23个月中确定受损害的婴儿2）2）累积医疗风险指数和NNNS在36周PMA（或从NICU出院时）的NNNS评分<30 WKS PMA和3 WKS PMA和3次及3个月份的近期护理环境因素的作用和33个月的作用。