The Development of Early Childhood Obesity in Children Born Preterm

早产儿早期肥胖的发展

• 批准号: 9112267
• 负责人: Sarah Keim
• 金额: $ 7.48万
• 依托单位: RESEARCH INST NATIONWIDE CHILDREN'S HOSP
• 依托单位国家: 美国
• 财政年份: 2016
• 资助国家: 美国
• 起止时间: 2016-09-22 至 2018-08-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/9112267
• 关键词: 3 year old; Age; Anxiety; Attention; Birth; Body mass index; Cardiovascular Diseases; Caring; Child; Clinical; Coupled; Data; Data Set; Development; Diagnosis; Elderly; Ensure; Environment; Epidemic; Evidence based intervention; Family; Future; Goals; Growth; Individual; Intervention; Knowledge; Length; Life; Longitudinal Studies; Low Birth Weight Infant; Measures; Medical; Medical Records; Mental Depression; Mission; Modeling; Nature; Neonatal; Obesity; Overweight; Patients; Pediatric Hospitals; Population; Premature Birth; Premature Infant; Prevalence; Prevention; Prevention strategy; Provider; Public Health; Quality of life; Records Controls; Research; Risk; Sampling; Small for Gestational Age Infant; Statistical Methods; Stress; Testing; Time; United States National Institutes of Health; Visit; Weight; base; body system; burden of illness; clinical care; clinical practice; cohort; cost; early childhood; evidence base; innovation; kindergarten; obesity in children; obesity prevention; obesogenic; patient population; pediatric patients; premature; prevent; programs; psychosocial; public health relevance; research clinical testing; screening; social; socioeconomics; tool

 DESCRIPTION (provided by applicant): Facilitating catch-up growth and preventing growth faltering is a major component of clinical care for children born preterm to at least age two. However, our preliminary data suggest that obesity is a major, under- recognized problem in the preterm population and likely emerges differently than for children born at term. Obesity has harmful consequences for children born preterm, far greater than the consequences for children born at term. Without knowledge to fill gaps about the extent, nature, and timing of obesity development and how consistently obesity is recognized in clinical care, tailored prevention strategies cannot be developed to help clinicians and families promote adequate growth while preventing excess growth among preterm children. The long-term goal, which will be the subject of a subsequent R01 application, is to develop evidence-based strategies tailored to preterm children to guide clinicians and families in preventing overweight and obesity. The objective of the study proposed in this R03 application, which is the next step towards that goal, is to apply cutting edge statistical methods to determine the prevalence and timing of the development of overweight and obesity in early childhood among preterm children, as compared to term children, to identify optimal intervention windows, and to document the extent of under-recognition of obesity during clinical care in a longitudinal sample of more than 16,000 children. The central hypothesis is: as compared to children born at term, growth trajectories will differ most especially before age 3 among preterm children but overweight and obesity will be nearly as prevalent by ages 4-6, and that obese children born preterm will be less likely to have an obesity diagnosis. The hypothesis was formulated based on data from historic low birth weight cohorts and our preliminary data. The rationale for the proposed study is to support the development of evidence-based interventions targeting sensitive periods to prevent overweight and obesity in children born preterm. The hypothesis will be tested by pursuing two specific aims: 1) Identify critical windows for obesity prevention by characterizing growth trajectories from birth to age 6 for children born preterm, and contrasting these with trajectories for children born at term, to compare the prevalence and timing of the development of overweight and obesity, and 2) Determine the extent of obesity under-diagnosis among children born preterm, as compared to children born at term. The approach will be a longitudinal study of more than 16,000 children from birth to age 6, patients of primary and subspecialty care providers at a major free-standing children's hospital. The proposed research is innovative because it will apply state-of-the-art analytic tools to model growth trajectories in a modern sample, using a detailed, research-ready longitudinal growth dataset based in a very large pediatric patient population, including children born preterm and at term, with an average of more than 13 measures before age six. The proposed research is significant because it is the next step in devising strategies to help clinicians and families promote healthy growth in children born preterm while preventing obesity.

 描述（由适用提供）：促进追赶增长并防止伪造增长是至少两岁的早产儿童临床护理的主要组成部分。但是，我们的初步数据表明，肥胖症在早产中是一个重大的，不认可的问题，并且可能与学期出生的儿童不同。肥胖对出生的儿童有害后果，远大于对学期出生的儿童的后果。如果没有知识来填补肥胖发展的程度，性质和时机以及在临床护理中如何确认肥胖的差距，则无法制定量身定制的预防策略来帮助临床医生和家庭促进足够的增长，同时预防早产儿童的增长。长期目标将是随后的R01应用程序的主题，是制定针对早产儿童量身定制的循证策略，以指导临床医生和家庭预防超重和肥胖。 The objective of the study proposed in this R03 application, which is the next step towards that goal, is to apply cutting edge statistical methods to determine the prevalence and timing of the development of overweight and obesity in early childhood among preterm children, as compared to term children, to identify optimal intervention windows, and to document the extent of under-recognition of obesity during clinical care in a longitudinal sample of more than 16,000 children.中心假设是：与期限出生的儿童相比，生长轨迹将有所不同，尤其是在早产儿童中3岁之前，但超重和肥胖几乎以4-6岁的年龄在4-6岁时普遍存在，而肥胖的儿童出生的早产的可能性较小的可能性较小。该假设是根据历史悠久的低出生体重队列和我们的初步数据的数据提出的。拟议研究的理由是支持针对敏感时期的基于证据的干预措施的发展，以防止早产儿童超重和肥胖。该假设将通过追求两个具体目的来检验：1）通过表征从出生到6岁的孩子的生长轨迹来确定预防肥胖的关键窗口 与期相比，与期限相比，与期限相比，与期限相比，与期相比，与期限相比，与期待肥胖症的诊断程度不足，与期限相比，与期限相比，与期待肥胖的程度相比，与期限相比，与期限相比，生于学期。该方法将是对从出生到6岁的16,000多名儿童的纵向研究，在一家主要独立儿童医院的初级和专科护理提供者中。拟议的研究具有创新性，因为它将使用最先进的分析工具来模拟现代样本中的生长轨迹，并使用基于非常大的儿科患者群体的详细的，可以进行研究的纵向生长数据集，包括早产儿和年龄的平均13个以上的措施。拟议的研究很重要，因为这是制定策略来帮助临床医生和家庭促进早产儿童的健康成长的下一步，同时预防肥胖。