A Protocol to Assess Adult Outcomes at 30 Years Following Preterm Birth.
A Protocol to Assess Adult Outcomes at 30 Years Following Preterm Birth.
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DOI：
10.1097/nnr.0000000000000612
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发表时间：
2022-11-01
期刊：
影响因子：
2.5
通讯作者：
Kelly, Michelle M.
中科院分区：
文献类型：
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作者：
Sullivan, Mary C.;D'Agata, Amy L.;Stanley, Zachary;Brewer, Pamela;Kelly, Michelle M.
对于婴儿来说，最严重的逆境经历之一就是早产。早产标志着生命历程的开始，广泛影响家庭、医疗保健、教育、社会制度和幸存者本身。对于许多人来说，向成年的过渡充满挑战，并且常常受到认知、身心健康、运动和独立困难的阻碍。分享针对 30 多岁早产儿的第 10 次随访研究的综合方案。该方案考虑了新生儿期的压力、发育的累积背景（风险、保护）、生物和表观遗传机制以及个人复原力。前瞻性 5 组纵向设计包括 215 名 30-35 岁患有各种新生儿疾病的足月出生和早产个体。成人成果包括健康、适应性、执行功能、工作和社交能力。新的措施是非稳态负荷（AL）和表观遗传学的四个系统指标。背景衡量标准包括社会经济风险和个人复原力。所有测量的选择都是基于与科学目标结构的一致性、强大的心理测量学、重复测量的连续性以及最小的受试者负担。客观评估包括身体成分成像、运动测试、血液和唾液采集以及体动记录仪。两阶段方案大约需要 8 小时。在因新冠肺炎 (COVID-19) 疫情暂停 11 个月后，参与者反应强烈。截至 2022 年 5 月，75 名参与者已完成完整方案，其中 99 名参与者同意参与。当社会经济风险得到控制时，我们假设足月和早产新生儿发病组之间的生理和心理健康、适应功能和执行功能的生命历程轨迹将有所不同。 AL 因群体而异，并会影响结果。我们期望近端保护和复原力能够调节累积的医疗和社会经济风险以及 AL。表观基因组范围内的 DNA 甲基化以及年龄加速的估计将在各组之间进行检查，并探索与医疗风险、社会经济地位和保护的纵向关联。据我们所知，这是美国唯一一项针对 30-35 岁早产儿的研究。随着数百万早产儿进入成年，该方案将分子和遗传生物标志物纳入生命历程发育检查中，以告知干预的时间和内容。
Among the most intense adversity experiences for infants is premature birth. Early birth marks the beginning of a life course that broadly affects families, health care, education, social systems, and the survivors themselves. For many, the transition to adulthood is challenging and often hampered by cognitive, physical and mental health, and motor and independence difficulties. To share a comprehensive protocol of a 10th follow-up study of premature infants in their 30s. The protocol accounts for stress during the neonatal period, the cumulative context (risk, protection) of development, biological and epigenetic mechanisms, and individual resilience. The prospective 5-group longitudinal design includes 215 term-born and preterm-born individuals with various neonatal morbidities at ages 30–35. Adult outcomes include health, adaptive, executive function, work, and social competence. Novel measures are four system indicators of allostatic load (AL) and epigenetics. Contextual measures include socioeconomic risk and individual resilience. All measures were selected based on coherence with constructs of the scientific aims, strong psychometrics, continuity for repeated measures, and minimal subject burden. Objective assessments include body composition imaging, exercise testing, blood and saliva collection, and actigraphy. The 2-phase protocol takes approximately 8 hours. After an 11-month COVID-19 pause, participant response has been strong. As of May 2022, 75 participants have completed the full protocol, and 99 have consented to participate. When socioeconomic risk is controlled, we hypothesize that life course trajectories in physical and psychological health, adaptive function, and executive function will differ between term and preterm neonatal morbidity groups. AL will vary across groups and contribute to outcomes. We expect proximal protection and resilience to mediate the cumulative medical and socioeconomic risk and AL. Epigenome-wide DNA methylation, with estimates of age acceleration, will be examined across groups and explored in longitudinal associations with medical risk, socioeconomic status, and protection. To our knowledge, this is the only U.S. study of premature infants aged 30–35 years. With millions of preterm-born individuals reaching adulthood, the protocol incorporates molecular and genetic biomarkers in a life course developmental examination to inform the timing and content of interventions.
DOI：
10.1111/cch.12616
发表时间：
2019-01
期刊：
Child: care, health and development
影响因子：
--
作者：
Sullivan MC;Winchester SB;Msall ME
通讯作者：
Msall ME