Collaborative Research: SCH: Movement as a Vital Sign in Preterm Infants

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Each year in the United States, one in ten live births or roughly 380,000 babies are born prematurely, with a mortality of 27%. Nearly one third of those surviving suffer from lifelong neurological conditions including cerebral palsy, autism, and psychiatric disorders with substantial personal and societal costs. Despite advances in neonatal intensive care, little progress has been made in monitoring maturation of neurological function in preterm infants. This proposal addresses an urgent need for continuous monitoring of neurological function in the neonatal intensive care unit to advance our understanding of normal and abnormal neurological maturation and to develop timely clinical interventions to improve the health outcomes and reduce costs of prematurity. The research program aims to show that bodily movements of infants are a vital marker for the functional integrity of the nervous system. In Objective 1 the team will quantify movement bouts in routinely obtained data sets over ~3 months, from birth (29 weeks gestational age) until discharge from the neonatal intensive care unit (NICU). Pursuing the hypothesis that complexity of movement patterns increases with age as a sign of maturation, they will examine the evolving entropy of movement signals over several months. Objective 2 will quantify the strong physiological interactions of movement bouts with the respiratory and cardiac rhythms, and correlate movement to apneic events and cardiorespiratory instability. Objective 3 seeks to develop machine learning algorithms using features of movement and other physiological events for online prediction of apneic episodes. In return, the algorithms will reveal physiological features and mechanisms that enhance clinical insights. Preliminary data promise results that support our thesis that movement in newborn infants is an important vital sign. Taken together, this quantitative approach will advance understanding maturation of the neonatal nervous system and how movement can stabilize or disrupt cardiorespiratory control in neonates. The team has also identified multiple outreach activities to foster the integration of scientific research, technology and STEM education, including a workshop on Movement Science, Data, and Technology, in collaboration with a minority-serving institution to increase minority representation in the movement, data, and computational sciences.This award reflects NSF's statutory mission and has been deemed worthy of support through evaluation using the Foundation's intellectual merit and broader impacts review criteria.