Phenotypic Driven Growth Trajectories in Very Preterm Infants to Define Nutritionally Mediated Health Outcomes and Modifiable Targets

表型驱动的极早产儿的生长轨迹来定义营养介导的健康结果和可修改的目标

• 批准号: 10307451
• 负责人: CAMILIA R MARTIN
• 金额: $ 43.57万
• 依托单位: YALE UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2021
• 资助国家: 美国
• 起止时间: 2021-08-20 至 2026-05-31
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10307451
• 关键词: 2 year old; Admission activity; Age; Biological; Birth; Body Composition; Brain; Caring; Clinical; Clinical Trials; Collection; Coupled; Data; Detection; Development; Dietary Intervention; Enrollment; Ensure; Environmental Exposure; Environmental Risk Factor; Exhibits; Fetal health; Fostering; Future; Gestational Age; Growth; Health; Health Status; Hospitals; Impaired cognition; Infant; Infant Care; Infant Development; Infant Health; Intake; Intervention; Intervention Trial; Investigation; Knowledge; Lead; Life; Link; Longitudinal cohort study; Maternal Health; Measures; Mediating; Metabolism; Methodology; Micronutrients; Modeling; Neonatal; Neonatal Intensive Care Units; Nutrient; Nutritional; Nutritional Study; Outcome; Pattern; Phenotype; Population; Population Intervention; Pregnancy; Premature Infant; Prevention; Problem behavior; Prospective cohort study; Public Health; Research; Research Personnel; Role; Sampling; Sentinel; Social support; Time; Work; clinical care; cohort; expectation; experience; fetal; infancy; infant outcome; motor learning; neonatal health; nutrition; operation; outcome prediction; postnatal; prospective; repository; social; social determinants; social health determinants; sociodemographics; socioenvironmental factor

PROJECT SUMMARY Very preterm infant growth patterns are linked to neurodevelopmental and health outcomes, yet, ideal growth pattern trajectories have not been established as a means to guide nutritional intervention for this population. With the majority of very preterm infants exhibiting growth below the expected fetal or infant trajectory, greater characterization of very preterm infant growth is an essential step to elucidate the role of nutrition in the care and development of preterm infants. The overarching objective is to identify very preterm infant growth patterns prior to term age and across the first year of life that are phenotypically-defined (maternal, infant, and environmental factors including social determinants of health) and determine the impact of the phenotypically- informed growth patterns on very preterm infant neurodevelopmental and health outcomes. We hypothesize that phenotypic-derived latent class growth analysis-derived curves encompassing clinical and environmental exposures across the continuum of the neonatal intensive care unit (NICU) and post-discharge periods will identify growth patterns predictive of outcomes. To investigate this hypothesis, patterns of growth will be classified for two sentinel epochs spanning birth to 36 weeks' gestational age (the NICU period) and birth to 12 months' corrected age (infancy). Through a detailed collection of maternal and infant health, social and environmental determinants of health, nutrient intake, and body composition; the very preterm infant exposures differentially represented in these phenotypically-informed growth patterns will be identified. Subsequently, the impact of these phenotypically-informed growth patterns on neurodevelopmental and health outcomes will be determined. Lastly, a repository of longitudinally-collected biologic samples through the first two years of age will be established to foster a deeper exploration of the metabolic processes related to the identified phenotypes. This examination will be the first to bridge the NICU and post-hospital discharge epochs to investigate growth trajectory without predetermined expectations and informed by extensive nutrition, health, and social data. Through this investigation of phenotypically-defined growth patterns, the modifiable factors influencing growth trajectory and its link to very preterm infant outcomes will be revealed to inform both clinical care and future interventional trials to optimize nutrition and growth for each very preterm infant.

项目总结