BIRTH OUTCOMES, SOCIAL RISKS AND CHILD HEALTH

虽然一些临床研究已经检查了 不利的出生结果之间的关联，无论是单独或在 与儿童健康和发展相结合，研究 通常基于来自小样本和/或一个或几个样本的数据。 医院，因此结果的概括是不确定的， 大量的风险因素的影响是困难的， 不可能的 此外，由于这些研究的性质，种族 儿童健康和发展结果的具体模型是 几乎不存在 另一方面，儿童健康研究使用 大规模的，基于人口的数据集往往受到缺乏 出生结果的信息，往往不考虑范围 我们可以将其纳入拟议分析的风险因素。 因此 拟议研究的总体目标是更广泛和 严格探索不良出生结果之间的关联， 社会风险因素，以及儿童健康和发展成果， 美国比以往任何时候都要多。 该委员会的具体目标 项目是：（1）建立不良出生结局之间的关系模型 和儿童健康和发展的几项措施;（2）测试 不良出生结果、社会风险 这些因素与儿童健康和发展是相互叠加或相互作用的， (3)将生物学、人口统计学、健康 护理，行为和政府援助的风险因素-所有这些 文献表明，这可能对儿童健康和发育很重要; (4)来模拟出生结果，其他风险因素， 和儿童健康与发展在黑人中的比较 （5）明确不良生育与 结果，其他风险因素，以及儿童健康和发展， 美国人口的代表性样本。 我们将使用1988年全国人口普查的1991年纵向随访， 母婴健康调查（NMIHS-LF）作为我们的数据来源。的 NMIHS-LF具有全国代表性，包括出生结果测量 从最初的NMIHS，包括广泛的人口， 社会、生物和行为风险因素与健康， 2岁以下儿童的发展成果措施， 四

Although a number of clinically-based studies have examined the association between adverse birth out comes, either singly or in combination, with child health and development, that research has typically been based on data from small samples and/or one or a few hospitals so that generalization of results is uncertain and modeling of the effects of a large number of risk factors is difficult or impossible. Moreover, because of the nature of these studies, race- specific modeling of child health and developmental outcomes are virtually non-existent. On the other hand, child health research using large-scale, population based data sets is often hampered by the lack of information on birth outcomes and often does not consider the range of risk factors that we can include in the proposed analysis. Thus, the general objective of the proposed research is a more extensive and rigorous exploration of the association between adverse birth outcomes, social risk factors, and child health and developmental outcomes in the U.S. than has heretofore been accomplished. The specific aims of the project are: (1) to model the association between adverse birth outcomes and several measures of child health and development; (2) to test whether the associations between adverse birth outcomes, social risk factors, and child health and development are additive or interactive, (3) to build into the explanatory model biological, demographic, health care, behavioral, and government assistance risk factors -all which the literature suggest may be important for child health and development; (4) to model the association between birth outcomes, other risk factors, and child health and development in a comparative context among blacks and whites; and (5) to specify the relationship between adverse birth outcomes, other risk factors, and child health and development for a representative sample of the U.S. population. We will use the 1991 Longitudinal Follow-up of the 1988 National Maternal and Infant Health Survey (NMIHS-LF) as our data source. The NMIHS-LF is nationally-representative, includes birth outcome measures from the original NMIHS, and includes a wide range of demographic, social, biological, and behavioral risk factors and health and development outcome measures for children between the ages of two and four.