Longitudinal Trajectories of Adolescents Born Preterm

早产青少年的纵向轨迹

• 批准号: 6877156
• 负责人: Mary C Sullivan
• 金额: $ 29.99万
• 依托单位: UNIVERSITY OF RHODE ISLAND
• 依托单位国家: 美国
• 财政年份: 1994
• 资助国家: 美国
• 起止时间: 1994-09-30 至 2008-03-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/6877156
• 关键词: academic achievement; adolescence (12-20); behavior disorders; behavioral /social science research tag; child physical development; child psychology; clinical research; disease /disorder proneness /risk; epidemiology; human morbidity; human subject; longitudinal human study; low birth weight infant human; mathematical model; model design /development; nervous system disorder; outcomes research; performance; postnatal growth disorder; premature infant human; psychomotor disorders; psychomotor function; socioeconomics

DESCRIPTION (provided by applicant): This research continuation into adolescence proposal is a request to follow a unique sample of children born at various degrees of prematurity and late medical risk. We have been following 192 families whose children were born at medical risk, from birth to age 12, with continual funding from NINR. This proposal incorporates the research directions established by the National Institute of Nursing Research's initiative and Healthy People 2010 to develop practice knowledge in health promotion for older children and adolescents. The proposed project is an innovative and unique effort to examine both the transition from early to late adolescence as well as the entire continuation of childhood in a sample of children born at various degrees of medical risk. Results from our research to date inclusive from birth to age 12, provide a comprehensive understanding of specific developmental trajectories and risk and protective processes that exacerbate or ameliorate the impact of cumulative risk on competency outcomes in full term and preterm children. The Specific Aims: (1) Investigate and model developmental trajectories from birth to age 18, in the sample of children born at various degrees of perinatal morbidity. The trajectories of growth, medical, neurological, motor and problem behavior. (2) Examine the models by which cumulative medical and environmental risk, from birth to age 12, have an independent effect on developmental competency constructs of health, academic, social and functional performance at last adolescence. (3) Examine how cumulative protective processes, from age 4 to 18, will have an independent effect and/or mediating effect on cumulative risk, on developmental competency constructs of health, academic, social, and functional performance at late adolescence. Compelling findings from our work support the need for trajectory follow up. For example, physical attainment at adolescence shows some "catch up" growth, yet preterm, especially SGA children, remain smaller and lighter than their peers at age 12. The rate of overweight and obesity rates were three to four times the national average in the preterm group ranging from 32% to 41%. In the motor trajectory, the incidence of motor deficits doubled from 11% at age 8 to 21% at age 12. Our most striking finding has been the importance of cumulative risk and cumulative protective processes heretofore undocumented, in the prediction of competency of early adolescence. Repeated measures using mixed effects models will be used to determine developmental trajectories and test the effects of risk and protection in determining health, academic functioning, and social competency outcomes at age 18. Late adolescence will be an important and necessary addition in developing a total model of development that incorporates both time-specific and cumulative risks as well as protective processes for an entire period of childhood. Such studies are urgently needed to build a broader scientific foundation for nursing interventions. This proposal is very specific in identifying connections between the literature, our prior studies, the need for trajectory follow through, and risk and protection in the understanding child competency outcomes. Based on the cutting edge work of our collaborators in risk contexts, we will develop models where cumulative risk and protective processes are highlighted.

描述（由申请人提供）：这项研究继续涉及青春期提案，要求遵循以各种早产和晚期医疗风险出生的儿童的独特样本。我们一直在关注192个家庭，他们的孩子从出生到12岁的孩子出生，忍者不断提供资金。该提案纳入了美国国家护理研究所的倡议和健康人民2010年建立的研究方向，旨在为年龄较大的儿童和青少年发展健康促进实践知识。拟议的项目是一项创新且独特的努力，旨在研究以不同程度的医疗风险出生的儿童样本中从青春期到晚期的过渡以及整个童年的过渡。从我们的研究到迄今为止，从出生到12岁的研究的结果，对特定的发展轨迹以及风险和保护过程提供了全面的理解，这些过程加剧或改善了累积风险对全学期和早产儿童的累积风险对能力成果的影响。具体目的是：（1）研究并模拟从出生到18岁的发育轨迹，在不同程度的围产期发病率的孩子样本中。生长，医学，神经系统，运动和问题行为的轨迹。 （2）检查从出生到12岁的累积医疗和环境风险的模型，对最终青春期的健康，学术，社会和功能绩效的发展能力构建具有独立的影响。 （3）检查从4岁到18岁的累积保护过程如何对累积风险产生独立的影响和/或中介作用，对青少年晚期健康，学术，社会和功能绩效的发展能力结构。我们工作中引人入胜的发现支持轨迹跟进的需求。例如，青春期的身体成就显示出一些“赶上”的增长，但早产，尤其是SGA儿童，比12岁时的同龄人更小，更轻。在运动轨迹中，运动缺陷的发生率从12岁时的11％增加了一倍，即12岁。我们最惊人的发现是累积风险和累积保护过程的重要性，迄今无证明是青春期早期能力的重要性。使用混合效应模型的重复测量将用于确定发展轨迹并测试风险和保护在确定18岁时的健康，学术功能和社会能力成果中的影响。青春期晚期将在开发整个开发模型中是一个重要且必要的补充，该模型既包括时间特异性和累积的风险，又是整个儿童时期的保护过程。迫切需要进行此类研究来为护理干预措施建立更广泛的科学基础。该建议在识别文献，我们先前的研究，轨迹遵循的需求以及理解儿童能力结果的风险和保护之间非常具体。根据我们在风险环境中合作者的尖端工作，我们将开发模型，其中突出了累积风险和保护过程。