Does Early Experience Improve Preterm Neurodevelopment?

早期经验能否改善早产神经发育？

• 批准号: 7264515
• 负责人: HEIDELISE ALS
• 金额: $ 43万
• 依托单位: BOSTON CHILDREN'S HOSPITAL
• 依托单位国家: 美国
• 财政年份: 2006
• 资助国家: 美国
• 起止时间: 2006-08-01 至 2011-05-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7264515
• 关键词: 8 year old; Accounting; Age; Behavior; Behavior Therapy; Birth; Birth Weight; Brain; Caring; Child; Child Development; Cognitive; Condition; Control Groups; Cross-Sectional Studies; Development; Effectiveness; Failure; Frequencies; Gestational Age; Goals; Growth; Head circumference; Infant; Intervention; Intervention Studies; Investigation; Knowledge; Learning; Learning Disabilities; Magnetic Resonance Imaging; Measures; Medical; Modeling; Neonatal Intensive Care Units; Numbers; Outcome; Parents; Performance; Physical Function; Premature Infant; Problem behavior; Public Health; Purpose; Randomized; Recruitment Activity; Regression Analysis; Relative (related person); Research; Risk; Sample Size; Sampling; School-Age Population; Schools; Socioeconomic Status; Standards of Weights and Measures; Structure; Students; System; Tail; Testing; Time; Tissues; Week; Weight; base; cognitive function; cohort; cost; early experience; frontal lobe; improved; innovation; neurodevelopment; peer; psychosocial; size; treatment effect; white matter

DESCRIPTION (provided by applicant): About fifty percent of prematurely born infants develop learning/behavior problems and school failure. The study will test the primary hypotheses, that preterm infants (PT) randomized to developmental care in the Newborn Intensive Care Unit (NICU) will be superior in cognitive performance at school age when compared to their peers, who did not receive the intervention. Fifty-two [26 control (C); 26 experimental (E)] infants born at a gestational age (GA) of 28-33 week (w) will be studied at 8 years(y) corrected age (CA). A sample of 26 fullterm-born (FT) healthy 8y-olds will provide an additional control group for descriptive purposes. Three secondary hypotheses will be tested: The PT-E group will be superior to the PT-C, 1) in academic performance; 2) in long distance cortical connectivity of frontal and occipital brain systems (EEC coherence), and 3) in frontal cortical white matter volumes (MRI). The FT group will be superior to both PT groups. Child physical and psychosocial functioning will be explored descriptively. The primary independent variable will be treatment group (PT-control, PT-experimental). Additionally tested will be GA, growth percentile (weight and head circumference) at birth, parent socioeconomic status, and parent cognitive function, all expected to influence outcome. The PT sample will be described by previously collected medical and demographic measures at birth, and by behavior and brain function at 2wCA and 9mCA. For testing the primary (school age cognitive function) and the two secondary dependent variables (frontal coherence and frontal white matter volume), stepwise multiple linear regression analysis will be used; the five independent variables will be entered into the models. Main effects and two and three-way interaction terms will be evaluated with goodness-of-fit assessed using adjusted R-squared. A sample size of 26 subjects per PT group will provide 80% statistical power (beta=0.20; alpha=0.05, 2-tailed) to detect a 12 point or higher mean difference in the cognitive measure, assuming a pooled standard deviation of 15 points (effect size sigma = 12/15 = 0.8) based on a two-sample Student t-test. The study will provide, for the first time, evidence at school age of the effectiveness of a much needed, low cost, early behavioral intervention. The expected reduction in learning and school failure for the increasing numbers of preterm-born children in the nation's schools, would give the study and the intervention, significant national public health importance.,

描述（由申请人提供）：大约50%的早产婴儿会出现学习/行为问题和学业失败。该研究将检验主要假设，即在新生儿重症监护病房（NICU）随机接受发育护理的早产儿（PT）在学龄时的认知表现优于未接受干预的同龄人。52[26]对照(C)；26个实验(E)]胎龄（GA） 28-33周(w)出生的婴儿将在8岁(y)矫正年龄（CA）时进行研究。26名足月出生（FT）健康的8岁儿童样本将作为描述目的的额外对照组。三个次要假设将被检验：PT-E组将优于PT-C组，1)学业成绩；2)额叶和枕叶脑系统的长距离皮质连通性（EEC相干性）和3)额叶皮质白质体积（MRI）。FT组将优于PT组。儿童身体和社会心理功能将被描述性地探讨。主要自变量为实验组（PT-control， pt -实验组）。此外，还将测试GA、出生时的生长百分位数（体重和头围）、父母的社会经济地位和父母的认知功能，这些都预计会影响结果。PT样本将通过先前收集的出生时的医学和人口统计数据，以及在2wCA和9mCA时的行为和脑功能来描述。对于小学（学龄认知功能）和两个次要因变量（额叶连贯性和额叶白质体积）的测试，将采用逐步多元线性回归分析；五个自变量将被输入到模型中。主效应和双向和三方相互作用项将用调整后的r平方来评估拟合优度。每个PT组26名受试者的样本量将提供80%的统计能力（beta=0.20; alpha=0.05，双尾），以检测认知测量中12点或更高的平均差异，假设基于两样本学生t检验的合并标准差为15点（效应量sigma = 12/15 = 0.8）。这项研究将首次为学龄儿童提供证据，证明一种急需的、低成本的早期行为干预的有效性。在全国的学校里，越来越多的早产儿童的学习和学业失败的预期减少，将使这项研究和干预具有重大的国家公共卫生意义。