Adolescent Outcomes of <1000 gram Birth Weight Children

描述(由申请人提供)：此申请请求支持，以继续我们对极低出生体重(ELBW)对结局的影响的检查。自出生以来，我们前瞻性地跟踪了219名出生于1992-1995年的ELBW。在8岁时招募了176名正常出生体重(NBW)对照组的学校匹配组。8年后的研究结果显示，慢性病和特殊卫生保健需求以及认知和神经心理缺陷的比率非常高，这对学习和行为有影响。这些都会增加家庭压力和负担。自那以后，孩子们进入了青春期，这是一个特殊的生物、心理和社会变化时期，对ELBW儿童构成了特殊的挑战。这项应用的主要目标是将纵向随访延长到14岁，以检查ELBW的持续影响以及青春期可能发生的健康、发育和行为的关键变化。我们提出了一个发育的生物心理社会框架，与NBW儿童相比，该框架考虑了ELBW对青春期结局的后遗症。较高的围产期风险(主要是脑和肺损伤)预计会导致较差的学业成绩、行为和心理社会适应能力。该模型考察了包括家庭、同伴和学校关系在内的人际关系作为围产期风险的中介因素，以及社会人口和个人内部因素(如性别和种族)的调节作用。我们还计划检查结果的纵向变化及其与背景变量的关系。我们假设：a)低出生体重儿在健康、神经心理和学习功能以及行为方面将继续比正常出生体重儿有更差的结局；以及对家庭的负面影响；b)低出生体重儿在青春期的高患病率和特殊健康护理需求将增加；c)相对于正常体重儿，低出生体重儿将出现的影响包括增加社会孤立、焦虑和抑郁症状，以及减少冒险行为。早产儿组代表了美国唯一出生于1990年代S的学龄儿童。这一发现将为旨在减少或防止不良后果的干预措施提供依据。我们的数据还将提供规划和提供服务所需的重要信息，为那些在新生儿重症监护中幸存的ELBW儿童提供服务。

DESCRIPTION (provided by applicant): This application requests support to continue our examination of the effects of of extremely low birth weight (ELBW,<1kg) on outcomes. We have prospectively followed 219 ELBW born 1992-1995 since birth. A school matched group of 176 normal birth weight (NBW) controls were recruited at age 8 years. Results of the study at 8 years reveal very high rates of chronic conditions and special health care needs as well as cognitive and neuropsychologic deficits that have implications for learning and behavior. These result in increased family stress and burden. The children have since entered adolescence, a period of extraordinary biological, psychological and social change that pose special challenges to ELBW children. The major objective of this application is to extend the longitudinal follow up to age 14 years in order to examine the continuing impact of ELBW and the critical changes in health,development and behavior that may occur during adolescence. We present a developmental biopsychosocial framework which considers the sequelae of ELBW on outcomes of adolescence when compared to NBW children. Higher perinatal risk (mainly brain and lung injury) is predicted to result in poorer academic achievement, behavior and psychosocial adjustment. The model examines interpersonal contexts including family, peer and school relationships as mediators of perinatal risk, as well as the moderating effects of sociodemographic and intrapersonal factors such as gender and ethnicity. We also plan to examine the longitudinal changes in outcomes and their relationship to the contextual variables. We hypothesize that a) ELBW children will continue to have poorer outcomes than NBW children in health, neuropsychologic and academic function, and behavior; and negative impact on the family, b) The high rates of chronic disorders and special health care needs of the ELBW group will increase during adolescence; c) Effects of ELBW relative to NBW that will emerge will include increase in social isolation, symptoms of anxiety and depression, and diminished risk taking. The ELBW group represents the only such children followed to school age in the USA who were born in the 1990's. The findings will inform interventions designed to lessen or prevent adverse outcomes. Our data will also provide important information needed for the planning and provision of services for ELBW children who survive neonatal intensive care.