Inflammatory Mediators of Stress Exposure and Neurodevelopment in Very Preterm Infants
Inflammatory Mediators of Stress Exposure and Neurodevelopment in Very Preterm Infants
批准号:
9394533
负责人:
MARLIESE D NIST
金额:
$3.68万
依托单位:
依托单位国家:
美国
项目类别:
财政年份:
2017
资助国家:
美国
项目状态:
已结题
起止时间:
2017-08-15 至 2019-08-14
关键词:
AffectAgeAnti-Inflammatory AgentsAnti-inflammatoryBehaviorBehavioralBiological AssayBiological MarkersBiologyBirthBrainBrain InjuriesCare given by nursesChildhoodChronicChronic stressCognitionCognitiveCritical IllnessDevelopmentDevicesDiscipline of NursingFellowshipFoundationsFutureGoalsHairHealthHospitalizationHydrocortisoneImmune responseImpairmentIndividualInfantInfant MortalityInflammationInflammation MediatorsInflammatoryInterventionKnowledgeLanguageLifeLinkMeasurementMeasuresMediatingMediationMediator of activation proteinMedicalMissionMolecular BiologyMotorNational Institute of Nursing ResearchNeonatalNeonatal Intensive Care UnitsNeurodevelopmental ImpairmentNursesNursing ResearchOutcomePainPathway interactionsPerformancePhysiologicalPlayPopulationPremature BirthPremature InfantProceduresPublishingResearchResearch AssistantResearch PersonnelRiskRoleScientific Advances and AccomplishmentsSensorySepsisSolidStressStructureSurvivorsTechniquesTimeTrainingUnited Statesbasebiological adaptation to stresscareercytokineemerging adultexperiencehigh risk infanthypothalamic-pituitary-adrenal axisimmune system functionimprovedinflammatory markerinnovationneurobehavioralneurodevelopmentphysiologic stressorpostnatalprogramsskillsstressor
中文摘要
项目总结/文摘
英文摘要
PROJECT SUMMARY/ABSTRACT
Infants born very preterm (28-31 weeks post-menstrual age (PMA)) are at an increased risk for impaired
neurodevelopment as a result of their preterm birth and extended hospitalization in the neonatal intensive care unit
(NICU). Very preterm infants experience poorer cognitive, motor, behavioral, and socioemotional functioning compared
to healthy infants born at term, which may persist into late childhood and early adulthood. Preterm infants are exposed to
numerous experiential (e.g. painful procedures), environmental (e.g. sensory stimulation), and physiologic (e.g. sepsis,
critical illness) stressors during their hospitalization which may affect their long-term neurodevelopment. Researchers
have suggested a direct causal pathway linking inflammation with brain injury and impaired neurodevelopment in preterm
infants. Determining the potentially modifiable mediators linking stress and neurodevelopment is paramount to improve
the long-term outcomes of very preterm infants. The purpose of this study is to evaluate the relationships among stress
exposure, inflammation, and neurodevelopment in very preterm infants. This study will accomplish the following specific
aims: (1) determine the relationships among stress exposure, inflammation, and neurodevelopment in very preterm
infants, (2) determine the effect of stress exposure on weekly changes in inflammatory and anti-inflammatory cytokines
from one week of age until 35 weeks PMA, and (3) examine the correlation between a published scale of NICU stress
exposure and chronic stress response measured by hair cortisol concentration in very preterm infants. Cumulative and
weekly stress exposure scores will be calculated using the Neonatal Infant Stressor Scale (NISS). Inflammation will be
measured with a panel of pro-inflammatory and anti-inflammatory cytokines, quantified by multi-plex assay.
Neurodevelopment will be assessed using the Neurobehavioral Assessment of the Preterm Infant (NAPI). The study
includes an exploratory aim to measure the correlation between NISS scores and hair cortisol concentration, an innovative
approach to the measurement of a chronic stress response in hospitalized preterm infants. This study aligns with the
National Institute of Nursing Research’s mission to promote life-long wellness and is an important step in the
development of targeted interventions to optimize neurodevelopmental outcomes for preterm infants. The training plan
will provide the applicant with numerous formal and informal opportunities for professional development while allowing
the applicant to build a solid foundation for a successful career as an independent researcher. This study builds on the
applicant’s experiences as a NICU nurse and research assistant and integrates her knowledge of biology, nursing, and
molecular biology lab techniques.
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