YOUNG ADULT OUTCOMES OF VERY LOW BIRTHWEIGHT CHILDREN

描述：该提案要求支持一项为期四年的随访研究 极低出生体重（VLBW小于1.5 公斤）。 对1977-1979年出生的249名LBW进行了纵向研究， 5次：出生、预产期、8个月、2年和8 岁的 获得了社会人口统计学和围产期数据， 出生和生长时的变量、疾病变量和神经发育变量 所有后续时间点的状态。 在8岁时，结果是 与363例正常出生体重（NBW）的区域对照组相比， 孩子 拟议的研究将纵向数据集扩展到18个 岁的 在这个时候，它还将包括一个兄弟姐妹对照组。 将收集关于成长成就、健康、心理社会 发展、个人功能以及同伴和家庭关系。 的 研究人员将在18岁时检验下列关于极低出生体重的假设 与NBW对照组和相同性别和年龄的同胞相比： 1)VLBW将表现出增长的追赶，但重量较低 指数和青春期发病的后期史; 2）VLBW将显示 健康指标的显著差异--更多的呼吸道症状， 降低血压和运动功能较差; 3）VLBW将 表现出明显较差的学术和心理社会功能， 更差的感知能力和更多的行为症状（这将是 与更高水平的药物滥用和暴力行为有关）， 更糟糕的同伴和家庭关系。 研究人员还假设， 假设3中描述的结果在青少年中会更糟 认知能力低于正常和来自社会弱势家庭。 数据 分析计划是检查VLBW对18年结果的直接影响 以及干预变量的中介和调节作用 这可能会影响这种关系。 将从青少年中收集数据 通过结构化访谈和问卷调查， 测试，生长和血压测量。 数据将与 以前记录的措施。 将进行三类分析： 1)VLBW和对照组的同期比较; 2）纵向结局; （3）极低出生体重儿亚群间的内部比较。 的计划 检查VLBW青少年作为个体和 他们的同龄人和家人将提供一个社会和生命跨度的角度来看， VLBW的后果。 这些结果对 目前对极不成熟婴儿的积极新生儿护理。

DESCRIPTION: This proposal requests support for a four-year follow-up study of the adolescent consequences of very low birthweight (VLBW less than 1.5 Kg). A cohort of 249 LBW born in 1977-1979 was studied longitudinally at five previous times: birth, expected term date, 8 months, 2 years, and 8 years of age. Data were obtained on sociodemographic and perinatal variables at birth and on growth, disease variables and neurodevelopmental status at all subsequent time points. At 8 years of age, outcomes were compared to a regional comparison group of 363 normal birthweight (NBW) children. The proposed study will extend the longitudinal data set to 18 years of age. At this time it will also include a sibling control group. Follow up data will be gathered on growth attainment, health, psychosocial development, individual functioning and peer and family relationships. The investigators will test the following hypotheses regarding VLBW at 18 years of age compared to NBW controls and same sex and age appropriate siblings: 1) VLBW will demonstrate catch up in growth but will have lower ponderal indices and a later history of puberty onset; 2) VLBW will demonstrate significant differences in health measures -- more respiratory symptoms, lower blood pressure and poorer motor functioning; and 3) VLBW will demonstrate significantly poorer academic and psychosocial functioning, poorer perceived competence and more behavioral symptoms (which will be associated with higher levels of drug abuse and violent behavior), and poorer peer and family relationships. The investigators also hypothesize that the outcomes described in Hypothesis 3 will be worse in adolescents with subnormal cognition and from socially disadvantaged families. The data analytic plan is to examine the direct effects of VLBW on 18 year outcomes as well as the mediating and moderating influences of intervening variables which may affect this relationship. Data will be gathered from adolescents and mothers via structured interviews and questionnaires, a standardized IQ test, and growth and blood pressure measurements. Data will be merged with previously documented measures. Three types of analyses will be performed: 1) con-current comparisons of VLBW and controls; 2) longitudinal outcomes; and 3) internal comparisons between subsets of VLBW children. The plan to examine functional outcomes of VLBW adolescents as individuals and among their peers and family will provide a societal and life span perspective of the consequences of VLBW. The results have implications concerning the current aggressive neonatal care of extremely immature infants.