SCHOOL AGE CONSEQUENCES OF 750 GRAM BIRTHWEIGHT

这项建议要求支持研究儿童在学龄前的后果， 出生体重<750克。一组84名出生体重<750克的幸存者， 每年有30，000名新生儿的地区将在5-8年进行评估 年龄。他们的学龄期功能将与84名早产儿进行比较。 出生体重750-1499克的儿童和足月出生的同学; 对照组在年龄、性别、种族和社会阶层上相匹配。 将在1990-1991年期间收集关于增长和医疗保健的后续数据。 状态;认知和神经心理学表现;行为，学习， 和适应功能;和养育变量。 假设：1）出生体重<750克的儿童将表现出更多的 消极的行为，学习和适应性结果比任何一个 对照组。这些问题将与神经感觉障碍有关 或智力缺陷，但也有更微妙的缺陷，在认知和 神经心理学技能; 2）出生体重<750克的儿童的父母将 经历更多的心理社会困难比父母的大非常低 出生体重的孩子或同学; 3）生物和环境风险 这些因素将对结果产生综合影响。我们特别 预计不良后果将是最常见的儿童谁有 生物风险，即，严重新生儿并发症（慢性 肺部疾病、脑室内出血）、视力缺陷和后期不良 成长成就。我们预计，这些风险将因社会因素而加剧。 弱势和父母的不良作用。 将通过结构化访谈从儿童和家长那里收集数据 问卷调查、体格检查和标准化的心理测量 试验.分析将包括<750的多变量配对比较。 每个对照组的出生体重儿童，回归分析 检查预测变量和结果之间的关系， 应用结构方程模型探索 生物和环境风险，认知神经心理技能， 和行为学习适应功能。 这些结果将提高目前对后遗症的认识，并帮助我们 预见到在极限下出生可能带来的问题， 人类的生存能力。

This proposal requests support for study of the school-age consequences of <750 gm birthweight. A cohort of 84 <750 gm birthweight survivors from a region representing 30,000 births per year will be evaluated at 5-8 years of age. Their school-age functioning will be compared to that of 84 preterm children with birthweights 750-1499 gm and to term-born classmates; each of the comparison groups being matched on age, sex, race, and social class. Follow-up data will be gathered during 1990-1991 on growth and medical status; cognitive and neuropsychological performance; behavior, learning, and adaptive functioning; and parenting variables. Hypotheses are that: 1) <750 gm birthweight children will exhibit more negative behavior, learning, and adaptive outcomes than either of the comparison groups. These problems will be related to neurosensory disorders or mental deficiency, but also to more subtle deficits in cognitive and neuropsychological skills; 2) Parents of <750 gm birthweight children will experience more psychosocial difficulties than parents of larger very low birthweight children or of classmates; 3) Biological and environmental risk factors will have combined influences on outcome. Specifically, we anticipate that adverse outcomes will be most common in children who have experienced biologic risk, i.e., severe neonatal complications (chronic lung disease, intraventricular hemorrhage), visual deficits, and poor later growth attainment. We expect that these risks will be heightened by social disadvantage and poor parental functioning. Data will be collected from children and parents via structured interviews and questionnaires, physical examinations and standardized psychometric tests. Analysis will consist of multivariate paired comparisons of the <750 birthweight children to each comparison group, regression analyses to examine relationships between predictor variables and outcome, and application of structural equation modeling to explore links between biological and environmental risks, cognitive-neuropsychological skills, and behavior-learning-adaptive functioning. These results will enhance current knowledge of sequelae and assist us in anticipating the problems that may be associated with birth at the limits of human viability.