RISK FACTORS IN BRONCHOPULMONARY DYSPLASIA

描述：403名极低出生体重(1,500克)新生儿护理幸存者，出生 在1988年8月至1991年6月期间，一直跟踪到5-8岁。时间 出生日期包括表面活性物质治疗的批准日期。因此， 首批在综合新生儿ICU接受肺表面活性物质治疗的儿童 (NICU)实习现在进入学龄期，提供了第一次机会 评估学校表现，评估呼吸道疾病的真实慢性化程度 限制。现有的群体为这样的人提供了一个独特的机会 评估，因为它跨越表面活性剂批准期，比其他 美国随访队列，是NICU幸存者的代表 地理区域。拟议的研究将利用 在第三季度利用标准化学校成绩测试的机会 四年级和其他丰富的学校记录信息。最近 经过验证和标准化的便携式峰值流量测量设备将 用于肺部评估，因为队列在地理上分散。 关于队列的大型NICU和后续数据库包含广泛的 呼吸系统疾病基线评估、新生儿治疗和 诊断，以及功能评估、健康状况和保健 4-6岁时的使用率。添加10岁以下数据将确认或 对4-6岁儿童的功能结果可能较低的调查结果提出异议 在表面活性物质上市后出生的儿童， 长期呼吸道问题的患病率保持不变。新的 要收集的结果数据包括学校的表现，来自学校的 记录、家长和教师问卷、高峰呼吸功能 流量计和呼吸道症状及家长的呼吸系统药物 访谈和问卷调查。这些数据将通过以下方式处理：1)VLBW 儿童与常模和来自同一所学校的对照组进行比较 地区；2)是否存在出生年份间的时间趋势；以及3) 哪些因素具有预测性，利用基线、儿童早期和 并发数据。

DESCRIPTION: A cohort of 403 VLBW (<1500 g) neonatal care survivors, born during August 1988-June 1991, have been followed to ages 5-8. The time period of birth includes the approval dates for surfactant therapy. Hence, the first children to be treated with surfactant in general neonatal ICU (NICU) practice are now entering school age, providing a first opportunity to evaluate school performance, and to assess true chronicity of respiratory limitations. The existing cohort provides a unique opportunity for such evaluation, as it spans the surfactant approval period, is larger than other U.S. follow-up cohorts, and is representative of NICU survivors in a geographic area. The proposed research will take advantage of the opportunity to tap into standardized school achievement testing in the third and fourth grades and a wealth of other school record information. Recently validated and standardized portable peak flow measurement devices will be utilized for pulmonary assessment as the cohort is geographically dispersed. A large NICU and follow-up data base on the cohort contains extensive baseline assessment of respiratory disease, neonatal treatments and diagnoses, as well as functional assessment, health status and health care utilization at ages 4-6. The addition of data up to age 10 will confirm or dispute findings from ages 4-6 that functional outcome may be lower among children born after surfactant was released for marketing, and that the prevalence of long-term respiratory problems has remained the same. The new outcome data to be collected include school performance, from school records, parent and teacher questionnaires, respiratory function by peak flow meters and respiratory symptoms and respiratory medications by parent interview and questionnaires. These data will be addressed by: 1) how VLBW children compare to norms and to comparison groups from the same schools and districts; 2) whether there has been a time trend across birth years; and 3) what factors are predictive, utilizing baseline, early childhood and concurrent data.