BIRTH OUTCOMES, SOCIAL RISKS AND CHILD HEALTH

尽管一些基于临床的研究已经检查了 不良分娩之间的关联，无论是单独的还是在 与儿童健康和发展相结合，这项研究 通常基于来自小样本和/或一个或几个样本的数据 医院使结果的推广具有不确定性和模型性 大量风险因素的影响是困难的或 不可能。此外，由于这些研究的性质，种族- 儿童健康和发展结果的具体模型是 实际上是不存在的。另一方面，儿童健康研究使用 大规模的、基于人口的数据集经常受到缺乏的阻碍 关于出生结局的信息，通常不考虑范围 我们可以在拟议的分析中包括的风险因素。因此， 拟议研究的总体目标是更广泛和 严格探索不良生育结果之间的联系， 社会风险因素，以及儿童健康和发展结果 美国是迄今为止所取得的最大成就。《公约》的具体目标 项目是：(1)建立不良生育结果之间的关联模型 以及儿童健康和发育的几个衡量标准；(2)测试 不良生育结局、社会风险之间的关系 因素，以及儿童健康和发展是相加或相互作用的， (3)将生物学、人口学、健康学纳入解释模型 护理、行为和政府援助的风险因素-所有这些 文献表明，这对儿童的健康和发育可能很重要； (4)建立出生结局、其他危险因素、 和黑人比较背景下的儿童健康和发展 和白人；以及(5)明确不利出生之间的关系 结果，其他危险因素，以及儿童健康和发展 美国人口的代表性样本。 我们将使用1991年的纵向跟踪1988年全国 以《母婴健康调查》(NMIHS-LF)为数据来源。这个 NMIHS-LF具有全国代表性，包括出生结局测量 从最初的NMIHS，并包括广泛的人口统计， 社会、生物和行为风险因素与健康和 两岁至#岁儿童的发展成果衡量标准 四。

Although a number of clinically-based studies have examined the association between adverse birth out comes, either singly or in combination, with child health and development, that research has typically been based on data from small samples and/or one or a few hospitals so that generalization of results is uncertain and modeling of the effects of a large number of risk factors is difficult or impossible. Moreover, because of the nature of these studies, race- specific modeling of child health and developmental outcomes are virtually non-existent. On the other hand, child health research using large-scale, population based data sets is often hampered by the lack of information on birth outcomes and often does not consider the range of risk factors that we can include in the proposed analysis. Thus, the general objective of the proposed research is a more extensive and rigorous exploration of the association between adverse birth outcomes, social risk factors, and child health and developmental outcomes in the U.S. than has heretofore been accomplished. The specific aims of the project are: (1) to model the association between adverse birth outcomes and several measures of child health and development; (2) to test whether the associations between adverse birth outcomes, social risk factors, and child health and development are additive or interactive, (3) to build into the explanatory model biological, demographic, health care, behavioral, and government assistance risk factors -all which the literature suggest may be important for child health and development; (4) to model the association between birth outcomes, other risk factors, and child health and development in a comparative context among blacks and whites; and (5) to specify the relationship between adverse birth outcomes, other risk factors, and child health and development for a representative sample of the U.S. population. We will use the 1991 Longitudinal Follow-up of the 1988 National Maternal and Infant Health Survey (NMIHS-LF) as our data source. The NMIHS-LF is nationally-representative, includes birth outcome measures from the original NMIHS, and includes a wide range of demographic, social, biological, and behavioral risk factors and health and development outcome measures for children between the ages of two and four.