SCHOOL AGE OUTCOMES OF <1000 GRAM BIRTHWEIGHT CHILDREN

本提案要求支持对出生体重小于1000克的学龄儿童的多种功能结局和特殊保健需求进行全面检查。对1992-1995年出生的221名<1000 gm的儿童在校正年龄20个月时进行了评估，其中48%有神经和/或发育障碍。在拟议的研究中，我们计划在8岁时将他们的学龄期功能和特殊保健需求与年龄，性别和种族匹配的正常出生体重学校对照进行比较。为了评估健康状况和特殊保健需求，我们计划使用最近开发的儿童健康测量方法(儿童健康和疾病概况（CHIP-CE）和儿童慢性病识别问卷（QuICCC），以及更传统的神经感觉和发育结果分类测量方法。数据收集将包括父母、儿童和教师的问卷调查和访谈，身体和神经感觉状态的直接评估以及心理测试。我们假设出生体重< 1000 gm的儿童的结果与8岁时正常出生体重控制的结果在三个方面不同；a)从父母和儿童的角度来看，出生体重<1000 gm的儿童一般健康状况较差，功能限制较多，需要补偿性辅助和常规以上的服务；b)采用直接评价方法和教师报告，出生体重< 1000 gm的儿童发育不正常、神经感觉障碍发生率较高，认知能力、学业成绩、神经心理功能和学习成绩较差；c)出生体重< 1000克儿童的父母将报告对家庭的负面影响，包括家庭功能障碍、母亲抑郁和经济困难的发生率更高。数据分析将包括对群体差异的检查；对儿童的直接评估与父母和以儿童为基础的健康结果报告之间的关系；以及社会和生物因素与儿童功能的关系以及对家庭的影响。这项研究将提供关键的基于研究和政策相关的信息，以衡量新生儿重症监护的结果，以及为高风险儿童规划和提供服务。

This proposal requests support for a comprehensive examination of the multiple functional outcomes and special health care needs of <1000 gm birth weight children at school age. A cohort of 221 <1000 gm children born 1992-1995 was evaluated at 20 months corrected age at which time 48% had neurologic and/or developmental impairment. In the proposed study, we plan to examine their school age functioning and special health care needs at age 8 years compared to normal birth weight school controls matched by age, gender and race. To assess Health Status and Special Health Care Needs, we plan to use recently developed measures of child health (the Child Health and Illness Profile (CHIP-CE) and the Questionnaire for Identifying Children with Chronic Diseases (QuICCC), together with the more traditional categorical measures of neurosensory and developmental outcome. Data collection will include parent, child and teacher questionnaires and interviews, direct assessment of physical and neurosensory status and psychometric testing We hypothesize that the outcomes of the < 1000 gm birth weight children will differ in three ways from outcomes of the normal birth weight controls at age 8 years; a) From the parent and child's perspective, children of <1000 gm birth weight will have poorer general health status and more functional limitations, need for compensatory aids and services above routine; b) Using direct assessment methods and teacher report, < 1000 gm birth weight children will have higher rates of subnormal growth, neurosensory impairments and poorer cognitive ability, academic achievement, neuropsychologic functioning and school performance; and c) Parents of < 1000 gm birth weight children will report a negative impact on the family including higher rates of family dysfunction, maternal depression and economic hardship. Data analysis will include examination of group differences; the relationship of direct assessments of the child to parent and child-based reports of health outcomes; and the relationship of social and biologic factors to the child's functioning and to impact on the family. This study will provide critical research-based and policy related information needed both for measuring outcomes of neonatal intensive care and for the planning and provision of services for high risk children.