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Advancing Applied MCH Research

Psycho-Social Sequelae of BPD and VLBW: Phase (3) Three

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Project Number: R40 MC 00334-04
Grantee: Case Western Reserve University
Project Date: 01/01/2003

Final Report

Psycho-Social Sequelae of BPD and VLBW: Phase (3) Three Final Report (PDF) Exit Disclaimer

Principal Investigator

Lynn T. Singer, Ph.D.
CWRU The Triangle Building, Suite 250A 11400 Euclid Avenue
Cleveland, OH  44106
Phone: (216) 844-6212
Email: /


  • Perinatal/Infancy (0-12 months)
  • Adolescence (12-18 years)


Bronchopulmonary dysplasia (BPD), a chronic lung disease of prematurity, currently occurs in 25-40% of very low birthweight (VLBW) births and has been found to be significantly related to poorer developmental outcome in VLBW cohorts. The first waves of post-surfactant survivors are now approaching early adolescence, with little known about their long-term pulmonary outcomes, growth or functional abilities. Since 1990, incidence of BPD has increased more than 50% with >11,000 new cases annually. Further, there are few data regarding behavioral, psychosocial and family outcomes of VLBW cohorts in general, because VLBW infants are disproportionately minority (African-American) and of low SES, understanding the role of these factors in moderating outcomes is important. The proposed study will assess 302 fourteen-year old children (110 BPD, 80 VLBW, 112 healthy, term), previously followed from birth--8 years of age in longitudinal studies of the medical/psychosocial correlates of BPD and VLBW. The proposed research will investigate their early adolescent outcomes with a focus on the influence of BPD, relative to other risk factors, on pulmonary, cognitive, language, neuropsychological and behavioral/emotional outcomes. Standardized measures of child outcomes, teacher and parental report of child behaviors, and parental report of psychological and parenting stress, coping mechanisms and social supports will be given. Groups do not differ on age, race, sex, SES, parental education/marital status. Descriptive statistics, MANOVAS/MANCOVAS and multiple regression will be used to assess group differences and the relative effects of BPD, VLBW, and other risk factors, especially race and SES, on outcomes. Data sets from the prior longitudinal studies will be merged with 14 year outcome data to assess changes over time and predictive models of infant risk, using general linear mixed or structural equation models. Delineation of specific relationships of early medical conditions, such as BPD, relative to other complications of prematurity, to adolescent outcomes may lead to early identification of those VLBW infants at highest risk for learning and behavior problems, and elucidate biologic and psychological mechanisms related to the negative sequelae of VLBW birth.


Listed is descending order by year published.

Nelson S, Albert JM, Lombardi G, Wishnek S, Asaad G, Kirchner HL, Singer LT. Dental caries and enamel defects in very low birth weight adolescents. Caries Res. 2010;44(6):509-18.

Lewis B, Fulton S, Short E, Nelson S, Lombardi J, Rosenbaum D, Kercsmar C, Baley J, Singer LT. A longitudinal case study of a child with mosaic trisomy 22: language, cognitive, behavioral, physical, and dental outcomes. Am J Med Genet A. 2007 Sep 1;143A(17):2070-4.

Short EJ, Kirchner L, Asaad GR, Fulton SE, Lewis BA, Klein N, et al. Developmental sequelae in preterm infants having a diagnosis of bronchopulmonary dysplasia: analysis using a severity-based classification system. Arch Pediatr Adolesc Med. 2007 Nov;161(11):1082-7.

Singer LT, Fulton S, Kirchner HL, Eisengart S, Lewis B, Short E, Min MO, Kercsmar C, Baley JE. Parenting very low birth weight children at school age: maternal stress and coping. J Pediatr. 2007 Nov;151(5):463-9. Epub 2007 Aug 23.

Eisengart SP, Singer LT, Kirchner HL, Min MO, Fulton S, Short EJ, Minnes S. Factor structure of coping: two studies of mothers with high levels of life stress. Psychol Assess. 2006 Sep;18(3):278-88.

Eisengart SP, Singer LT, Fulton S, Baley J. Coping and psychological distress in mothers of very low birth weight infants. Parenting Sci Pract. 2003 Jan-Mar;3(1):49-72.

Short EJ, Klein NK, Lewis BA, Fulton S, Eisengart S, Kercsmar C, et al. Cognitive and academic consequences of bronchopulmonary dysplasia and very low birth weight: 8-year-old outcomes. Pediatrics. 2003 Nov;112(5):e359.

Singer LT, Fulton S, Davillier M, Koshy D, Salvator A, Baley JE. Effects of infant risk status and maternal psychological distress on maternal-infant interactions during the first year of life. J Dev Behav Pediatr. 2003 Aug;24(4):233-41.

Lewis BA, Singer LT, Fulton S, Salvator A, Short EJ, Klein N, et al. Speech and language outcomes of children with bronchopulmonary dysplasia. J Commun Disord. 2002 Sep-Oct;35(5):393-406.

Singer LT, Hawkins S, Huang J, Davillier M, Baley J. Developmental outcomes and environmental correlates of very low birthweight, cocaine-exposed infants. Early Hum Dev. 2001 Sep;64(2):91-103.

Singer LT, Siegel AC, Lewis B, Hawkins S, Yamashita T, Baley J. Preschool language outcomes of children with history of bronchopulmonary dysplasia and very low birthweight. J Dev Behav Pediatr. 2001 Feb;22(1):19-26.

Singer LT. Randomized clinical trials in infancy: methodologic issues. Semin Neonatol. 2001 Oct;6(5):393-401.

Singer LT, Salvator A, Guo S, Collin M, Lilien L, Baley J. Maternal psychological distress and parenting stress after the birth of a very low-birth-weight infant. JAMA. 1999 Mar 3;281(9):799-805.

Singer L, Yamashita T, Lilien L, Collin M, Baley J. A longitudinal study of developmental outcome of infants with bronchopulmonary dysplasia and very low birth weight. Pediatrics. 1997 Dec;100(6):987-93.

Singer LT, Davillier M, Bruening P, Hawkins S, Yamashita TS. Social support, psychological distress, and parenting strains in mothers of very low birthweight infants. Fam Relations. 1996 Jul;45(3):343-50.

Singer LT, Davillier M, Preuss L, Szekely L, Hawkins S, Yamashita T, Baley J. Feeding interactions in infants with very low birth weight and bronchopulmonary dysplasia. J Dev Behav Pediatr. 1996 Apr;17(2):69-76.

Singer LT, Yamashita TS, Hawkins S, Cairns D, Baley J, & Kliegman R. Increased incidence of intraventricular hemorrhage and developmental delay in cocaine-exposed, very low birth weight infants. J Pediatr. 1994 May;124(5 Pt 1):765-71.

Singer L, Martin RJ, Hawkins SW, Benson-Szekely LJ, Yamashita TS, Carlo WA. Oxygen desaturation complicates feeding in infants with bronchopulmonary dysplasia after discharge. Pediatrics. 1992 Sep;90(3):380-4.


Low Birthweight, Cognitive & Linguistic Development, Preterm, Chronic Illness, Social & Emotional Development, School Outcomes & Services, Stress, Special Health Care Needs

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