(SDAS) Longitudinal analyses of the Psychosocial sequelae of VLBW and BPD, Phases 1-3
Grantee: Case Western Reserve University
Principal Investigator: Lynn T. Singer
Project Number: R40MC08966
Project Date: 2/1/2008
Final Report
Age group(s)
- Perinatal/Infancy (0-12 months)
- Toddlerhood (13-35 months)
- Early Childhood (3-5 years)
- Middle Childhood (6-11 years)
- Adolescence (12-18 years)
Abstract
The proposed research is a secondary analysis of an ongoing fourteen year longitudinal project entitled Psychosocial Sequelae of BPD and VLBW. This grant addresses the longitudinal analyses of outcomes obtained in Phases 1 through 3 (MCJ 390592, 390715/R40-MC00127, and R40-MC00334) and is unique in several ways, including the large prospective sample VLBW children with and without BPD, the well characterized, prospectively followed group of term children, group equivalence on racial, demographic, and socioeconomic factors, and the availability of seven longitudinal assessment points in a largely intact sample with an overall retention rate of 84%. Examination of the longitudinal outcomes associated with BPD, relative to other medical, neurologic and sociodemographic risk factors, on pulmonary, cognitive, language, neuropsychological and behavioral outcomes at birth, 8, 12, 24, and 36 months, and 8 and 14 years of age is essential to a comprehensive understanding of prematurity and disease states, with family stressors also of interest. These analyses will use a cohort of 302 children (110 BPD, 80 VLBW without BPD, 112 healthy, term) that have at least one follow up visit. The proposed study addresses MCH Strategic Research Issue IV Promoting the Healthy Development of MCH Populations through its longitudinal study of health and normative development in minority children and children with special health needs, as well as its examination of how child, parental, family coping/resilience are associated with significant injuries and chronic disease conditions. The three aims will focus on growth modeling and traditional longitudinal regression methods using mixed linear models and Generalized Estimating Equations (GEE). Longitudinal analyses will ascertain whether differences emerge early and are maintained or whether these group differences change with development. Aim 1: The differential stability of intelligence will be examined from birth through adolescence. We hypothesized that children with BPD would evidence deficient cognitive skills and be at greater risk for developmental handicaps than either VLBW or term children early in life, with these differences increasing in magnitude during adolescence. Children with VLBW were hypothesized to be deficient in cognitive skills in the first few years of life as well, with this initial difference remaining relatively unchanged in adolescence. Aim 2: The differential stability of linguistic skills will be examined also. Our sample provides a unique opportunity to examine the differential stability of individual dimensions of language, with an eye for how factors like BPD, parenting practices, neurologic, and sociodemographic factors impact language across the developmental continuum. Aim 3: The impact that neonatal medical status and neurological risk factors have on the trajectory of parenting stress, maternal mental health, and coping strategies will be examined. Longitudinal analyses will examine the differential stability of stress within these three cohorts and the effect stress has on children's cognitive and behavioral development. These initial studies will be the basis for future longitudinal analyses, including the differential stability of attention and behavioral problems, the longitudinal consequences of pulmonary problems in children diagnosed with BPD, the developmental trajectory of physical growth in premature and term infants and its relationship to obesity. This secondary data analysis grant will contribute substantially to the diagnosis, prognosis, and treatment of high risk children/ adolescents.Publications
Listed is descending order by year published.
Nelson S, Albert JM, Lombardi G, et al. Dental caries and enamel defects in very low birth weight adolescents. Caries Res. 2010;44(6):509-518.
Singer LT, Fulton S, Kirchner HL, et al. Longitudinal predictors of maternal stress and coping after very low-birth-weight birth. Arch Pediatr Adolesc Med. 2010 Jun;164(6):518-524.
Short EJ, Kirchner HL, Asaad GR, Fulton S, Lewis B, Eisengart S, Baley J, Kercsmar C, Min MO, Singer LT. Long-term sequelae of postnatal surfactant and corticosteroid therapies for BPD. J Perinatol. 2008 Jul;28(7):498-504.
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