The purposes of this study are to compare the effectiveness and clinical utility of 4 indices of biological risk in predicting the developmental and health outcomes of premature infants and to examine how these measures interact with social risks. The ultimate goal of this study is to identify infants in need of intervention. Early intervention service resources could then be targeted to infants most likely to benefit from them Specific research questions to be addressed are: effectiveness of 4 indices of biological risk -- sleeping and waking state maturation, EEG dysmaturity, neurological insults (NBRS), and visual recognition memory -- in predicting 9- and 27-month health and developmental outcomes of premature infants; relation between the indices of biological risk; interaction of the biological risk indices with social risk indices (overall quality of the environment and mother-infant interactions) in predicting 9- and 27-month developmental and health outcome of premature; and the identification of effective prediction equations for developmental and health outcomes. One hundred and thirty high-risk preterm infants from two hospitals will be recruited as soon as their medical conditions are no longer critical and will be followed until 2 years past term. During the preterm period, 2-hour state observation and respiration recordings will be conducted weekly up to 8 time and repeated at 1-month post-term. This data will be used to determine the developmental trajectories of sleep-wake states and related behaviors. EEG's will be conducted during the second, fourth and eight observations and at 1-month. Visual attention measures will be obtained at 2, 6, and 9 months. Home visits will be made at 6 and 18 months to score the HOME Inventory and videotape mother-infant interactions. Outcome measures will be the Bayley II at 9 and 27 months, a language test at 27 months, infant growth parameters throughout the first 2 years, and the health problems experienced by age 2. Data analysis will concentrate on determining similarities and differences in the biological risk indices, determining the degree to which biological and social risks interact to predict outcome, identifying a prediction equation for each outcome, and determining the sensitivity and specificity of these equations.

Agency
National Institute of Health (NIH)
Institute
National Institute of Nursing Research (NINR)
Type
Research Project (R01)
Project #
5R01NR001894-09
Application #
6363748
Study Section
Nursing Research Study Section (NURS)
Program Officer
Bryan, Yvonne E
Project Start
1988-08-01
Project End
2003-02-28
Budget Start
2001-03-01
Budget End
2003-02-28
Support Year
9
Fiscal Year
2001
Total Cost
$386,171
Indirect Cost
Name
University of North Carolina Chapel Hill
Department
Other Health Professions
Type
Schools of Nursing
DUNS #
078861598
City
Chapel Hill
State
NC
Country
United States
Zip Code
27599
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Bozzette, Maryann; Holditch-Davis, Diane (2015) A Preliminary Study of Depressive Symptoms in Mothers of 3-Year-Old Prematurely Born Children. Child Health Care 44:54-68
Scher, Mark S; Johnson, Mark W; Ludington, Susan M et al. (2011) Physiologic brain dysmaturity in late preterm infants. Pediatr Res 70:524-8
Cho, June; Holditch-Davis, Diane; Miles, Margaret S (2010) Effects of gender on the health and development of medically at-risk infants. J Obstet Gynecol Neonatal Nurs 39:536-49
Holditch-Davis, Diane; Levy, Janet (2010) Potential Pitfalls in Collecting and Analyzing Longitudinal Data from Chronically Ill Populations. Newborn Infant Nurs Rev 10:10-18
Holditch-Davis, Diane; Merrill, Piper; Schwartz, Todd et al. (2008) Predictors of wheezing in prematurely born children. J Obstet Gynecol Neonatal Nurs 37:262-73
Cho, June; Holditch-Davis, Diane; Miles, Margaret S (2008) Effects of maternal depressive symptoms and infant gender on the interactions between mothers and their medically at-risk infants. J Obstet Gynecol Neonatal Nurs 37:58-70