The clinical core is a unique resource for the efficient, cost-effective support of major research projects examining the impact of prenatal alcohol exposure on perinatal/infant outcome. The Core's broad, long- term objectives are to maintain for study a high-risk, inner-city population and to make alcohol/drug screening techniques available to other research projects within the Center, other institutions, and other health-care facilities. The main goals for this Core are: 1) to provide reliable data collection from a woman's first visit to the antenatal clinic up to 12 months postpartum; 2) to coordinate patient recruitment within and between studies; 3) to coordinate the transition of subjects from one study to the next with minimal loss; and 4) to continue to refine screening and retention techniques for use in other clinical studies of alcohol misuse. To accomplish these goals, the three Core functions -- prenatal screening, tracking of infants to 12 months, and developmental testing -- are headed by an Associate Director for each function. Approximately 10,000 Black gravidas will be interviewed in the antenatal clinic over 4 years. Of these, approximately 1,400 will be recruited into three studies. This subsample of 1,400 will receive repeated in- pregnancy interviews, and postpartum in-person and phone interviews. Four hundred of these women will be followed for as long as five years through two pregnancies. Their children will receive dysmorphologic examinations at birth and developmental tests at 12 months postpartum. A subset of these infants will receive Brain-stem Auditory Evoked Potential (BAEP) at birth and 12 months. The Home Observation of the Environment (HOME) will be assessed on the same sample. For all human studies, data will be maintained in a centralized data base with medical/obstetrical information for each subject. The Clinical Core will provide greater efficiency in accessing and maintaining human subjects, as well s reliable data collection of various dependent variables obtained consistently through a long period, thus enabling stable comparisons. This component will be under the direction of Principal Investigator and Project Director and Associate Directors for the prenatal period, tracking, and developmental testing.
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