Perinatal morbidity and preschool motor performance of two NICU cohorts born 10 years apart

2.50
Hdl Handle:
http://hdl.handle.net/10755/163474
Category:
Abstract
Type:
Presentation
Title:
Perinatal morbidity and preschool motor performance of two NICU cohorts born 10 years apart
Author(s):
Sullivan, Mary; McGrath, Margaret M.
Author Details:
Mary Sullivan, Associate Professor, University of Rhode Island, College of Nursing, West Kingston, Rhode Island, USA, email: mcsullivan@uri.edu; Margaret M. McGrath
Abstract:
Purpose: Prenatal steroids, surfactant for respiratory distress syndrome, indomethacin to prevent intraventricular hemorrhage, better feeding and nutrition, and improved pulmonary ventilation are credited for increased survival rates of premature infants. The technology of Neonatal Intensive Care Unit (NICU) care in 90's differs from that of ten years earlier, allowing smaller infants to survive. These infants are a heterogeneous group due to various medical and/or neurological morbidities that occur during the neonatal period. With increasing numbers of NICU survivors, the focus of follow-up studies has shifted to gain a better understanding of the scope and nature of subtle long-term morbidities. Poor preschool motor performance has been shown to compromise later school success, but it is equivocal how motor function is related to perinatal morbidity and newer NICU technologies. The purpose of this study is to investigate perinatal morbidity and preschool motor function in two cohorts of preterm infants born 10 years apart. Specific Aim: To compare general motor, fine motor, gross motor and visual-motor integration at age 4 in two cohort samples of NICU survivors grouped by perinatal risk. Motor performance data for Cohort 1 (1985-89) have been collected. For Cohort 2 (1996-98), identical dimensions of motor performance are currently being assessed. Framework: This study utilizes the transactional model, which incorporates biological (perinatal morbidity) and environmental influences on child development. Preschool motor delay is not solely attributed to adverse consequences of prematurity, but reflect the continual interplay between the developing child and his/her dynamic environment. Methods: Both of these cohort samples are from a large tertiary medical center with the best ranking in the nation for survival and quality of outcomes for the lowest birth weight preterm infants. These children received the latest advances in neonatal care representing the potential for both the best and worst motor outcomes. Both cohorts were recruited at birth and grouped by perinatal morbidity as (1) full term, healthy infants (FT); (2) preterm infants with medical illness (MPT); (3) preterm infants with neurological illness (NPT). Cohort 1 has 124 infants. Data collection for Cohort 2 is ongoing with 60 infants seen at age 4 at the present time. Socioeconomic status was stratified within groups in both cohorts. Identical dimensions of motor performance were used for both Cohorts. The instruments are well standardized with excellent reliability and validity and are sensitive to the weaknesses that preschoolers born at medical risk may exhibit. Results and Conclusions: Cohort 1: Significant differences were found in general motor, fine motor, gross motor and visual-motor integration at age 4. Scores for the groups decreased with increasing morbidity (i.e., FT> MPT> NPT). Children with motor delay at age 4 had lower school achievement and higher rates of school services at age 8. Preliminary results for Cohort 2,born 10 years after Cohort 1, find significant differences in general motor, fine motor and gross motor at age 4. Motor scores for the full term group in both cohorts are consistent with the standardized norms for 4 year olds. Implications: The innovation of this study lies in its precise, relevant and circumscribed focus and its reliance on existing data coupled with primary data collection to compare cohorts of survivors separated by a decade from a nationally recognized clinical and research center for high risk infants. With the technological advances of the past decade, it is expected that Cohort 2 will be more fragile and have lower birth weight and younger gestational age. Identification of subtle motor deficits as precursors to school outcomes inform neonatal, early intervention, and school programs.
Repository Posting Date:
27-Oct-2011
Date of Publication:
27-Oct-2011
Conference Date:
2002
Conference Name:
14th Annual Scientific Sessions
Conference Host:
Eastern Nursing Research Society
Conference Location:
University Park, Pennsylvania, USA
Note:
This is an abstract-only submission. If the author has submitted a full-text item based on this abstract, you may find it by browsing the Virginia Henderson Global Nursing e-Repository by author. If author contact information is available in this abstract, please feel free to contact him or her with your queries regarding this submission. Alternatively, please contact the conference host, journal, or publisher (according to the circumstance) for further details regarding this item. If a citation is listed in this record, the item has been published and is available via open-access avenues or a journal/database subscription. Contact your library for assistance in obtaining the as-published article.

Full metadata record

DC FieldValue Language
dc.type.categoryAbstracten_US
dc.typePresentationen_GB
dc.titlePerinatal morbidity and preschool motor performance of two NICU cohorts born 10 years aparten_GB
dc.contributor.authorSullivan, Maryen_US
dc.contributor.authorMcGrath, Margaret M.en_US
dc.author.detailsMary Sullivan, Associate Professor, University of Rhode Island, College of Nursing, West Kingston, Rhode Island, USA, email: mcsullivan@uri.edu; Margaret M. McGrathen_US
dc.identifier.urihttp://hdl.handle.net/10755/163474-
dc.description.abstractPurpose: Prenatal steroids, surfactant for respiratory distress syndrome, indomethacin to prevent intraventricular hemorrhage, better feeding and nutrition, and improved pulmonary ventilation are credited for increased survival rates of premature infants. The technology of Neonatal Intensive Care Unit (NICU) care in 90's differs from that of ten years earlier, allowing smaller infants to survive. These infants are a heterogeneous group due to various medical and/or neurological morbidities that occur during the neonatal period. With increasing numbers of NICU survivors, the focus of follow-up studies has shifted to gain a better understanding of the scope and nature of subtle long-term morbidities. Poor preschool motor performance has been shown to compromise later school success, but it is equivocal how motor function is related to perinatal morbidity and newer NICU technologies. The purpose of this study is to investigate perinatal morbidity and preschool motor function in two cohorts of preterm infants born 10 years apart. Specific Aim: To compare general motor, fine motor, gross motor and visual-motor integration at age 4 in two cohort samples of NICU survivors grouped by perinatal risk. Motor performance data for Cohort 1 (1985-89) have been collected. For Cohort 2 (1996-98), identical dimensions of motor performance are currently being assessed. Framework: This study utilizes the transactional model, which incorporates biological (perinatal morbidity) and environmental influences on child development. Preschool motor delay is not solely attributed to adverse consequences of prematurity, but reflect the continual interplay between the developing child and his/her dynamic environment. Methods: Both of these cohort samples are from a large tertiary medical center with the best ranking in the nation for survival and quality of outcomes for the lowest birth weight preterm infants. These children received the latest advances in neonatal care representing the potential for both the best and worst motor outcomes. Both cohorts were recruited at birth and grouped by perinatal morbidity as (1) full term, healthy infants (FT); (2) preterm infants with medical illness (MPT); (3) preterm infants with neurological illness (NPT). Cohort 1 has 124 infants. Data collection for Cohort 2 is ongoing with 60 infants seen at age 4 at the present time. Socioeconomic status was stratified within groups in both cohorts. Identical dimensions of motor performance were used for both Cohorts. The instruments are well standardized with excellent reliability and validity and are sensitive to the weaknesses that preschoolers born at medical risk may exhibit. Results and Conclusions: Cohort 1: Significant differences were found in general motor, fine motor, gross motor and visual-motor integration at age 4. Scores for the groups decreased with increasing morbidity (i.e., FT> MPT> NPT). Children with motor delay at age 4 had lower school achievement and higher rates of school services at age 8. Preliminary results for Cohort 2,born 10 years after Cohort 1, find significant differences in general motor, fine motor and gross motor at age 4. Motor scores for the full term group in both cohorts are consistent with the standardized norms for 4 year olds. Implications: The innovation of this study lies in its precise, relevant and circumscribed focus and its reliance on existing data coupled with primary data collection to compare cohorts of survivors separated by a decade from a nationally recognized clinical and research center for high risk infants. With the technological advances of the past decade, it is expected that Cohort 2 will be more fragile and have lower birth weight and younger gestational age. Identification of subtle motor deficits as precursors to school outcomes inform neonatal, early intervention, and school programs.en_GB
dc.date.available2011-10-27T11:08:12Z-
dc.date.issued2011-10-27en_GB
dc.date.accessioned2011-10-27T11:08:12Z-
dc.conference.date2002en_US
dc.conference.name14th Annual Scientific Sessionsen_US
dc.conference.hostEastern Nursing Research Societyen_US
dc.conference.locationUniversity Park, Pennsylvania, USAen_US
dc.description.noteThis is an abstract-only submission. If the author has submitted a full-text item based on this abstract, you may find it by browsing the Virginia Henderson Global Nursing e-Repository by author. If author contact information is available in this abstract, please feel free to contact him or her with your queries regarding this submission. Alternatively, please contact the conference host, journal, or publisher (according to the circumstance) for further details regarding this item. If a citation is listed in this record, the item has been published and is available via open-access avenues or a journal/database subscription. Contact your library for assistance in obtaining the as-published article.-
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