Cognitive Risk Mapping in Low Birthweight Children

Ohio State University, Columbus OH

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Abstract

PROJECT SUMMARY Low birthweight (LBW), or weight less than 2,500g at birth, is a serious public health problem in the United States, affecting 8% of all births and more than 13% of births to African Americans. Adults and children born LBW have previously been found to have delays in general measures of cognition, language processing, visual processing, executive function, and academic achievement. These delays limit education attainment, socioeconomic mobility, and quality of life across the lifespan. Despite these compelling health disparities, no national standard exists for referral to early intervention for LBW children. Current regional strategies for referral rely on waiting for significant delays to develop or referring all infants below a threshold birthweight or gestational age, but these thresholds vary significantly across communities and considerable variation exists in outcomes even for ?low risk? LBW infants born above 1,500g. According to life course and child development theories, social context, including socioeconomic status, exerts a powerful influence on child development, including cognitive development, and may help explain this variation, but referrals made solely on the basis of socioeconomic status would quickly overwhelm the capacities of intervention programs and providers in communities where the highest rates of LBW occur. Identification of key factors beyond socioeconomic status that protect cognitive development or place it at risk, including both family-level social context and neighborhood/community contexts, would allow providers to determine which children were most in need of early intervention. In addition to social context, recent gains in genetic and genomic analysis have implicated genetic variation in susceptibility to environmental risks for poor neurodevelopmental outcomes across the lifespan. This proposed secondary analysis research seeks to examine these possible explanations for risk variation using data from the Fragile Families and Child Wellbeing Study, a nationally-representative longitudinal cohort of children born in 1998-2000. Specifically, our aims are to 1) examine relationships between early life social risk/protective factors and cognition in LBW school-aged children, and 2) examine relationships between selected genetic variants (COMT, BDNF, and 5-HTTLPR) and cognition in LBW school- aged children. Completion of this research will identify key social contextual and genetic antecedents to cognitive dysfunction that will inform development of a risk-based model for early intervention referral and that may present novel targets for intervention research. The goals of the training plan are to provide the applicant with diverse educational and professional experiences supporting her career objective of becoming an independent researcher and nursing faculty member in a research-intensive academic setting.