Assessing Positive Child Health among Individuals Born Extremely Preterm

Bangma, Jacqueline T.; Kwiatkowski, Evan; Psioda, Matthew A.; Santos, Hudson P.; Hooper, Stephen R.; Douglass, Laurie M.; Joseph, Robert M.; Frazier, Jean A.; Kuban, Karl; Fry, Rebecca C.

doi:10.1016/j.jpeds.2018.06.037

Cited by 14 publications

(15 citation statements)

References 28 publications

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“…Eleven adverse outcomes were assessed at the 10-year follow-up: moderate/severe cognitive impairment (7), bilateral blindness (12), hearing impairment (12), gross motor function (GMF) impairment (7); epilepsy (5); attention-deficit/hyperactivity disorder (ADHD) (13); autism (4); anxiety; depression; asthma; and obesity (i.e., body mass index (BMI) above the 95 percentile). Based on these 11 adverse outcomes, a PCHI was generated for each child (8). Supplemental Table S1 compares the maternal and newborn characteristics of the 889 children who were assessed and the 77 children who were not assessed from among the 966 children eligible for study participation.…”

Section: Methodsmentioning

confidence: 99%

“…For example, at ten years of age, in the Extremely Low Gestational Age Newborn (ELGAN) study cohort of children born at less than 28 weeks gestation in the United States, 25% had moderate-to-severe cognitive impairment (3), 7.1% had autism spectrum disorder (4), 7.6% had epilepsy (5), 11.4% had cerebral palsy (6) and 4.9% had severe motor impairment (7). We recently described a positive child health index (PCHI) based on 11 adverse outcomes and found that within the ELGAN cohort, higher values on this index were associated with higher Quality of Life (QoL) scores (8). Notably, 32% of the cohort had none of the 11 adverse outcomes (PCHI of 100%) at age 10.…”

Section: Introductionmentioning

confidence: 99%

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Early life antecedents of positive child health among 10-year-old children born extremely preterm

et al. 2019

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Objective.To identify modifiable antecedents during pre-pregnancy and pregnancy windows associated with a positive child health at 10 years of age.Study design.Data on 889 children enrolled in the Extremely Low Gestational Age Newborn (ELGAN) study in 2002–2004 were analyzed for associations between potentially modifiable maternal antecedents during pre-pregnancy and pregnancy time windows and a previously described positive child health index (PCHI) score at 10 years of age. Stratification by race was also investigated for associations with investigated antecedents.Results.Factors associated with higher PCHI (more positive health) included greater gestational age, birth weight, multiple gestation, and medical interventions, including assisted reproduction, and cervical cerclage. Factors associated with lower PCHI included correlates of lower socioeconomic status, pre-pregnancy chronic medical disorders in the mother like pre-pregnancy BMI, maternal asthma. When stratified by race, variation in significant results was observed.Conclusions.Among children born extremely preterm, medical interventions and higher SES were associated with improved PCHI while chronic illness and high BMI in the mother is associated with lower PCHI at 10 years of age. Knowledge of such antecedent factors could inform efforts to develop interventions that promote positive child health outcomes in future pregnancies.

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Section: Methodsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Early life antecedents of positive child health among 10-year-old children born extremely preterm

et al. 2019

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“…Individuals born preterm also experience a higher risk of health disorders (e.g., asthma) and have a shorter life expectancy [ 8 ]. Our team has investigated 11 health disorders that are associated with preterm birth including bilateral blindness, hearing impairment, moderate/severe cognitive impairment, epilepsy, gross motor function impairment, attention-deficit/hyperactivity disorder, anxiety, depression, asthma, autism, and obesity (i.e., body mass index above the 95 percentile) [ 9 ]. Further, preterm birth in the U.S. is associated with billions of dollars of annual societal economic burden [ 10 ].…”

Section: Introductionmentioning

confidence: 99%

A mixed-effects two-part model for twin-data and an application on identifying important factors associated with extremely preterm children’s health disorders

et al. 2022

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Our recent studies identifying factors significantly associated with the positive child health index (PCHI) in a mixed cohort of preterm-born singletons, twins, and triplets posed some analytic and modeling challenges. The PCHI transforms the total number of health disorders experienced (of the eleven ascertained) to a scale from 0 to 100%. While some of the children had none of the eleven health disorders (i.e., PCHI = 1), others experienced a subset or all (i.e., 0 ≤PCHI< 1). This indicates the existence of two distinct data processes—one for the healthy children, and another for those with at least one health disorder, necessitating a two-part model to accommodate both. Further, the scores for twins and triplets are potentially correlated since these children share similar genetics and early environments. The existing approach for analyzing PCHI data dichotomizes the data (i.e., number of health disorders) and uses a mixed-effects logistic or multiple logistic regression to model the binary feature of the PCHI (1 vs. < 1). To provide an alternate analytic framework, in this study we jointly model the two data processes under a mixed-effects two-part model framework that accounts for the sample correlations between and within the two data processes. The proposed method increases power to detect factors associated with disorders. Extensive numerical studies demonstrate that the proposed joint-test procedure consistently outperforms the existing method when the type I error is controlled at the same level. Our numerical studies also show that the proposed method is robust to model misspecifications and it is applicable to a set of correlated semi-continuous data.

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“…As a first step toward addressing limitations of measures of child health, Bangma et al 2 shows that the positive child health index (PCHI) is correlated with the Pediatric Quality of Life Inventory (PedsQL), which includes measures of quality of life across physical and psychosocial domains as reported by a parent or guardian. The developed PCHI aims to make a connection on the state of well-being of the child beyond the perception of a parent or guardian.…”

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confidence: 99%

“…Once determined to be associated with the PedQL, the strength of Bangma et al 2 was the development of a PCHI measure that utilizes disease susceptibility or health to further interrogate aspects of positive child health. There are, however, aspects of positive health that can only be ascertained from the individual directly.…”

mentioning

confidence: 99%