Cohort profile: the Neonatal Intensive Care Unit Hospital Exposures and Long-Term Health (NICU-HEALTH) cohort, a prospective preterm birth cohort in New York City

Abstract

PurposeThe Neonatal Intensive Care Unit Hospital Exposures and Long-Term Health (NICU-HEALTH) longitudinal preterm birth cohort studies the impact of the NICU exposome on early-life development. NICU-HEALTH collects multiple biospecimens, complex observational and survey data and comprehensive multisystem outcome assessments to allow measurement of the impact of modifiable environmental exposures during the preterm period on neurodevelopmental, pulmonary and growth outcomes.ParticipantsModerately preterm infants without genetic or congenital anomalies and their mothers are recruited from an urban academic medical centre level IV NICU in New York City, New York, USA. Recruitment began in 2011 and continues through multiple enrolment phases to the present with goal enrolment of 400 infants. Follow-up includes daily data collection throughout the NICU stay and six follow-up visits in the first 2 years. Study retention is 77% to date, with the oldest patients turning age 8 in 2019.Findings to dateNICU-HEALTH has already contributed significantly to our understanding of phthalate exposure in the NICU. Phase I produced the first evidence of the clinical impact of phthalate exposure in the NICU population. Further study identified specific sources of exposure to clinically relevant phthalate mixtures in the NICU.Future plansFollow-up from age 3 to 12 is co-ordinated through integration with the Environmental Influences on Child Health Outcomes (ECHO) programme. The NICU-HEALTH cohort will generate a wealth of biomarker, clinical and outcome data from which future studies of the impact of early-life chemical and non-chemical environmental exposures can benefit. Findings from study of this cohort and other collaborating environmental health cohorts will likely translate into improvements in the hospital environment for infant development.Trial registration numbersThis observational cohort is registered with ClinicalTrials.gov (NCT01420029andNCT01963065).

Fisioterapia: uma abordagem contemporânea - Volume 6

“…A organização Mundial de Saúde define a queda como um evento não intencional, no qual a pessoa perde o equilíbrio e o corpo cai ao piso ou sobre uma superfície firme. Aqueda é um fato comum e muito receoso pelos idosos, por suas consequências desastrosas, que tem como resultado a mudança de posição do indivíduo para um nível mais baixo em relação a um ponto inicial (AGUIAR et al, 2019).…”

“…Atualmente, as lesões decorrentes de quedas são responsáveis por cerca de 70% de mortes acidentais em pessoas acima de 75 anos. Idosos indicam dez vezes mais hospitalizações e oito vezes mais mortes resultantes de quedas (AGUIAR et al, 2019).…”

“…Composta por um conjunto de três ossos: fêmur, tíbia, patela e pelas junções femorotibial e femoropatelar, formando assim os ligamentos cruzados anterior e posterior, colateral lateral e medial, menisco medial e lateral gerando mobilidades em flexão, extensão, rotação interna e rotação externa. Sendo assim, a probabilidade de lesões nesta região é extremamente alta (AGUIAR, 2019;ALVES et al 2021).…”