Cognitive Risk Mapping in Low Birthweight Children

Bibliographic Details
Main Author:	Blair, Lisa M.
Language:	English
Published:	The Ohio State University / OhioLINK 2018
Subjects:	Nursing Statistics Low Birth Weight genetics BDNF SLC6A4 COMT preterm birth social determinants of health life course health toxic stress neurodevelopment cognition Rasch nursing NICU
Online Access:	http://rave.ohiolink.edu/etdc/view?acc_num=osu153202738375901

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spelling	ndltd-OhioLink-oai-etd.ohiolink.edu-osu1532027383759012021-08-16T05:10:40Z Cognitive Risk Mapping in Low Birthweight Children Blair, Lisa M. Nursing Statistics Low Birth Weight genetics BDNF SLC6A4 COMT preterm birth social determinants of health life course health toxic stress neurodevelopment cognition Rasch nursing NICU Low birthweight is a serious public health problem in the United States, affecting 8% of all births with severe regional and ethnic disparities. Low birthweight children have previously been found to have persistent deficits in both general cognition and domain-specific cognitive outcomes. These deficits limit educational attainment, socioeconomic mobility, and quality of life. Current strategies for referral to early intervention services rely on waiting for significant delays to develop or referring all infants below a threshold birthweight or gestational age. Thresholds vary between settings and considerable variation exists in outcomes even for “low risk” low birthweight infants. Thus, referral criteria beyond birth weight and gestational age are needed..Social contexts and genetic variation both play important roles in the development of cognition. Low birthweight infants may be more susceptible to harmful effects of social contexts and genetic variation based on their comparative physiologic fragility and altered early life experiences. This study examined possible explanations for risk variation in cognitive outcomes of low birthweight children using data from the Fragile Families and Child Wellbeing Study, a nationally-representative longitudinal cohort. Specifically, our aims were to examine relationships between cognition in low birthweight, school-aged children and 1) early life social contexts, and 2) genetic variants of COMT, BDNF, and SLC6A4. To address the first aim, we constructed a standardized composite of four measures of general and domain-specific cognition and developed a series of models to estimate the effect of social contexts on cognition in low birthweight children at age 9 years (n = 140). A panel of social contexts (i.e. risk and protective factors) that were measurable at the birth of the focal child were selected based on prior empiric and theoretical relationships to child development. Our final model was statistically significant (F = 76.85, df = 16, p <.0001, R2 = .35,) and explained 35% of the total variability in cognitive scores, (R2¿ = .26) 26% more of the total variability than the "standard care" model of birthweight and gestational age alone (R2 = .09). The candidate genes for our second aim were selected based on biological plausibility to affect cognitive development, empiric evidence in the literature associating the gene with neurodevelopment and availability within the Fragile Families genotypic data. We constructed a multiple regression model that revealed that homozygous cytosine at single nucleotide polymorphism of BDNF (rs4074134) was related to significantly improved scores on the composite measure of cognition (ß = 0.62, SE 0.28, t = 2.26, p = .03, 95% CI [0.06-1.18]). Additionally, carriers of a rare, extra-long copy number variant of SLC6A4 and a long allele demonstrated statistically significantly improved composite scores (ß = 0.88, SE 0.42, t = 2.09, p = .04, 95% CI [0.02-1.74]).By demonstrating the potential for social contexts and genetic factors to assist with identifying risk for cognitive deficits in low birthweight children and those whose cognitive abilities are relatively protected, our findings contribute preliminary evidence necessary for the development of needs-based criteria for referral to early intervention. 2018-12-27 English text The Ohio State University / OhioLINK http://rave.ohiolink.edu/etdc/view?acc_num=osu153202738375901 http://rave.ohiolink.edu/etdc/view?acc_num=osu153202738375901 unrestricted This thesis or dissertation is protected by copyright: all rights reserved. It may not be copied or redistributed beyond the terms of applicable copyright laws.
collection	NDLTD
language	English
sources	NDLTD
topic	Nursing Statistics Low Birth Weight genetics BDNF SLC6A4 COMT preterm birth social determinants of health life course health toxic stress neurodevelopment cognition Rasch nursing NICU
spellingShingle	Nursing Statistics Low Birth Weight genetics BDNF SLC6A4 COMT preterm birth social determinants of health life course health toxic stress neurodevelopment cognition Rasch nursing NICU Blair, Lisa M. Cognitive Risk Mapping in Low Birthweight Children
author	Blair, Lisa M.
author_facet	Blair, Lisa M.
author_sort	Blair, Lisa M.
title	Cognitive Risk Mapping in Low Birthweight Children
title_short	Cognitive Risk Mapping in Low Birthweight Children
title_full	Cognitive Risk Mapping in Low Birthweight Children
title_fullStr	Cognitive Risk Mapping in Low Birthweight Children
title_full_unstemmed	Cognitive Risk Mapping in Low Birthweight Children
title_sort	cognitive risk mapping in low birthweight children
publisher	The Ohio State University / OhioLINK
publishDate	2018
url	http://rave.ohiolink.edu/etdc/view?acc_num=osu153202738375901
work_keys_str_mv	AT blairlisam cognitiveriskmappinginlowbirthweightchildren
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Cognitive Risk Mapping in Low Birthweight Children

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