The Brown Center For The

Study Of Children At Risk






Brown Center for the Study of Children at Risk
50 Holden Street
Providence RI 02908

Academic Administration:
(401) 453-7640

Clinical Services:
(401) 274-1122
x8936 or x8935

Contact Us

 

Preterm Infant Development

Preterm Infant to Adult Study

This study is funded by the NIH National Institute of Nursing Research and follows a unique group of 213 preterm infants born at Women & Infants Hospital between 1985 to 1989. It is one of the longest studies of preterm infants in the United States. Its purpose is to learn about development outcomes of preterm and full term infants from birth to young adulthood. Specifically, the study examines the influences of prematurity, medical, social, and other factors on achievements and deficits during young adulthood. Biomarkers of blood chemistry, pulmonary function testing, cardiopulmonary response to exercise and metabolic functioning, and HPA (hypothalamic-pituitary adrenal axis) function by salivary cortisol are also examined to better understand the impact prematurity has on health and early disease. With rising numbers of preterm infant survivors, this study serves as a model to understand how preterm infants born today will do when they reach adulthood. We expect that the results from this study may improve the care of future preterm infants and children, as well as help professionals and parents understand how preterm infants develop as young adults. It will allow professionals to make accurate predictions about the necessity, timing, and content of interventions required to promote, support, and sustain normal development. Formulating a science of prevention requires attention to complex interactions between infants and their contexts across periods of time.  For more information contact:  Mary Sullivan at MCSullivan@uri.edu or visit the study website.

Effects of Open-Bay vs. Single Room NICU on Infant Outcomes at Discharge

Prematurity is an increasing public health concern as the rate of prematurity in the U.S. is on the rise. Efforts to improve preterm infant outcomes include environmental stimulation (sound and light), psychosocial factors, developmental care, family centered care and staff behavior and attitudes. Women and Infants Hospital is building a new NICU with 70 individual single rooms. The “single family room” model of care is one of the environments thought to enhance medical and developmental outcomes. The single room concept is attractive because factors that adversely affect the infant can be better controlled, patient care can be individualized and parent satisfaction can be improved. However, nearly all of the evidence is anecdotal. This study aims to compare the medical and neurodevelopmental course from birth through discharge from the NICU between infants in the current open bay nursery with infants in the new single room nursery. This provides an exciting one-time opportunity to conduct a naturalistic study and compare infant outcome in the current open bay nursery with the outcome of infants in the coming single room nursery. Our plan is to study virtually all infants in the NICU, with birthweight <1500 gms, for four consecutive years, two years before and two years after the move to the new NICU. We hypothesize that infants in the single room NICU will have better medical and neurobehavioral outcomes at discharge than infants in the open bay NICU. Medical outcomes include length of stay, gestational age at discharge, weight, weight gain, illness severity and resource utilization, gestational age at enteral feeding, sepsis and necrotizing enterocolitis. Neurobehavioral outcomes include better NICU Network Neurobehavioral Scale (NNNS) profiles, better sleep state organization and sleep physiology, better infant mother feeding interaction scores and lower pain scores. We also hypothesize that the positive effects of the new NICU will be explained in part by other mediating factors that can be expected to co-occur with the transition to the new NICU. These factors include changes in family centered care, developmental care, parenting and family factors, staff behavior and attitudes and changes in medical practice. These factors will be measured repeatedly before and after the move to the new NICU and used as mediators in the statistical analysis. Findings from this study will likely influence the future quality of NICU design and model of care throughout the Nation. For more information contact: Katheleen Hawes at 274-1122 ext. 8966 or khawes@wihri.org.