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Cognitive Risk Mapping in Low Birthweight Children

Blair, Lisa M
http://orcid.org/0000-0002-6169-5876
http://rave.ohiolink.edu/etdc/view?acc_num=osu153202738375901

Abstract Details

2018, Doctor of Philosophy, Ohio State University, Nursing.
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.
Cindy Anderson, PhD (Committee Chair)
Rita Pickler, PhD (Committee Member)
Jodi Ford, PhD (Committee Member)
Paul Gugiu, PhD (Committee Member)
Cindy Munro, PhD (Committee Member)
129 p.
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;

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Citations

  • Blair, L. M. (2018). Cognitive Risk Mapping in Low Birthweight Children [Doctoral dissertation, Ohio State University]. OhioLINK Electronic Theses and Dissertations Center. http://rave.ohiolink.edu/etdc/view?acc_num=osu153202738375901

    APA Style (7th edition)

  • Blair, Lisa. Cognitive Risk Mapping in Low Birthweight Children. 2018. Ohio State University, Doctoral dissertation. OhioLINK Electronic Theses and Dissertations Center, http://rave.ohiolink.edu/etdc/view?acc_num=osu153202738375901.

    MLA Style (8th edition)

  • Blair, Lisa. "Cognitive Risk Mapping in Low Birthweight Children." Doctoral dissertation, Ohio State University, 2018. http://rave.ohiolink.edu/etdc/view?acc_num=osu153202738375901

    Chicago Manual of Style (17th edition)

osu153202738375901
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This open access ETD is published by The Ohio State University and OhioLINK.