Lex W Doyle1, Jeanie L Y Cheong2, Alice Burnett3, Gehan Roberts4, Katherine J Lee5, Peter J Anderson5. 1. Departments of Obstetrics and Gynaecology, and Paediatrics, University of Melbourne, Melbourne, Australia; Royal Women's Hospital, Melbourne, Australia; Murdoch Childrens Research Institute, Melbourne, Australia; and lwd@unimelb.edu.au. 2. Departments of Obstetrics and Gynaecology, and Royal Women's Hospital, Melbourne, Australia; Murdoch Childrens Research Institute, Melbourne, Australia; and. 3. Paediatrics, University of Melbourne, Melbourne, Australia; Royal Women's Hospital, Melbourne, Australia; Murdoch Childrens Research Institute, Melbourne, Australia; and. 4. Murdoch Childrens Research Institute, Melbourne, Australia; and Royal Children's Hospital, Melbourne, Australia. 5. Paediatrics, University of Melbourne, Melbourne, Australia; Murdoch Childrens Research Institute, Melbourne, Australia; and.
Abstract
BACKGROUND AND OBJECTIVES: The importance of biological versus social influences on long-term outcomes of extremely preterm children is debatable. The goal of this study was to determine the relative contributions of biological and social exposures to outcomes into adolescence in extremely preterm survivors, hypothesizing that biological exposures would be more important early, but social exposures would dominate later. METHODS: The study included 298 consecutive survivors born at <28 weeks' gestation or weighing <1000 g in Victoria, Australia (during 1991-1992), and 262 normal birth weight (>2499 g) control subjects who were used to standardize outcomes for the preterm group. Cognitive ability was assessed at 2, 5, 8, and 18 years of age. Academic achievement was assessed at 8 and 18 years of age. RESULTS: The differences between the preterm and control groups for cognitive and academic scores remained relatively constant over time. The biological variables most associated with worse outcomes within the extremely preterm group were intraventricular hemorrhage and postnatal corticosteroid therapy. Of the social variables, being reared in a multilingual household was disadvantageous early, with social class and maternal education becoming more important for later outcomes. The strength of the biological associations mostly equaled or exceeded those of social exposures, even in late adolescence. CONCLUSIONS: Contrary to expectations, several perinatal biological exposures had large and persistent adverse associations with cognitive and academic outcomes among extremely preterm survivors. As expected, some social variables assumed increasing importance in later years but mostly did not diminish or exceed the important biological associations.
BACKGROUND AND OBJECTIVES: The importance of biological versus social influences on long-term outcomes of extremely preterm children is debatable. The goal of this study was to determine the relative contributions of biological and social exposures to outcomes into adolescence in extremely preterm survivors, hypothesizing that biological exposures would be more important early, but social exposures would dominate later. METHODS: The study included 298 consecutive survivors born at <28 weeks' gestation or weighing <1000 g in Victoria, Australia (during 1991-1992), and 262 normal birth weight (>2499 g) control subjects who were used to standardize outcomes for the preterm group. Cognitive ability was assessed at 2, 5, 8, and 18 years of age. Academic achievement was assessed at 8 and 18 years of age. RESULTS: The differences between the preterm and control groups for cognitive and academic scores remained relatively constant over time. The biological variables most associated with worse outcomes within the extremely preterm group were intraventricular hemorrhage and postnatal corticosteroid therapy. Of the social variables, being reared in a multilingual household was disadvantageous early, with social class and maternal education becoming more important for later outcomes. The strength of the biological associations mostly equaled or exceeded those of social exposures, even in late adolescence. CONCLUSIONS: Contrary to expectations, several perinatal biological exposures had large and persistent adverse associations with cognitive and academic outcomes among extremely preterm survivors. As expected, some social variables assumed increasing importance in later years but mostly did not diminish or exceed the important biological associations.
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Authors: Peter J Anderson; Karli Treyvaud; Jeffrey J Neil; Jeanie L Y Cheong; Rodney W Hunt; Deanne K Thompson; Katherine J Lee; Lex W Doyle; Terrie E Inder Journal: J Pediatr Date: 2017-06-02 Impact factor: 4.406
Authors: R Cuzzilla; A J Spittle; K J Lee; S Rogerson; F M Cowan; L W Doyle; J L Y Cheong Journal: AJNR Am J Neuroradiol Date: 2018-05-17 Impact factor: 3.825
Authors: Robert Eves; Marina Mendonça; Nicole Baumann; Yanyan Ni; Brian A Darlow; John Horwood; Lianne J Woodward; Lex W Doyle; Jeanie Cheong; Peter J Anderson; Peter Bartmann; Neil Marlow; Samantha Johnson; Eero Kajantie; Petteri Hovi; Chiara Nosarti; Marit S Indredavik; Kari-Anne I Evensen; Katri Räikkönen; Kati Heinonen; Jennifer Zeitlin; Dieter Wolke Journal: JAMA Pediatr Date: 2021-08-02 Impact factor: 26.796