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Type: Journal article
Title: Biological and social influences on outcomes of extreme-preterm/low-birth weight adolescents
Author: Doyle, L.W.
Cheong, J.L.Y.
Burnett, A.
Roberts, G.
Lee, K.J.
Anderson, P.J.
Citation: Pediatrics, 2015; 136(6):E1513-E1520
Publisher: American Academy of Pediatrics
Issue Date: 2015
ISSN: 0031-4005
Statement of
Lex W. Doyle, Jeanie L.Y. Cheong, Alice Burnett, Gehan Roberts, Katherine J. Lee, Peter J. Anderson and for the Victorian Infant Collaborative Study Group
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.
Keywords: Victorian Infant Collaborative Study Group
Infant, Premature, Diseases
Intensive Care, Neonatal
Risk Factors
Case-Control Studies
Follow-Up Studies
Social Environment
Socioeconomic Factors
Child, Preschool
Infant, Newborn
Infant, Extremely Low Birth Weight
Infant, Extremely Premature
Protective Factors
Rights: Copyright © 2015 by the American Academy of Pediatrics.
DOI: 10.1542/peds.2015-2006
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Paediatrics publications

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