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https://hdl.handle.net/2440/130405
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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 1098-4275 |
Statement of Responsibility: | 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 Humans Infant, Premature, Diseases Intensive Care, Neonatal Risk Factors Case-Control Studies Follow-Up Studies Achievement Cognition Social Environment Socioeconomic Factors Adolescent Child Child, Preschool Infant, Newborn Female Male 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 |
Grant ID: | http://purl.org/au-research/grants/nhmrc/1060733 http://purl.org/au-research/grants/nhmrc/491246 http://purl.org/au-research/grants/nhmrc/628371 http://purl.org/au-research/grants/nhmrc/1053609 http://purl.org/au-research/grants/nhmrc/1053787 |
Published version: | http://dx.doi.org/10.1542/peds.2015-2006 |
Appears in Collections: | Aurora harvest 4 Paediatrics publications |
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