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Biological exposures adversely impact cognitive outcomes in preterm survivors
Biological exposures, such as intraventricular hemorrhage and postnatal corticosteroids, adversely affected cognitive and academic functioning among survivors of extreme preterm birth and extremely low weight birth, according to recent data in Pediatrics.
“Contrary to expectations, several perinatal biological exposures had large and persistent adverse associations with cognitive and academic outcomes among extremely preterm survivors,” Lex W. Doyle, MD, MSc, head of clinical research development at Royal Women’s Hospital in Melbourne, Australia, and colleagues wrote. “The magnitude of the biological associations mostly equals or exceeds those of social exposures, even in late adolescence.”
The researchers compared a group of 298 children born before 28 weeks gestation or weighing less than 1,000 g with a control group of 262 normal birth weight children. Study participants were born between 1991 and 1992. Variable group members were matched for comparison with controls by gender, maternal country of origin and maternal health insurance status. The researchers measured cognitive ability when participants were aged 2, 5, 8 and 18 years, and they assessed academic ability at 8 and 18 years.
Cognitive and academic scores were significantly lower in the preterm group compared with the control group at every age. The biological exposures that impacted cognitive and academic ability the most were intraventricular hemorrhage and postnatal corticosteroid therapy. Other biological exposures included cystic periventricular leukomalacia and surgery requiring an anesthetic.
The researchers wrote that among social exposures, being raised in a multilingual household was disadvantageous at earlier ages, while social class and maternal education status were found to impact cognitive and academic ability at later ages.
“Some social variables assumed increasing importance in later years but mostly did not diminish or exceed the important biological associations,” Doyle and colleagues wrote. “The relative importance of biological vs. social exposures on outcomes later in adulthood, and the influence of other biological and proximal social variables, requires further evaluation.” – by David Costill
Disclosure: The researchers report no relevant financial disclosures.
