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This study examined associations between SES, structural and functional development of neonatal hippocampus, and 18\u2010month cognition in very preterm neonates.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>In total, 179 preterm neonates were followed prospectively. Structural and resting\u2010state functional MRI were obtained early\u2010in\u2010life and at term\u2010equivalent age (median 32.9 and 41.1\u2009weeks post\u2010menstrual age) to calculate anterior and posterior hippocampal volumes and hippocampal functional connectivity strength. Eighteen\u2010month cognition was assessed via Bayley\u2010III. Longitudinal statistical analysis using generalized estimating equations, accounting for birth gestational age, post\u2010menstrual age at scan, sex, and motion, was performed.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>SES, measured as maternal education level, modified associations between anterior but not posterior hippocampal volumes and 18\u2010month cognition (interaction term <jats:italic>p<\/jats:italic>\u2009=\u20090.005), and between hippocampal connectivity and cognition (interaction term <jats:italic>p<\/jats:italic>\u2009=\u20090.05). Greater anterior hippocampal volumes and hippocampal connectivity were associated with higher cognitive scores only in the lowest SES group. Maternal education alone did not predict neonatal hippocampal volume from early\u2010in\u2010life and term.<\/jats:p><\/jats:sec><jats:sec><jats:title>Interpretation<\/jats:title><jats:p>SES modified the relationship between neonatal hippocampal development and 18\u2010month cognition in very preterm neonates. The lack of direct association between maternal education and neonatal hippocampal volumes indicates that socio\u2010environmental factors beyond the neonatal period contribute to modifying the relationship between hippocampal development and cognition. These findings point toward opportunities to more equitably promote optimal neurodevelopmental outcomes in very preterm infants.<\/jats:p><\/jats:sec>","DOI":"10.1002\/acn3.52168","type":"journal-article","created":{"date-parts":[[2024,8,8]],"date-time":"2024-08-08T22:53:42Z","timestamp":1723157622000},"page":"2499-2513","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":11,"title":["Socioeconomic status moderates associations between hippocampal development and cognition in preterms"],"prefix":"10.1002","volume":"11","author":[{"ORCID":"https:\/\/orcid.org\/0009-0002-8454-7363","authenticated-orcid":false,"given":"Julia","family":"Konrad","sequence":"first","affiliation":[{"name":"Department of Pediatrics The Hospital for Sick Children and University of Toronto  Toronto Ontario Canada"},{"name":"Department of Pediatrics Children's Hospital Dritter Orden  Munich 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