{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,19]],"date-time":"2026-09-19T20:22:10Z","timestamp":1789849330847,"version":"4.0.1"},"reference-count":30,"publisher":"American Academy of Pediatrics (AAP)","issue":"6","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2015,12,1]]},"abstract":"\n BACKGROUND AND OBJECTIVES:<\/jats:title>\n 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.<\/jats:p>\n <\/jats:sec>\n \n METHODS:<\/jats:title>\n The study included 298 consecutive survivors born at &lt;28 weeks\u2019 gestation or weighing &lt;1000 g in Victoria, Australia (during 1991\u20131992), and 262 normal birth weight (&gt;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.<\/jats:p>\n <\/jats:sec>\n \n RESULTS:<\/jats:title>\n 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.<\/jats:p>\n <\/jats:sec>\n \n CONCLUSIONS:<\/jats:title>\n 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.<\/jats:p>\n <\/jats:sec>","DOI":"10.1542\/peds.2015-2006","type":"journal-article","created":{"date-parts":[[2015,11,10]],"date-time":"2015-11-10T02:13:16Z","timestamp":1447121596000},"page":"e1513-e1520","source":"Crossref","is-referenced-by-count":125,"title":["Biological and Social Influences on Outcomes of Extreme-Preterm\/Low-Birth Weight Adolescents"],"prefix":"10.1542","volume":"136","author":[{"given":"Lex W.","family":"Doyle","sequence":"first","affiliation":[{"name":"Departments of Obstetrics and Gynaecology, and"},{"name":"Paediatrics, University of Melbourne, Melbourne, Australia;"},{"name":"Royal Women\u2019s Hospital, Melbourne, Australia;"},{"name":"Murdoch Childrens Research Institute, Melbourne, Australia; and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jeanie L.Y.","family":"Cheong","sequence":"additional","affiliation":[{"name":"Departments of Obstetrics and Gynaecology, and"},{"name":"Royal Women\u2019s Hospital, Melbourne, Australia;"},{"name":"Murdoch Childrens Research Institute, Melbourne, Australia; and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alice","family":"Burnett","sequence":"additional","affiliation":[{"name":"Paediatrics, University of Melbourne, Melbourne, Australia;"},{"name":"Royal Women\u2019s Hospital, Melbourne, Australia;"},{"name":"Murdoch Childrens Research Institute, Melbourne, Australia; and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gehan","family":"Roberts","sequence":"additional","affiliation":[{"name":"Murdoch Childrens Research Institute, Melbourne, Australia; and"},{"name":"Royal Children\u2019s Hospital, Melbourne, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Katherine 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