{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,10]],"date-time":"2026-11-10T15:05:29Z","timestamp":1794323129467,"version":"4.9.0"},"reference-count":0,"publisher":"European Society of Medicine","issue":"10","license":[{"start":{"date-parts":[[2025,10,28]],"date-time":"2025-10-28T00:00:00Z","timestamp":1761609600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["MRAJ"],"abstract":"<jats:p>This paper summarizes risk and protective factors modulating cognitive, language and motor outcomes in a cohort of preterm infants from Connecticut Children's Medical Center and University of Connecticut Health Center. Infants were born at 23-30 weeks gestational age and admitted to the neonatal unit (1991 \u2013 2017). Extracted and de-identified patient data included sex, gestational age (GA), birthweight, maternal health conditions (pre-eclampsia, diabetes, etc.), presence of necrotizing enterocolitis, intra-ventricular hemorrhage and grade, maternal magnesium sulfate (MGS) treatment, and administration of the methylxanthine (MX) adenosine antagonists (caffeine or theophylline) and timing (&lt; 48 hrs from birth (early) or &gt; 48 hrs (late)). Outcome measures were obtained at 18-month follow-up evaluations (Bayley Scale and\/or Cognitive Adaptive Test\/Clinical Linguistic and Auditory Milestone Scale). Scores on different components of the tests were z-scored and averaged into 3 categories for each infant as Language, Cognitive, and Motor indices. Significant risk factors for poor outcomes were found to include: (1) being male, (2) extremely low birthweight (a better predictor of poor outcome than low GA), (3) positive inflammatory perinatal profile; and (4) MGS exposure in males, particularly when followed by early MX treatment. Factors leading to significantly better outcomes included: (1) MX exposure within 48 hours of birth, particularly in infants with inflammation (but excluding males with prior MGS exposure); and (2) perinatal MGS exposure, particularly in lower birthweight females (but excluding early MX-treated males). This novel evidence of sub-group specific therapeutic benefits and harms emphasizes a serious need for additional research on individualized therapeutic interventions for at-risk preterm infants and reveals a novel deleterious interaction between magnesium sulfate exposure and subsequent treatment with methyxanthines (e.g., caffeine) within 48 hours of birth for preterm boys.<\/jats:p>","DOI":"10.18103\/mra.v13i10.7027","type":"journal-article","created":{"date-parts":[[2025,11,2]],"date-time":"2025-11-02T16:47:17Z","timestamp":1762102037000},"source":"Crossref","is-referenced-by-count":0,"title":["Protective versus Risk Factors for 18-month Outcomes in a multi-decade sample of preterm infants age 23-30 weeks"],"prefix":"10.18103","volume":"13","author":[{"given":"Ted S.","family":"Rosenkrantz","sequence":"first","affiliation":[{"name":"Dept of Pediatrics, University of Connecticut School of Medicine and Connecticut Childrens Medical Center"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ruth M.","family":"McLeod","sequence":"additional","affiliation":[{"name":"Dept. of Psychology, Kutztown University, Kutztown, PA, 19530"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"R. Holly","family":"Fitch","sequence":"additional","affiliation":[{"name":"Dept. of Psychological Sciences\/Behavioral Neuroscience, University of Connecticut, Storrs, CT, 06268."}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"7483","published-online":{"date-parts":[[2025,10,28]]},"container-title":["Medical Research Archives"],"original-title":[],"link":[{"URL":"https:\/\/esmed.org\/MRA\/mra\/article\/download\/7027\/99193549672","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/esmed.org\/MRA\/mra\/article\/download\/7027\/99193549672","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,10,16]],"date-time":"2026-10-16T14:07:21Z","timestamp":1792159641000},"score":1,"resource":{"primary":{"URL":"https:\/\/esmed.org\/MRA\/mra\/article\/view\/7027"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,10,28]]},"references-count":0,"journal-issue":{"issue":"10","published-online":{"date-parts":[[2025,11,1]]}},"URL":"https:\/\/doi.org\/10.18103\/mra.v13i10.7027","relation":{},"ISSN":["2375-1924","2375-1916"],"issn-type":[{"value":"2375-1924","type":"electronic"},{"value":"2375-1916","type":"print"}],"subject":[],"published":{"date-parts":[[2025,10,28]]}}}