Cortisol awakening response and developmental outcomes at 6–7 years in children born extremely preterm

Jean Lowe; Janell F. Fuller; Allison G. Dempsey; Barbara Do; Carla M. Bann; Abhik Das; Kathryn E. Gustafson; Betty R. Vohr; Susan R. Hintz; Kristi L. Watterberg; Alan H. Jobe; Michael S. Caplan; Richard A. Polin; Abbot R. Laptook; Angelita M. Hensman; Elisa Vieira; Emilee Little; Katharine Johnson; Barbara Alksninis; Mary Lenore Keszler; Andrea M. Knoll; Theresa M. Leach; Elisabeth C. McGowan; Victoria E. Watson; Michele C. Walsh; Avroy A. Fanaroff; Allison Payne; Deanne E. Wilson-Costello; Nancy S. Newman; Bonnie S. Siner; Arlene Zadell; Julie DiFiore; Monika Bhola; Harriet G. Friedman; Gulgun Yalcinkaya; Ronald N. Goldberg; C. Michael Cotten; Kathryn E. Gustafson; Ricki F. Goldstein; Patricia Ashley; Kathy J. Auten; Kimberley A. Fisher; Katherine A. Foy; Sharon F. Freedman; Melody B. Lohmeyer; William F. Malcolm; David K. Wallace; David P. Carlton; Barbara J. Stoll; Ira Adams-Chapman; Susie Buchter; Anthony J. Piazza; Sheena Carter; Sobha Fritz; Ellen C. Hale; Amy K. Hutchinson; Maureen Mulligan LaRossa; Yvonne Loggins; Diane Bottcher; Rosemary D. Higgins; Stephanie Wilson Archer; Brenda B. Poindexter; Gregory M. Sokol; Heidi M. Harmon; Lu Ann Papile; Abbey C. Hines; Leslie D. Wilson; Dianne E. Herron; Lucy Smiley; Douglas A. Granger; Kathleen A. Kennedy; Jon E. Tyson; Andrea F. Duncan; Allison G. Dempsey; Janice John; Patrick M. Jones; M. Layne Lillie; Saba Siddiki; Daniel K. Sperry; Carol J. Blaisdell; Abhik Das; Dennis Wallace; Marie G. Gantz; Jeanette O’Donnell Auman; Jane A. Hammond; Jamie E. Newman; W. Kenneth Poole; Krisa P. Van Meurs; David K. Stevenson; M. Bethany Ball; Maria Elena DeAnda; Gabrielle T. Goodlin; Ivan D. Frantz; John M. Fiascone; Elisabeth C. McGowan; Anne Kurfiss; Brenda L. MacKinnon; Ellen Nylen; Ana Brussa; Cecelia Sibley; Waldemar A. Carlo; Namasivayam Ambalavanan; Monica V. Collins; Shirley S. Cosby; Vivien A. Phillips; Kristy Domanovich; Sally Whitley; Leigh Ann Smith; Carin R. Kiser; Neil N. Finer; Donna Garey; Maynard R. Rasmussen; Paul R. Wozniak; Yvonne E. Vaucher; Martha G. Fuller; Natacha Akshoomoff; Wade Rich; Kathy Arnell; Renee Bridge; Elysia Poggi Davis; Edward F. Bell; Tarah T. Colaizy; John A. Widness; Jonathan M. Klein; Karen J. Johnson; Michael J. Acarregui; Diane L. Eastman; Tammy L.V. Wilgenbusch; Robin K. Ohls; Conra Backstrom Lacy; Rebecca A. Thomson; Sandra Brown; Pablo J. Sánchez; Roy J. Heyne; Charles R. Rosenfeld; Walid A. Salhab; Luc Brion; Sally S. Adams; James Allen; Laura Grau; Alicia Guzman; Gaynelle Hensley; Elizabeth T. Heyne; Jackie F. Hickman; Lizette E. Lee; Melissa H. Leps; Linda A. Madden; Melissa Swensen Martin; Nancy A. Miller; Janet S. Morgan; Araceli Solis; Catherine Twell Boatman; Diana M. Vasil; Bradley A. Yoder; Roger G. Faix; Shawna Baker; Karen A. Osborne; Carrie A. Rau; Sarah Winter; Sean D. Cunningham; Ariel C. Ford; Seetha Shankaran; Athina Pappas; Beena G. Sood; Rebecca Bara; Thomas L. Slovis; Laura A. Goldston; Mary Johnson

doi:10.1038/s41390-022-02113-9

Cortisol awakening response and developmental outcomes at 6–7 years in children born extremely preterm

Jean Lowe, Janell F. Fuller, Allison G. Dempsey, Barbara Do, Carla M. Bann, Abhik Das, Kathryn E. Gustafson, Betty R. Vohr, Susan R. Hintz, Kristi L. Watterberg, Alan H. Jobe, Michael S. Caplan, Richard A. Polin, Abbot R. Laptook, Angelita M. Hensman, Elisa Vieira, Emilee Little, Katharine Johnson, Barbara Alksninis, Mary Lenore KeszlerAndrea M. Knoll, Theresa M. Leach, Elisabeth C. McGowan, Victoria E. Watson, Michele C. Walsh, Avroy A. Fanaroff, Allison Payne, Deanne E. Wilson-Costello, Nancy S. Newman, Bonnie S. Siner, Arlene Zadell, Julie DiFiore, Monika Bhola, Harriet G. Friedman, Gulgun Yalcinkaya, Ronald N. Goldberg, C. Michael Cotten, Kathryn E. Gustafson, Ricki F. Goldstein, Patricia Ashley, Kathy J. Auten, Kimberley A. Fisher, Katherine A. Foy, Sharon F. Freedman, Melody B. Lohmeyer, William F. Malcolm, David K. Wallace, David P. Carlton, Barbara J. Stoll, Ira Adams-Chapman, Susie Buchter, Anthony J. Piazza, Sheena Carter, Sobha Fritz, Ellen C. Hale, Amy K. Hutchinson, Maureen Mulligan LaRossa, Yvonne Loggins, Diane Bottcher, Rosemary D. Higgins, Stephanie Wilson Archer, Brenda B. Poindexter, Gregory M. Sokol, Heidi M. Harmon, Lu Ann Papile, Abbey C. Hines, Leslie D. Wilson, Dianne E. Herron, Lucy Smiley, Douglas A. Granger, Kathleen A. Kennedy, Jon E. Tyson, Andrea F. Duncan, Allison G. Dempsey, Janice John, Patrick M. Jones, M. Layne Lillie, Saba Siddiki, Daniel K. Sperry, Carol J. Blaisdell, Abhik Das, Dennis Wallace, Marie G. Gantz, Jeanette O’Donnell Auman, Jane A. Hammond, Jamie E. Newman, W. Kenneth Poole, Krisa P. Van Meurs, David K. Stevenson, M. Bethany Ball, Maria Elena DeAnda, Gabrielle T. Goodlin, Ivan D. Frantz, John M. Fiascone, Elisabeth C. McGowan, Anne Kurfiss, Brenda L. MacKinnon, Ellen Nylen, Ana Brussa, Cecelia Sibley, Waldemar A. Carlo, Namasivayam Ambalavanan, Monica V. Collins, Shirley S. Cosby, Vivien A. Phillips, Kristy Domanovich, Sally Whitley, Leigh Ann Smith, Carin R. Kiser, Neil N. Finer, Donna Garey, Maynard R. Rasmussen, Paul R. Wozniak, Yvonne E. Vaucher, Martha G. Fuller, Natacha Akshoomoff, Wade Rich, Kathy Arnell, Renee Bridge, Elysia Poggi Davis, Edward F. Bell, Tarah T. Colaizy, John A. Widness, Jonathan M. Klein, Karen J. Johnson, Michael J. Acarregui, Diane L. Eastman, Tammy L.V. Wilgenbusch, Robin K. Ohls, Conra Backstrom Lacy, Rebecca A. Thomson, Sandra Brown, Pablo J. Sánchez, Roy J. Heyne, Charles R. Rosenfeld, Walid A. Salhab, Luc Brion, Sally S. Adams, James Allen, Laura Grau, Alicia Guzman, Gaynelle Hensley, Elizabeth T. Heyne, Jackie F. Hickman, Lizette E. Lee, Melissa H. Leps, Linda A. Madden, Melissa Swensen Martin, Nancy A. Miller, Janet S. Morgan, Araceli Solis, Catherine Twell Boatman, Diana M. Vasil, Bradley A. Yoder, Roger G. Faix, Shawna Baker, Karen A. Osborne, Carrie A. Rau, Sarah Winter, Sean D. Cunningham, Ariel C. Ford, Seetha Shankaran, Athina Pappas, Beena G. Sood, Rebecca Bara, Thomas L. Slovis, Laura A. Goldston, Mary Johnson

Research output: Contribution to journal › Article › peer-review

2 Scopus citations

Abstract

Background: Extremely preterm (EPT) birth has been related to dysregulation of stress responses and behavioral/learning problems at school age. Early adverse experiences can blunt HPA axis reactivity. We hypothesized that an attenuated cortisol awakening response would be associated with developmental and behavioral problems at school age in EPT children. Methods: This secondary analysis of a sub-cohort of the SUPPORT study included children born between 24 and 27 weeks, evaluated at 6–7 years with a neurodevelopmental battery and cortisol measures. Differences were tested between EPT and a term-born group. Relationships of cortisol awakening response to test scores were analyzed. Results: Cortisol was measured in 110 EPT and 29 term-born 6–7 year olds. Unadjusted WISC-IV and NEPSY-II scores were significantly worse among EPT children only. Conners Parent Rating Scale behavior scores were significantly worse among EPT children. After adjusting for covariates, blunted cortisol awakening responses were found to be associated with poorer scores on memory tests and greater problems with inattention for the EPT group (p < 0.05) only. Conclusions: Among children born EPT, we identified an association of blunted cortisol awakening response with memory and inattention problems. This may have implications related to stress reactivity and its relationship to learning problems in children born EPT. ClinicalTrials.gov ID: Extended Follow-up at School Age for the SUPPORT Neuroimaging and Neurodevelopmental Outcomes (NEURO) Cohort: NCT00233324. Impact: In children born EPT, stress reactivity may have a relationship to learning problems. Cortisol awakening response should be a component for follow-up in EPT born children. Components of executive function, such as memory and attention, are related to stress reactivity.

Original language	English (US)
Pages (from-to)	689-695
Number of pages	7
Journal	Pediatric Research
Volume	93
Issue number	3
DOIs	https://doi.org/10.1038/s41390-022-02113-9
State	Published - Feb 2023

ASJC Scopus subject areas

Pediatrics, Perinatology, and Child Health

Access to Document

10.1038/s41390-022-02113-9

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Lowe, J., Fuller, J. F., Dempsey, A. G., Do, B., Bann, C. M., Das, A., Gustafson, K. E., Vohr, B. R., Hintz, S. R., Watterberg, K. L., Jobe, A. H., Caplan, M. S., Polin, R. A., Laptook, A. R., Hensman, A. M., Vieira, E., Little, E., Johnson, K., Alksninis, B., ... Johnson, M. (2023). Cortisol awakening response and developmental outcomes at 6–7 years in children born extremely preterm. Pediatric Research, 93(3), 689-695. https://doi.org/10.1038/s41390-022-02113-9

Lowe, J, Fuller, JF, Dempsey, AG, Do, B, Bann, CM, Das, A, Gustafson, KE, Vohr, BR, Hintz, SR, Watterberg, KL, Jobe, AH, Caplan, MS, Polin, RA, Laptook, AR, Hensman, AM, Vieira, E, Little, E, Johnson, K, Alksninis, B, Keszler, ML, Knoll, AM, Leach, TM, McGowan, EC, Watson, VE, Walsh, MC, Fanaroff, AA, Payne, A, Wilson-Costello, DE, Newman, NS, Siner, BS, Zadell, A, DiFiore, J, Bhola, M, Friedman, HG, Yalcinkaya, G, Goldberg, RN, Cotten, CM, Gustafson, KE, Goldstein, RF, Ashley, P, Auten, KJ, Fisher, KA, Foy, KA, Freedman, SF, Lohmeyer, MB, Malcolm, WF, Wallace, DK, Carlton, DP, Stoll, BJ, Adams-Chapman, I, Buchter, S, Piazza, AJ, Carter, S, Fritz, S, Hale, EC, Hutchinson, AK, LaRossa, MM, Loggins, Y, Bottcher, D, Higgins, RD, Archer, SW, Poindexter, BB, Sokol, GM, Harmon, HM, Papile, LA, Hines, AC, Wilson, LD, Herron, DE, Smiley, L, Granger, DA, Kennedy, KA, Tyson, JE, Duncan, AF, Dempsey, AG, John, J, Jones, PM, Lillie, ML, Siddiki, S, Sperry, DK, Blaisdell, CJ, Das, A, Wallace, D, Gantz, MG, O’Donnell Auman, J, Hammond, JA, Newman, JE, Poole, WK, Van Meurs, KP, Stevenson, DK, Ball, MB, DeAnda, ME, Goodlin, GT, Frantz, ID, Fiascone, JM, McGowan, EC, Kurfiss, A, MacKinnon, BL, Nylen, E, Brussa, A, Sibley, C, Carlo, WA, Ambalavanan, N, Collins, MV, Cosby, SS, Phillips, VA, Domanovich, K, Whitley, S, Smith, LA, Kiser, CR, Finer, NN, Garey, D, Rasmussen, MR, Wozniak, PR, Vaucher, YE, Fuller, MG, Akshoomoff, N, Rich, W, Arnell, K, Bridge, R, Davis, EP, Bell, EF, Colaizy, TT, Widness, JA, Klein, JM, Johnson, KJ, Acarregui, MJ, Eastman, DL, Wilgenbusch, TLV, Ohls, RK, Lacy, CB, Thomson, RA, Brown, S, Sánchez, PJ, Heyne, RJ , Rosenfeld, CR, Salhab, WA, Brion, L, Adams, SS, Allen, J, Grau, L, Guzman, A, Hensley, G, Heyne, ET, Hickman, JF, Lee, LE, Leps, MH, Madden, LA, Martin, MS, Miller, NA, Morgan, JS, Solis, A, Boatman, CT, Vasil, DM, Yoder, BA, Faix, RG, Baker, S, Osborne, KA, Rau, CA, Winter, S, Cunningham, SD, Ford, AC, Shankaran, S, Pappas, A, Sood, BG, Bara, R, Slovis, TL, Goldston, LA & Johnson, M 2023, 'Cortisol awakening response and developmental outcomes at 6–7 years in children born extremely preterm', Pediatric Research, vol. 93, no. 3, pp. 689-695. https://doi.org/10.1038/s41390-022-02113-9

@article{fbbf6221dd6749aa9f5109cfe48fd383,

title = "Cortisol awakening response and developmental outcomes at 6–7 years in children born extremely preterm",

abstract = "Background: Extremely preterm (EPT) birth has been related to dysregulation of stress responses and behavioral/learning problems at school age. Early adverse experiences can blunt HPA axis reactivity. We hypothesized that an attenuated cortisol awakening response would be associated with developmental and behavioral problems at school age in EPT children. Methods: This secondary analysis of a sub-cohort of the SUPPORT study included children born between 24 and 27 weeks, evaluated at 6–7 years with a neurodevelopmental battery and cortisol measures. Differences were tested between EPT and a term-born group. Relationships of cortisol awakening response to test scores were analyzed. Results: Cortisol was measured in 110 EPT and 29 term-born 6–7 year olds. Unadjusted WISC-IV and NEPSY-II scores were significantly worse among EPT children only. Conners Parent Rating Scale behavior scores were significantly worse among EPT children. After adjusting for covariates, blunted cortisol awakening responses were found to be associated with poorer scores on memory tests and greater problems with inattention for the EPT group (p < 0.05) only. Conclusions: Among children born EPT, we identified an association of blunted cortisol awakening response with memory and inattention problems. This may have implications related to stress reactivity and its relationship to learning problems in children born EPT. ClinicalTrials.gov ID: Extended Follow-up at School Age for the SUPPORT Neuroimaging and Neurodevelopmental Outcomes (NEURO) Cohort: NCT00233324. Impact: In children born EPT, stress reactivity may have a relationship to learning problems. Cortisol awakening response should be a component for follow-up in EPT born children. Components of executive function, such as memory and attention, are related to stress reactivity.",

author = "Jean Lowe and Fuller, {Janell F.} and Dempsey, {Allison G.} and Barbara Do and Bann, {Carla M.} and Abhik Das and Gustafson, {Kathryn E.} and Vohr, {Betty R.} and Hintz, {Susan R.} and Watterberg, {Kristi L.} and Jobe, {Alan H.} and Caplan, {Michael S.} and Polin, {Richard A.} and Laptook, {Abbot R.} and Hensman, {Angelita M.} and Elisa Vieira and Emilee Little and Katharine Johnson and Barbara Alksninis and Keszler, {Mary Lenore} and Knoll, {Andrea M.} and Leach, {Theresa M.} and McGowan, {Elisabeth C.} and Watson, {Victoria E.} and Walsh, {Michele C.} and Fanaroff, {Avroy A.} and Allison Payne and Wilson-Costello, {Deanne E.} and Newman, {Nancy S.} and Siner, {Bonnie S.} and Arlene Zadell and Julie DiFiore and Monika Bhola and Friedman, {Harriet G.} and Gulgun Yalcinkaya and Goldberg, {Ronald N.} and Cotten, {C. Michael} and Gustafson, {Kathryn E.} and Goldstein, {Ricki F.} and Patricia Ashley and Auten, {Kathy J.} and Fisher, {Kimberley A.} and Foy, {Katherine A.} and Freedman, {Sharon F.} and Lohmeyer, {Melody B.} and Malcolm, {William F.} and Wallace, {David K.} and Carlton, {David P.} and Stoll, {Barbara J.} and Ira Adams-Chapman and Susie Buchter and Piazza, {Anthony J.} and Sheena Carter and Sobha Fritz and Hale, {Ellen C.} and Hutchinson, {Amy K.} and LaRossa, {Maureen Mulligan} and Yvonne Loggins and Diane Bottcher and Higgins, {Rosemary D.} and Archer, {Stephanie Wilson} and Poindexter, {Brenda B.} and Sokol, {Gregory M.} and Harmon, {Heidi M.} and Papile, {Lu Ann} and Hines, {Abbey C.} and Wilson, {Leslie D.} and Herron, {Dianne E.} and Lucy Smiley and Granger, {Douglas A.} and Kennedy, {Kathleen A.} and Tyson, {Jon E.} and Duncan, {Andrea F.} and Dempsey, {Allison G.} and Janice John and Jones, {Patrick M.} and Lillie, {M. Layne} and Saba Siddiki and Sperry, {Daniel K.} and Blaisdell, {Carol J.} and Abhik Das and Dennis Wallace and Gantz, {Marie G.} and {O{\textquoteright}Donnell Auman}, Jeanette and Hammond, {Jane A.} and Newman, {Jamie E.} and Poole, {W. Kenneth} and {Van Meurs}, {Krisa P.} and Stevenson, {David K.} and Ball, {M. Bethany} and DeAnda, {Maria Elena} and Goodlin, {Gabrielle T.} and Frantz, {Ivan D.} and Fiascone, {John M.} and McGowan, {Elisabeth C.} and Anne Kurfiss and MacKinnon, {Brenda L.} and Ellen Nylen and Ana Brussa and Cecelia Sibley and Carlo, {Waldemar A.} and Namasivayam Ambalavanan and Collins, {Monica V.} and Cosby, {Shirley S.} and Phillips, {Vivien A.} and Kristy Domanovich and Sally Whitley and Smith, {Leigh Ann} and Kiser, {Carin R.} and Finer, {Neil N.} and Donna Garey and Rasmussen, {Maynard R.} and Wozniak, {Paul R.} and Vaucher, {Yvonne E.} and Fuller, {Martha G.} and Natacha Akshoomoff and Wade Rich and Kathy Arnell and Renee Bridge and Davis, {Elysia Poggi} and Bell, {Edward F.} and Colaizy, {Tarah T.} and Widness, {John A.} and Klein, {Jonathan M.} and Johnson, {Karen J.} and Acarregui, {Michael J.} and Eastman, {Diane L.} and Wilgenbusch, {Tammy L.V.} and Ohls, {Robin K.} and Lacy, {Conra Backstrom} and Thomson, {Rebecca A.} and Sandra Brown and S{\'a}nchez, {Pablo J.} and Heyne, {Roy J.} and Rosenfeld, {Charles R.} and Salhab, {Walid A.} and Luc Brion and Adams, {Sally S.} and James Allen and Laura Grau and Alicia Guzman and Gaynelle Hensley and Heyne, {Elizabeth T.} and Hickman, {Jackie F.} and Lee, {Lizette E.} and Leps, {Melissa H.} and Madden, {Linda A.} and Martin, {Melissa Swensen} and Miller, {Nancy A.} and Morgan, {Janet S.} and Araceli Solis and Boatman, {Catherine Twell} and Vasil, {Diana M.} and Yoder, {Bradley A.} and Faix, {Roger G.} and Shawna Baker and Osborne, {Karen A.} and Rau, {Carrie A.} and Sarah Winter and Cunningham, {Sean D.} and Ford, {Ariel C.} and Seetha Shankaran and Athina Pappas and Sood, {Beena G.} and Rebecca Bara and Slovis, {Thomas L.} and Goldston, {Laura A.} and Mary Johnson",

note = "Publisher Copyright: {\textcopyright} The Author(s), under exclusive licence to the International Pediatric Research Foundation, Inc 2022.",

year = "2023",

month = feb,

doi = "10.1038/s41390-022-02113-9",

language = "English (US)",

volume = "93",

pages = "689--695",

journal = "Pediatric Research",

issn = "0031-3998",

publisher = "Lippincott Williams and Wilkins",

number = "3",

}

TY - JOUR

T1 - Cortisol awakening response and developmental outcomes at 6–7 years in children born extremely preterm

AU - Lowe, Jean

AU - Fuller, Janell F.

AU - Dempsey, Allison G.

AU - Do, Barbara

AU - Bann, Carla M.

AU - Das, Abhik

AU - Gustafson, Kathryn E.

AU - Vohr, Betty R.

AU - Hintz, Susan R.

AU - Watterberg, Kristi L.

AU - Jobe, Alan H.

AU - Caplan, Michael S.

AU - Polin, Richard A.

AU - Laptook, Abbot R.

AU - Hensman, Angelita M.

AU - Vieira, Elisa

AU - Little, Emilee

AU - Johnson, Katharine

AU - Alksninis, Barbara

AU - Keszler, Mary Lenore

AU - Knoll, Andrea M.

AU - Leach, Theresa M.

AU - McGowan, Elisabeth C.

AU - Watson, Victoria E.

AU - Walsh, Michele C.

AU - Fanaroff, Avroy A.

AU - Payne, Allison

AU - Wilson-Costello, Deanne E.

AU - Newman, Nancy S.

AU - Siner, Bonnie S.

AU - Zadell, Arlene

AU - DiFiore, Julie

AU - Bhola, Monika

AU - Friedman, Harriet G.

AU - Yalcinkaya, Gulgun

AU - Goldberg, Ronald N.

AU - Cotten, C. Michael

AU - Gustafson, Kathryn E.

AU - Goldstein, Ricki F.

AU - Ashley, Patricia

AU - Auten, Kathy J.

AU - Fisher, Kimberley A.

AU - Foy, Katherine A.

AU - Freedman, Sharon F.

AU - Lohmeyer, Melody B.

AU - Malcolm, William F.

AU - Wallace, David K.

AU - Carlton, David P.

AU - Stoll, Barbara J.

AU - Adams-Chapman, Ira

AU - Buchter, Susie

AU - Piazza, Anthony J.

AU - Carter, Sheena

AU - Fritz, Sobha

AU - Hale, Ellen C.

AU - Hutchinson, Amy K.

AU - LaRossa, Maureen Mulligan

AU - Loggins, Yvonne

AU - Bottcher, Diane

AU - Higgins, Rosemary D.

AU - Archer, Stephanie Wilson

AU - Poindexter, Brenda B.

AU - Sokol, Gregory M.

AU - Harmon, Heidi M.

AU - Papile, Lu Ann

AU - Hines, Abbey C.

AU - Wilson, Leslie D.

AU - Herron, Dianne E.

AU - Smiley, Lucy

AU - Granger, Douglas A.

AU - Kennedy, Kathleen A.

AU - Tyson, Jon E.

AU - Duncan, Andrea F.

AU - Dempsey, Allison G.

AU - John, Janice

AU - Jones, Patrick M.

AU - Lillie, M. Layne

AU - Siddiki, Saba

AU - Sperry, Daniel K.

AU - Blaisdell, Carol J.

AU - Das, Abhik

AU - Wallace, Dennis

AU - Gantz, Marie G.

AU - O’Donnell Auman, Jeanette

AU - Hammond, Jane A.

AU - Newman, Jamie E.

AU - Poole, W. Kenneth

AU - Van Meurs, Krisa P.

AU - Stevenson, David K.

AU - Ball, M. Bethany

AU - DeAnda, Maria Elena

AU - Goodlin, Gabrielle T.

AU - Frantz, Ivan D.

AU - Fiascone, John M.

AU - McGowan, Elisabeth C.

AU - Kurfiss, Anne

AU - MacKinnon, Brenda L.

AU - Nylen, Ellen

AU - Brussa, Ana

AU - Sibley, Cecelia

AU - Carlo, Waldemar A.

AU - Ambalavanan, Namasivayam

AU - Collins, Monica V.

AU - Cosby, Shirley S.

AU - Phillips, Vivien A.

AU - Domanovich, Kristy

AU - Whitley, Sally

AU - Smith, Leigh Ann

AU - Kiser, Carin R.

AU - Finer, Neil N.

AU - Garey, Donna

AU - Rasmussen, Maynard R.

AU - Wozniak, Paul R.

AU - Vaucher, Yvonne E.

AU - Fuller, Martha G.

AU - Akshoomoff, Natacha

AU - Rich, Wade

AU - Arnell, Kathy

AU - Bridge, Renee

AU - Davis, Elysia Poggi

AU - Bell, Edward F.

AU - Colaizy, Tarah T.

AU - Widness, John A.

AU - Klein, Jonathan M.

AU - Johnson, Karen J.

AU - Acarregui, Michael J.

AU - Eastman, Diane L.

AU - Wilgenbusch, Tammy L.V.

AU - Ohls, Robin K.

AU - Lacy, Conra Backstrom

AU - Thomson, Rebecca A.

AU - Brown, Sandra

AU - Sánchez, Pablo J.

AU - Heyne, Roy J.

AU - Rosenfeld, Charles R.

AU - Salhab, Walid A.

AU - Brion, Luc

AU - Adams, Sally S.

AU - Allen, James

AU - Grau, Laura

AU - Guzman, Alicia

AU - Hensley, Gaynelle

AU - Heyne, Elizabeth T.

AU - Hickman, Jackie F.

AU - Lee, Lizette E.

AU - Leps, Melissa H.

AU - Madden, Linda A.

AU - Martin, Melissa Swensen

AU - Miller, Nancy A.

AU - Morgan, Janet S.

AU - Solis, Araceli

AU - Boatman, Catherine Twell

AU - Vasil, Diana M.

AU - Yoder, Bradley A.

AU - Faix, Roger G.

AU - Baker, Shawna

AU - Osborne, Karen A.

AU - Rau, Carrie A.

AU - Winter, Sarah

AU - Cunningham, Sean D.

AU - Ford, Ariel C.

AU - Shankaran, Seetha

AU - Pappas, Athina

AU - Sood, Beena G.

AU - Bara, Rebecca

AU - Slovis, Thomas L.

AU - Goldston, Laura A.

AU - Johnson, Mary

N1 - Publisher Copyright: © The Author(s), under exclusive licence to the International Pediatric Research Foundation, Inc 2022.

PY - 2023/2

Y1 - 2023/2

N2 - Background: Extremely preterm (EPT) birth has been related to dysregulation of stress responses and behavioral/learning problems at school age. Early adverse experiences can blunt HPA axis reactivity. We hypothesized that an attenuated cortisol awakening response would be associated with developmental and behavioral problems at school age in EPT children. Methods: This secondary analysis of a sub-cohort of the SUPPORT study included children born between 24 and 27 weeks, evaluated at 6–7 years with a neurodevelopmental battery and cortisol measures. Differences were tested between EPT and a term-born group. Relationships of cortisol awakening response to test scores were analyzed. Results: Cortisol was measured in 110 EPT and 29 term-born 6–7 year olds. Unadjusted WISC-IV and NEPSY-II scores were significantly worse among EPT children only. Conners Parent Rating Scale behavior scores were significantly worse among EPT children. After adjusting for covariates, blunted cortisol awakening responses were found to be associated with poorer scores on memory tests and greater problems with inattention for the EPT group (p < 0.05) only. Conclusions: Among children born EPT, we identified an association of blunted cortisol awakening response with memory and inattention problems. This may have implications related to stress reactivity and its relationship to learning problems in children born EPT. ClinicalTrials.gov ID: Extended Follow-up at School Age for the SUPPORT Neuroimaging and Neurodevelopmental Outcomes (NEURO) Cohort: NCT00233324. Impact: In children born EPT, stress reactivity may have a relationship to learning problems. Cortisol awakening response should be a component for follow-up in EPT born children. Components of executive function, such as memory and attention, are related to stress reactivity.

AB - Background: Extremely preterm (EPT) birth has been related to dysregulation of stress responses and behavioral/learning problems at school age. Early adverse experiences can blunt HPA axis reactivity. We hypothesized that an attenuated cortisol awakening response would be associated with developmental and behavioral problems at school age in EPT children. Methods: This secondary analysis of a sub-cohort of the SUPPORT study included children born between 24 and 27 weeks, evaluated at 6–7 years with a neurodevelopmental battery and cortisol measures. Differences were tested between EPT and a term-born group. Relationships of cortisol awakening response to test scores were analyzed. Results: Cortisol was measured in 110 EPT and 29 term-born 6–7 year olds. Unadjusted WISC-IV and NEPSY-II scores were significantly worse among EPT children only. Conners Parent Rating Scale behavior scores were significantly worse among EPT children. After adjusting for covariates, blunted cortisol awakening responses were found to be associated with poorer scores on memory tests and greater problems with inattention for the EPT group (p < 0.05) only. Conclusions: Among children born EPT, we identified an association of blunted cortisol awakening response with memory and inattention problems. This may have implications related to stress reactivity and its relationship to learning problems in children born EPT. ClinicalTrials.gov ID: Extended Follow-up at School Age for the SUPPORT Neuroimaging and Neurodevelopmental Outcomes (NEURO) Cohort: NCT00233324. Impact: In children born EPT, stress reactivity may have a relationship to learning problems. Cortisol awakening response should be a component for follow-up in EPT born children. Components of executive function, such as memory and attention, are related to stress reactivity.

UR - http://www.scopus.com/inward/record.url?scp=85148017935&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=85148017935&partnerID=8YFLogxK

U2 - 10.1038/s41390-022-02113-9

DO - 10.1038/s41390-022-02113-9

M3 - Article

C2 - 35715492

AN - SCOPUS:85148017935

SN - 0031-3998

VL - 93

SP - 689

EP - 695

JO - Pediatric Research

JF - Pediatric Research

IS - 3

ER -

Cortisol awakening response and developmental outcomes at 6–7 years in children born extremely preterm

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