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Poverty and InequalitySexual and Reproductive HealthFamily, Maternal & Child HealthMethodology

Prematurity, Birth Weight, and Socioeconomic Status Are Linked to Atypical Diurnal Hypothalamic-Pituitary-Adrenal Axis Activity in Young Adults

TitlePrematurity, Birth Weight, and Socioeconomic Status Are Linked to Atypical Diurnal Hypothalamic-Pituitary-Adrenal Axis Activity in Young Adults
Publication TypeJournal Article
Year of Publication2016
AuthorsWinchester, SB, Sullivan, MC, Roberts, MB, Granger, DA
JournalRes Nurs Health
Volume39
Pagination15-29
Date PublishedFeb
ISBN Number1098-240X (Electronic)0160-6891 (Linking)
Accession Number26676400
KeywordsAdolescent, Adult, allostatic load, Birth Weight/*physiology, Case-Control Studies, Child, Child, Preschool, Circadian Rhythm/*physiology, disparities, diurnal cortisol, Female, Follow-Up Studies, Humans, Hydrocortisone/*analysis, hypothalamic-pituitary-adrenal axis (HPA), Hypothalamo-Hypophyseal System/*physiology, Infant, Infant, Newborn, Infant, Premature/*physiology, Longitudinal Studies, Male, neonatal care, New England, Nicu, Pituitary-Adrenal System/*physiology, Pregnancy, preterm infants, Prospective Studies, Saliva/*chemistry, Social Class, Socioeconomic Factors, Stress, Psychological, Time Factors, Young Adult
Abstract

In a prospective, case-controlled longitudinal design, 180 preterm and fullterm infants who had been enrolled at birth participated in a comprehensive assessment battery at age 23. Of these, 149 young adults, 34 formerly full-term and 115 formerly preterm (22 healthy preterm, 48 with medical complications, 21 with neurological complications, and 24 small for gestational age) donated five saliva samples from a single day that were assayed for cortisol to assess diurnal variation of the hypothalamic-pituitary-adrenal (HPA) axis. Analyses were conducted to determine whether prematurity category, birth weight, and socioeconomic status were associated with differences in HPA axis function. Pre- and perinatal circumstances associated with prematurity influenced the activity of this environmentally sensitive physiological system. Results are consistent with the theory of Developmental Origins of Health and Disease and highlight a possible mechanism for the link between prematurity and health disparities later in life.