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Official websites use. Share sensitive information only on official, secure websites. A preterm birth represents a stressful event having potentially negative long-term consequences. Salivary cortisol, collected four times a day over two consecutive days, was measured with radioimmunoassay technique at six months and nine years to assess the hypothalamic-pituitary-adrenal HPA axis. Results showed a significant difference in cortisol regulation at nine years between preterm and full-term children but no differences in adjustment problems.
Whereas biological factors i. In conclusion, very preterm birth has some long-term consequences on the HPA-axis regulation at nine years. Although cortisol regulation is mostly influenced by biological factors, the presence of maternal post-traumatic symptoms predicts the manifestation of adjustment problems in both groups. This shows the importance of maternal psychological well-being for child development.
Preterm birth is defined [ 1 ] by birth before 37 weeks of gestation with sub-categories: moderate preterm—32 to 37 weeks, very preterm—28 to 32 weeks, and extremely preterm—less than 28 weeks. Recent progress in medical techniques and care instructions of preterm infants has enabled to increase the survival rate of premature infants [ 3 , 4 , 5 ].
However, it is nowadays well established that premature birth has an important impact on the infant and the family not only at birth but also on long-term [ 6 , 7 ]. Indeed, preterm children are at higher risk for long-term medical and developmental difficulties [ 6 , 8 , 9 ]. In particular, it has been recognized that preterm-born children are more at risk of presenting maladaptive self-regulation skills including stress response system regulation such as the hypothalamic-pituitary-adrenal HPA axis [ 10 ], as well as the development of behavioral or externalizing and emotional or internalizing problems [ 11 ].
Although some studies have shown that preterm children were more at risk to develop internalizing and externalizing problems [ 6 , 7 , 12 ], other studies did not observe any difference between preterm and full-term children [ 13 , 14 ]. Internalizing and externalizing problems are often co-morbid and closely related to each other in children and adolescents [ 15 , 16 , 17 ].