This study examined the link between two biological markers of stress vulnerability at 22–26 years of age and telomere length at 30–35 among extremely low birth weight (ELBW; <1000 g) survivors and normal birth weight (NBW; >2500 g) control participants. Sixteen ELBW and 22 NBW participants provided baseline afternoon salivary cortisol samples and resting frontal electroencephalogram (EEG) alpha asymmetry data at 22–26 years. Buccal cells were assayed for telomere length at 30–35 years. Analyses controlled for sex, postnatal steroid exposure, childhood socioeconomic status, time of cortisol sample collection, and body mass index at 22–26 years. Salivary cortisol and frontal asymmetry at age 22–26 independently predicted telomere length at age 30–35, such that relatively higher cortisol and greater relative right frontal asymmetry at rest predicted telomere shortening among NBW controls, but not among ELBW survivors. However, similar associations were not noted in ELBW survivors, suggesting that ELBW survivors may have different mechanisms of stress coping as a result of their early-life exposures. These findings offer preliminary evidence in support of the role of stress in the genesis of cellular senescence at least among those born at NBW, but that these links may differ in those born preterm.

This study identified selected perinatal and neonatal variables that place ELBW children at particularly high risk for cognitive delay. Forty children weighing less than 1000 grams (ELBW) at birth underwent developmentol assessment at 9 and 18 months on the Bayley II Mental Development lndex (MDI). Decline in MDI scores between these two ages was evident for infants under 26 weeks gestation at birth as well as for children categorised with an impairment (outcome categories I and II). At 9 months, MDI scores were significantly lower for children with chronic lung disease, for those who required formal developmental intervention, and for those hospitalised for respiratory problems. At 18 months, cognitive scores were significantly lower for children on four variables: gestational age less than 26 weeks; semi-skilled, unskilled, unemployed parents (levels 5 and 6); formal intervention; and admission to hospital for respiratory illness. Greater emphasis on intervention for these at-risk variables is recommended.