***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: CONTEXT Traditionally , educational attainment , getting a job , living independently , getting married , and parenthood have been considered as markers of successful transition to adulthood . OBJECTIVE To describe and compare the achievement and the age at attainment of the above markers between extremely low-birth-weight ( ELBW ) and normal birth-weight ( NBW ) young adults . DESIGN , SETTING , AND PARTICIPANTS A prospect i ve , longitudinal , population -based study in central -west Ontario , Canada , of 166 ELBW participants who weighed 501 to 1000 g at birth ( 1977 - 1982 ) and 145 sociodemographically comparable NBW participants assessed at young adulthood ( 22 - 25 years ) .  Interviewers masked to participant status administered vali date d question naires via face-to-face interviews between January 1 , 2002 , and April 30 , 2004 . MAIN OUTCOME MEASURES Markers of successful transition to adulthood , including educational attainment , student and /or worker role , independent living , getting married , and parenthood . RESULTS At young adulthood , 149 ( 90 % ) of 166 ELBW participants and 133 ( 92 % ) of 145 NBW participants completed the assessment s at mean ( SD ) age of 23.3 ( 1.2 ) years and 23.6 ( 1.1 ) years , respectively . We included participants with neurosensory impairments ( ELBW vs NBW : 40 [ 27 % ] vs 3 [ 2 % ] ) and 7 proxy respondents . The proportion who graduated from high school was similar ( 82 % vs 87 % , P = .21 ) . Overall , no statistically significant differences were observed in the education achieved to date . A substantial proportion of both groups were still pursuing post secondary education ( 47 [ 32 % ] vs 44 [ 33 % ] ) . No significant differences were observed in employment/school status ; 71 ( 48 % ) ELBW vs 76 ( 57 % ) NBW young adults were permanently employed ( P = .09 ) . In a sub analysis , a higher proportion of ELBW young adults were neither employed nor in school ( 39 [ 26 % ] vs 20 [ 15 % ] , P = .02 by Holm 's correction ) ; these differences did not persist when participants with disabilities were excluded . No significant differences were found in the proportion living independently ( 63 [ 42 % ] vs 70 [ 53 % ] , P = .19 ) , married/cohabitating ( 34 [ 23 % ] vs 33 [ 25 % ] , P = .69 ) , or who were parents ( 16 [ 11 % ] vs 19 [ 14 % ] , P = .36 ) . The age at attainment of the above markers was similar for both cohorts . CONCLUSION Our study results indicate that a significant majority of former ELBW infants have overcome their earlier difficulties to become functional young adults OBJECTIVES To investigate the prevalence , correlates , and antecedents of autism spectrum disorders ( ASD ) in extremely preterm children . STUDY DESIGN We conducted a prospect i ve study of all births < 26 weeks gestation in the United Kingdom and Irel and in 1995 . Of 307 survivors at 11 years , 219 ( 71 % ) were assessed and compared with 153 term-born classmates . Parents completed the  Social Communication Question naire ( SCQ )  to assess autism spectrum symptoms , and ASD were diagnosed by using a psychiatric evaluation . An IQ test and clinical evaluation were also administered . Longitudinal outcome data were available for extremely preterm children . RESULTS Extremely preterm children had significantly higher SCQ scores than classmates ( mean difference , 4.6 points ; 95 % CI , 3.4 - 5.8 ) . Sixteen extremely preterm children ( 8 % ) were assigned an ASD diagnosis , compared with none of the classmates . By hospital discharge , male sex , lower gestation , vaginal breech delivery , abnormal cerebral ultrasound scanning results , and not having had breast milk were independently associated with autism spectrum symptoms . By 6 years , independent associates were cognitive impairment , inattention and peer problems , withdrawn behavior at 2.5 years , and not having had breast milk . CONCLUSIONS Extremely preterm children are at increased risk for autism spectrum symptoms and ASD in middle childhood . These symptoms and disorders were associated with neurocognitive outcomes , suggesting that ASD may result from abnormal brain development in this population Replacement therapy with exogenous surfactant has been studied for both prevention and treatment of respiratory distress syndrome . Although reports demonstrate improved survival rates for surfactant-treated infants with RDS , the impact of this therapy on outcome of extremely low birth weight infants is unknown . TM Previous studies have not reported outcome after surfactant treatment for the subset of premature infants who are born at ELBWs and who are at the highest risk for complications of prematurity . We report the outcome of infants born with birth weights between 600 and 750 gm who underwent prospect i ve r and om selection to receive either surfactant or placebo as part of a multidose prevention study Poor executive function ( EF ) has been linked to attention-deficit/hyperactivity disorder ( ADHD ) . Children born at extremely low birth weight ( ELBW ; < 1000 g ) have been found to show both poor EF , as well as elevated levels of symptoms of ADHD . In the present study , we examined whether fluid intelligence moderates the link between birth weight and later ADHD symptoms by prospect ively following a cohort of 179 survivors who were born at ELBW . When participants were 8 years-old , they were matched with 145 normal birth weight ( NBW ; ≥2500 g ) control participants . At age 8 , fluid intelligence was measured , and during young adulthood ( ages 22–26 ) , participants ' self-reported levels of ADHD symptoms were examined . We found that ELBW survivors , who also showed poor fluid intelligence , had the highest rates of ADHD symptoms , and particularly , symptoms of inattention . These findings point to the importance of examining developmental trajectories that contribute to risk for psychopathology in those exposed to intrauterine adversity Discrepancies often arise among multiple informants ' reports of child and adolescent psychopathology and related constructs ( e.g. , parenting , family relationship quality and functioning , parental monitoring ) . Recently , studies using various design s ( laboratory , longitudinal , r and omized controlled trial , meta- analysis ) have revealed that discrepancies among informants ' reports ( a ) yield important information regarding where children express behaviors ( time course , features of the context [ s ] of behavioral expression ) and about the informants who observe their expression , ( b ) demonstrate stability over time in both community and clinic setting s , ( c ) predict poor child and adolescent outcomes in ways that the individual informants ' reports do not , and ( d ) can be used to identify meaningful treatment outcomes patterns within r and omized controlled trials . Using existing data sources , the articles in this special section exp and upon this emerging body of research . In particular , the articles illustrate how clinical science and practice can use informant discrepancies to increase underst and ing of the causes and consequences of , as well as treatments for , child and adolescent psychopathology Fetal programming of the hypothalamus-pituitary-adrenal ( HPA ) axis was proposed as one mechanism underlying the link between prenatal stress , adverse birth outcomes ( particularly low birth weight ) and an enhanced vulnerability for several diseases later in life . In recent studies , birth weight was significantly related to basal cortisol levels as well as to cortisol responses to pharmacological stimulation . In order to investigate the association between cortisol responses to psychological challenge , birth weight and length of gestation , 106 young healthy males were exposed to the ' Trier Social Stress Test ' .  Salivary cortisol responses to the stress exposure were significantly and inversely related to the subjects ' birth weight , while the analysis of the impact of gestational age yielded inconsistent results . This finding is consistent with the concept of fetal programming of the HPA axis and provides the first preliminary evidence for an association between birth weight and adrenocortical responses to psychosocial stress . As the investigated subjects were twins , possible implication s of this sample characteristic for the present findings are discussed OBJECTIVES Our goals were to determine the mortality risk for infants weighing 501 to 1500 gm according to gestational age , birth weight , and gender and to document birth weight-related changes in mortality and morbidity over a 5-year time period . STUDY DESIGN In this observational study perinatal data were prospect ively collected by the 12 participating centers of the National Institute of Child Health and Human Development Neonatal Research Network from May 1991 through December 1992 and compared with the corresponding data from 1987 through 1990 . St and ard definitions were used to record sociodemographic factors , perinatal events , and the neonatal course to 120 days of life , discharge , or death . RESULTS The 1991 and 1992 cohort included 4279 in-born infants . Among their mothers 10 % were < 18 years old ; 55 % were black , 31 % were white , and 11 % were Hispanic ; 14 % had received no prenatal care ; and 20 % had received antenatal corticosteroids .  Multiple gestations accounted for 20 % of the births . Fifty percent of the infants were delivered by cesarean section . During 1991 and 1992 the overall survival for infants weighing 501 to 1500 gm at birth was 81 % , compared with 74 % in 1987 and 1988 . Survival at birth weight 501 to 750 gm was 44 % ; it was 81 % at 751 to 1000 gm , 92 % at 1001 to 1250 gm , and 95 % between 1251 and 1500 gm . Female infants had a significantly greater chance of surviving than male infants at similar birth weights and gestational ages . At any given gestational age , smaller infants were less likely to survive . Survival in all birth weight categories increased between 1987 and 1992 , without accompanying increases in medical morbidity . Major morbidity increased with decreasing birth weight and included late-onset septicemia 22 % , chronic lung disease ( oxygen dependence at 36 weeks ' corrected age ) 18 % , severe intraventricular hemorrhage ( grade s III and IV ) 11 % , and necrotizing enterocolitis 5 % . Twelve percent of all infants were treated with corticosteroids for chronic lung disease , including 36 % of infants who were oxygen dependent at age 28 days . The mean length of hospital stay was 69 days for survivors and 18 days for infants who died . CONCLUSIONS Mortality for infants between 501 and 1500 gm at birth has declined over the past 5 years . There are interactions between birth weight , gestational age , gender , and survival rate . This increase in survival was not accompanied by an increase in medical morbidity OBJECTIVE : To determine the risk for psychiatric disorders among extremely low birth weight ( ELBW ) survivors in their early to mid-30s and to determine whether those born small for gestational age or those exposed to a full course of antenatal corticosteroids ( ACS ) were at particularly high risk . METHODS : A prospect i ve , longitudinal , population -based cohort of 84 ELBW survivors and 90 normal birth weight ( NBW ) control participants born in Ontario , Canada from 1977 to 1982 were assessed by interviewers naive to birth weight status using the Mini-International Neuropsychiatric Interview . RESULTS : ELBW survivors had lower odds of an alcohol or substance use disorder but higher odds of current non – substance-related psychiatric problems ( odds ratio [ OR ] = 2.47 ; 95 % confidence interval [ CI ] , 1.19–5.14 ) . Those born ELBW and SGA exhibited the same patterns with larger effects . ACS-exposed ELBW survivors had even higher odds of any current non – substance-related psychiatric disorder ( OR = 4.41 ; 95 % CI , 1.65–11.82 ) , particularly generalized anxiety disorder ( OR = 3.42 ; 95 % CI , 1.06–11.06 ) , the generalized type of social phobia ( OR = 5.80 ; 95 % CI , 1.20–27.99 ) , and the inattentive subtype of attention-deficit/hyperactivity disorder ( OR = 11.45 ; 95 % CI , 2.06–63.50 ) . CONCLUSIONS : In their early to mid-30s , ELBW survivors were less likely to have alcohol or substance use disorders but may be at greater risk for other psychiatric problems . Those exposed to ACS were at especially high risk and manifested no reduction in alcohol or substance use disorders . ELBW survivors exposed to ACS may be a special group at risk for psychopathology in adulthood Objectives . To investigate behavioral and emotional problems and positive adjustment of 15-to 16-year-olds who were born at extremely low gestational age ( ELGA ) , from the perspective of parents , teachers , and teenagers . Methods . Prospect i ve follow-up was conducted of birth cohorts , with classroom control subjects . All infants who were born before 29 weeks in 1983–1984 ( mean gestational age : 27 weeks ) 
    Output:
    
Children born at ELBW were reported by parents and teachers to be at significantly greater risk than NBW controls for inattention and hyperactivity , internalizing , and externalizing symptoms .
ELBW children were also at greater risk for conduct and oppositional disorders , autistic symptoms , and social difficulties .
Risks for parent-reported inattention and hyperactivity , internalizing , and social problems were greater in adolescents born at ELBW .
In contrast , ELBW teens self-reported lower inattention , hyperactivity , and oppositional behavior levels than their NBW peers .
Depression , anxiety , and social difficulties were elevated in ELBW survivors in adulthood .
Group differences were robust to region of birth , era of birth , and the presence of neurosensory impairments .