BACKGROUND: Low birth weight (LBW) is a leading cause of infant mortality and morbidity, and a specific risk for the development of neuro-developmental and academic problems. AIM: To examine the medical, cognitive and academic outcomes of VLBW (<1,500 g) children, born in one maternity hospital in Dublin between 1995 and 1997. METHODS: The study employed a prospective/cohort design, with semi-structured, and standardised measures, along with the completion of a study-specific questionnaire. Ratings were obtained from parents and teachers. RESULTS: Of the 127 surviving VLBW cohort, 64 (50 %) consented to assessment at a mean age of 11.6 years (SD 1.0) along with a matched-weight and gender control sample of 51. VLBW children had an increased risk of chronic medical problems and neuro-sensory deficits, but without any increased use in services. Similarly, they had lower IQ (mean 89.7 compared to NBW 101.3, p < 0.001) and more were identified by teachers to have special education needs (33 % VLBW vs. 7 % NBW, p < 0.005). With regard to academic attainments, birth weight had a significant [t(98) = -4.54, p < 0.001] and robust effect (η(2) = 0.17) on mathematical attainment scores. Those with lower SES fared least well off. CONCLUSIONS: Although significant advances have been made in reducing infant mortality, there is a recognised increased risk of subsequent disability especially with decreasing gestational age, and when coupled with low SES. Having facilitated the survival of vulnerable infants, services must be available for the necessary on-going medical and educational support and treatment that they require throughout adolescent years.
BACKGROUND:Low birth weight (LBW) is a leading cause of infant mortality and morbidity, and a specific risk for the development of neuro-developmental and academic problems. AIM: To examine the medical, cognitive and academic outcomes of VLBW (<1,500 g) children, born in one maternity hospital in Dublin between 1995 and 1997. METHODS: The study employed a prospective/cohort design, with semi-structured, and standardised measures, along with the completion of a study-specific questionnaire. Ratings were obtained from parents and teachers. RESULTS: Of the 127 surviving VLBW cohort, 64 (50 %) consented to assessment at a mean age of 11.6 years (SD 1.0) along with a matched-weight and gender control sample of 51. VLBW children had an increased risk of chronic medical problems and neuro-sensory deficits, but without any increased use in services. Similarly, they had lower IQ (mean 89.7 compared to NBW 101.3, p < 0.001) and more were identified by teachers to have special education needs (33 % VLBW vs. 7 % NBW, p < 0.005). With regard to academic attainments, birth weight had a significant [t(98) = -4.54, p < 0.001] and robust effect (η(2) = 0.17) on mathematical attainment scores. Those with lower SES fared least well off. CONCLUSIONS: Although significant advances have been made in reducing infant mortality, there is a recognised increased risk of subsequent disability especially with decreasing gestational age, and when coupled with low SES. Having facilitated the survival of vulnerable infants, services must be available for the necessary on-going medical and educational support and treatment that they require throughout adolescent years.
Authors: Maureen Hack; H Gerry Taylor; Dennis Drotar; Mark Schluchter; Lydia Cartar; Laura Andreias; Deanne Wilson-Costello; Nancy Klein Journal: JAMA Date: 2005-07-20 Impact factor: 56.272
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