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Follow-up of very low birthweight babies to adolescence
1Department of Pediatrics, McMaster University, Hamilton, Ontario, Canada. saigal@fhs.mcmaster.ca
Insights
Infants born very low birthweight (VLBW) show poorer school-age outcomes and behavioral issues in adolescence compared to peers. Early identification and interventions are crucial for these vulnerable children.
Area of Science:
- Pediatrics
- Developmental Psychology
- Neuroscience
Background:
- Emerging reports detail school-age outcomes and adolescent behavioral difficulties in very low birthweight (VLBW) infants.
- VLBW survivors consistently demonstrate poorer performance compared to same-age controls, with cognitive and achievement scores 8-13 points lower.
- Even VLBW children without neurological impairments exhibit significantly lower cognitive and achievement scores.
Purpose of the Study:
- To review school-age outcomes and adolescent behavioral difficulties in very low birthweight (VLBW) infants.
- To highlight the persistent challenges faced by VLBW and extremely low birthweight (ELBW) adolescents.
- To advocate for methodologically rigorous studies on the impact of medical innovations and for targeted interventions.
Main Methods:
- Review of existing literature on school-age outcomes and adolescent behavioral difficulties in VLBW and ELBW populations.
- Comparison of performance measures between VLBW/ELBW cohorts and their normal birthweight peers.
- Analysis of academic achievement, remedial assistance rates, and grade failure.
Main Results:
- VLBW adolescents exhibit significantly poorer performance on cognitive and achievement measures compared to controls.
- Extremely low birthweight (ELBW) adolescents fare worse, particularly in mathematics.
- A substantial proportion of VLBW (15-20%) and ELBW (30-50%) adolescents require remedial assistance or have failed a grade.
- Behavioral problems remain significantly greater in the VLBW cohort during adolescence.
Conclusions:
- VLBW and ELBW infants face significant, lasting psychoeducational and behavioral challenges into adolescence.
- Technological advancements in neonatal care require evaluation for their impact on long-term outcomes.
- Future research should focus on early identification and targeted interventions for vulnerable infants to mitigate these difficulties.
Abstract:
Reports on the school-age outcomes and behavioural difficulties at adolescence of infants who were very low birthweight (VLBW) are only just emerging. Studies which compare VLBW with same age controls consistently show significantly poorer performance, with average scores between 8 and 13 points lower. Even children with no neurological impairments have scores which are significantly lower on cognitive and achievement measures. The extremely low birthweight (ELBW) adolescents fare worse on all measures and perform particularly poorly in mathematics. A high proportion of VLBW adolescents (15%-20%), and an even higher proportion of ELBW adolescents (30%-50%), are receiving remedial assistance and/or have failed a grade. There are conflicting reports on whether the behavioural problems increase or improve with age, but most studies show that at adolescence the problems are still significantly greater in the VLBW cohort than in their peers. Methodologically rigorous studies of the current survivors to school-age should be conducted to determine whether the technological innovations in the 1990s have contributed to a reduction in psychoeducational and behavioural difficulties. Future research should also be directed towards early identification of school difficulties and development of intervention strategies targeted to the most vulnerable infants.