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School-age consequences of birth weight less than 750 g: a review and update
1Department of Pediatrics, Case Western Reserve University, Rainbow Babies & Children's Hospital of University Hospitals of Cleveland, USA. hgt2@po.cwru.edu
Insights
Children born with very low birth weight (LBW) face long-term challenges. Those under 750g show persistent developmental issues, highlighting the need for continued research and support.
Area of Science:
- Neonatalogy
- Developmental Pediatrics
- Perinatal Care
Background:
- Advances in perinatal care increase survival rates for extremely premature infants.
- Children with very low birth weight (LBW; <1,500g) exhibit poorer outcomes compared to normal birth weight infants.
- Outcomes for infants born at the lower limits of viability require further investigation.
Purpose of the Study:
- To review current knowledge on the outcomes of LBW children.
- To emphasize the specific outcomes for children with birth weights less than 750g.
- To identify factors influencing sequelae in LBW infants.
Main Methods:
- Review of current literature on LBW outcomes.
- Analysis of data from an ongoing longitudinal study.
- Comparison of outcomes across different birth weight categories (<750g, 750-1,499g) and term-born controls.
Main Results:
- A gradient of sequelae exists, with infants <750g experiencing poorer outcomes than those 750-1,499g and term-born controls.
- Children <750g birth weight do not catch up with peers and may face increasing age-related sequelae.
- Outcomes are influenced by neonatal complications and social risk factors.
Conclusions:
- Infants with birth weights <750g face significant, persistent developmental challenges.
- Understanding the etiology and neuropathology of LBW sequelae is crucial.
- Further research is needed to address the long-term developmental implications and treatment needs of LBW children.
Abstract:
Recent advances in perinatal care have led to the survival of increasing numbers of children born at the lower limits of viability. Children with very low birth weight (LBW; less than 1,500 g, 3 lb 5 oz) have been studied extensively. Findings document poorer outcomes relative to normal birth weight term-born controls in neurologic and health status, cognitive-neuropsychological skills, school performance, academic achievement, and behavior. This report reviews current knowledge regarding LBW children, with special emphasis on outcomes for children with birth weight less than 750 g (1 lb 10 oz). Results from an ongoing longitudinal study suggest a gradient of sequelae, with poorer outcomes in less than 750 g birth weight children compared to both 750 g to 1,499 g birth weight children and term-born controls. Children with less than 750 g birth weight fail to catch up with their peers over time and may even be at risk for age-related increases in sequelae. Outcomes are highly variable but related to neonatal medical complications of prematurity and social risk factors. Further research is needed to understand the etiology and neuropathological basis of sequelae, the long-term developmental implications of LBW, and treatment needs.