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Long-term family outcomes for children with very low birth weights
H G Taylor1, N Klein, N M Minich
1Department of Pediatrics, Rainbow Babies and Children's Hospital, 11100 Euclid Ave, Cleveland, OH 44106-6038, USA.
Insights
Families with very low birth weight children (<1500 g) face more long-term stress, especially those with higher medical risk. Child functioning issues significantly impact family well-being, highlighting the need for support.
Area of Science:
- Pediatric Health
- Family Studies
- Developmental Psychology
Background:
- Very low birth weight (VLBW) infants (<1500 g) require specialized care and long-term monitoring.
- Understanding the long-term impact of VLBW and neonatal medical risk on family functioning is crucial for developing targeted support systems.
Purpose of the Study:
- To investigate the long-term outcomes for families of children with VLBW.
- To assess the relationship between the degree of low birth weight, neonatal medical risk, and family well-being.
Main Methods:
- A prospective cohort study followed families of school-aged children.
- Participants included children with birth weights <750 g, 750-1499 g, and normal birth weight controls.
- Parental reports on psychological distress, family function, and child-related stress were collected.
Main Results:
- Families of children with birth weights <750 g reported higher stress levels compared to controls.
- Sociodemographically advantaged families experienced greater stress.
- Higher neonatal medical risk correlated with negative family impact, particularly in advantaged families.
- Child functioning problems mediated adverse family outcomes.
Conclusions:
- Children born with very low birth weights (<750 g) are associated with increased long-term family adversity.
- Family sequelae are evident in VLBW children with high neonatal medical risk.
- Ongoing child health and behavioral issues are key contributors to family stress, with sociodemographic status playing a significant role.
Objective:
To examine long-term outcomes in families of children with very low birth weights (<1500 g) in relation to the extent of low birth weight and neonatal medical risk.
Design:
Concurrent/cohort prospective study.
Setting:
Regional follow-up program.
Participants:
Families of 60 children of school age with birth weights less than 750 g, 55 with birth weights between 750 and 1499 g, and 49 normal birth weight full-term controls.
Main Outcome Measures:
Parent ratings of psychological distress, family function, and child-related stress.
Results:
Families with children with birth weights less than 750 g experienced greater stress than did families of controls (born at full term), and families who were sociodemographically advantaged experienced greater stress than did those who were disadvantaged. Higher neonatal medical risk also predicted a more negative impact on the family, but only in advantaged families. Regression analyses suggested that adverse family outcomes were mediated by ongoing problems in child functioning.
Conclusions:
Families of children with birth weights less than 750 g experience more long-term adversity than families of full-term children. Family sequelae are also present for children with very low birth weight at high neonatal medical risk. Ongoing child health and behavior problems may be the major source of these sequelae, and sociodemographic status is an important consideration in identifying family adversity. Although many families appear unaffected, results support the need to monitor family outcomes and develop interventions for both the child and family.