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Middle-school-age outcomes in children with very low birthweight
H G Taylor1, N Klein, N M Minich
1Department of Pediatrics, Rainbow Babies & Childrens Hospital, Cleveland, OH 44106-6038, USA. HGT2@PO.CWRU.EDU
Insights
Children born weighing less than 750 grams often face developmental challenges into middle school. These long-term outcomes in cognitive function and academic performance highlight risks for extremely low birthweight individuals.
Area of Science:
- Pediatrics
- Developmental Psychology
- Neuroscience
Background:
- Previous research on children with birthweight less than 750 grams primarily examined early childhood outcomes.
- Long-term developmental trajectories for this high-risk population require further investigation.
Purpose of the Study:
- To evaluate the middle school-age outcomes of children with birthweight less than 750 grams.
- To compare their performance against children with higher birthweights (750-1,499 g) and term-born controls.
Main Methods:
- A regional sample of 60 children with birthweight <750 g was assessed at middle school age (mean 11 years).
- Comparison groups included 55 children with birthweight 750-1,499 g and 49 term controls, matched for age, gender, and demographics at an earlier assessment (mean age 7 years).
- Assessments covered cognitive function, academic achievement, behavior, and motor skills.
Main Results:
- Children with birthweight <750 g demonstrated poorer outcomes in cognitive function, achievement, behavior, and academic performance compared to term controls.
- Outcomes for the <750 g group were frequently less favorable than for the 750-1,499 g group.
- Even children in the <750 g group without neurosensory disorders or global cognitive impairment showed significant deficits in motor skills, math, and complex drawing recall compared to term peers, persisting after IQ control.
Conclusions:
- Children with birthweight <750 g are at significant risk for long-term developmental problems, extending into middle school.
- Disparities between extremely low birthweight and term-born children can widen with age.
- While many achieve favorable outcomes, the population warrants continued monitoring for developmental issues.
Abstract:
Most previous studies of children with birthweight <750 g have focused on early childhood sequelae. To evaluate later outcomes, a regional sample of 60 <750-g birthweight children was compared at middle school age (M = 11 years) to 55 children with birthweight 750-1,499 g and 49 term controls. The groups were matched on age, gender, and demographic variables at the time of an early-school-age assessment (mean age 7 years). The <750-g birthweight group fared less well at middle school age than the term group on measures of cognitive function, achievement, behavior, and academic performance. In many instances, outcomes were less favorable for the <750-g children than for the 750 to 1,499-g group. Children in the <750-g group who were free of neurosensory disorders and global cognitive impairment performed more poorly on several tests than their term counterparts. Group differences in this subsample on tests of motor skills, math, and the ability to copy and recall a complex drawing remained significant even after controlling for IQ. Disparities between the <750-g and term groups increased with age for some measures. Despite favorable outcomes for many children in the <750-g group, this population is at risk for long-term developmental problems.