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Assessment and Evaluation of the High Risk Neonate: The NICU Network Neurobehavioral Scale
Published on: August 25, 2014
Outcomes in young adulthood for very-low-birth-weight infants
Maureen Hack1, Daniel J Flannery, Mark Schluchter
1Department of Pediatrics, Case Western Reserve University, Cleveland, USA. mxh7@po.cwru.edu
Insights
Very-low-birth-weight survivors face lasting educational and cognitive challenges into adulthood. These long-term outcomes highlight the persistent disadvantages associated with extremely low birth weight.
Area of Science:
- Neonatalogy
- Developmental Pediatrics
- Public Health
Background:
- Neonatal intensive care has advanced significantly, allowing more very-low-birth-weight infants to survive into adulthood.
- Long-term outcomes for this cohort are crucial for understanding the lifelong impact of prematurity and low birth weight.
Purpose of the Study:
- To assess the long-term educational, cognitive, and health outcomes of very-low-birth-weight survivors at young adulthood.
- To compare these outcomes with a normal birth weight control group.
Main Methods:
- A cohort study comparing 242 very-low-birth-weight survivors (born 1977-1979) with 233 normal birth weight controls.
- Assessment at 20 years of age included education level, cognitive and academic achievement, chronic illness, and risk-taking behaviors.
- Statistical adjustments were made for sex and sociodemographic status.
Main Results:
- Very-low-birth-weight young adults had lower high school graduation rates (74% vs. 83%) and postsecondary enrollment (30% vs. 53% for men).
- Mean IQ (87 vs. 92) and academic achievement scores were significantly lower in the very-low-birth-weight group.
- Higher rates of neurosensory impairments (10% vs. <1%) and subnormal height were observed, alongside lower rates of substance use and pregnancy.
Conclusions:
- Educational disadvantages associated with very low birth weight persist into early adulthood.
- These findings underscore the need for continued support and interventions for individuals with a history of very low birth weight.
Background:
Very-low-birth-weight infants (those weighing less than 1500 g) born during the initial years of neonatal intensive care have now reached young adulthood.
Methods:
We compared a cohort of 242 survivors among very-low-birth-weight infants born between 1977 and 1979 (mean birth weight, 1179 g; mean gestational age at birth, 29.7 weeks) with 233 controls from the same population in Cleveland who had normal birth weights. We assessed the level of education, cognitive and academic achievement, and rates of chronic illness and risk-taking behavior at 20 years of age. Outcomes were adjusted for sex and sociodemographic status.
Results:
Fewer very-low-birth-weight young adults than normal-birth-weight young adults had graduated from high school (74 percent vs. 83 percent, P=0.04). Very-low-birth-weight men, but not women, were significantly less likely than normal-birth-weight controls to be enrolled in postsecondary study (30 percent vs. 53 percent, P=0.002). Very-low-birth-weight participants had a lower mean IQ (87 vs. 92) and lower academic achievement scores (P<0.001 for both comparisons). They had higher rates of neurosensory impairments (10 percent vs. <1 percent, P<0.001) and subnormal height (10 percent vs. 5 percent, P=0.04). The very-low-birth-weight group reported less alcohol and drug use and had lower rates of pregnancy than normal-birth-weight controls; these differences persisted when comparisons were restricted to the participants without neurosensory impairment.
Conclusions:
Educational disadvantage associated with very low birth weight persists into early adulthood.
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