Lower cognitive test scores at age 7 in children born with marginally low birth weight
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Updated: Feb 13, 2026

Measuring the Functional Abilities of Children Aged 3-6 Years Old with Observational Methods and Computer Tools
Published on: June 20, 2020
Josefine Starnberg1, Mikael Norman2, Björn Westrup3
1Department of Clinical Sciences, Pediatrics, Umeå University, Umeå, Sweden.
Insights
Children born with marginally low birth weight (2000-2500g) show lower verbal IQ, visual-motor skills, and attention compared to normal birth weight peers. This suggests potential early school-age cognitive challenges.
Area of Science:
- Pediatric Neurodevelopment
- Perinatal Health Outcomes
- Cognitive Psychology
Background:
- Very low birth weight (<1500g) is linked to later neurocognitive deficits.
- Marginally low birth weight (2000-2500g) requires further investigation for neurodevelopmental outcomes.
Purpose of the Study:
- To explore neurodevelopmental functions in children born with marginally low birth weight (LBW).
- To compare cognitive and motor skills of marginally LBW children with normal birth weight (NBW) controls.
Main Methods:
- Observational analysis of a combined marginally LBW group from a prior randomized controlled trial.
- Comparison with 95 normal birth weight (NBW) controls.
- Neurodevelopmental assessment at 7 years using WISC-IV, Beery VMI, and TEA-Ch.
Main Results:
- Marginally LBW children exhibited lower verbal comprehension IQ (104 vs. 107).
- Lower visual-motor integration (VMI) scores (96.5 vs. 100) were observed in the marginally LBW group.
- Reduced attention performance (TEA-Ch scores) was noted in marginally LBW children compared to NBW controls.
Conclusions:
- Marginally LBW is associated with deficits in verbal comprehension, visual-motor integration, and attention.
- These findings indicate an elevated risk for cognitive difficulties in early school-aged children born with marginally low birth weight.
Abstract:
BackgroundBeing born with very low birth weight (<1500 g) is associated with poorer neurocognition later in life. The aim of this study was to explore neurodevelopmental functions in those born with marginally LBW (2000-2500 g).MethodsThis was originally a randomized controlled trial investigating the effects of early iron supplementation in 285 marginally LBW children. Herein, we explored the combined marginally LBW group and compared their results to 95 normal birth weight (NBW; 2501-4500 g) controls in an observational design. At 7 years, a pediatric psychologist tested the children using Wechsler Intelligence Scale for Children (WISC IV), Beery-Buktenica developmental test of Visual-Motor Integration (Beery VMI), and Test of Everyday Attention for Children (TEA-Ch).ResultsThe marginally LBW children had lower verbal comprehension intelligence quotient (IQ) (104 vs. 107, P=0.004), lower VMI scores (96.5 vs. 100, P=0.028), and lower total mean TEA-Ch scores (8.5 vs. 9.7, P=0.006), compared to controls. Also, the marginally LBW children group had a higher proportion of children below -1 SD for VMI and TEA-Ch.ConclusionsMarginally LBW children had lower verbal comprehension IQ, lower visual-motor integration, and lower attention performance than NBW children, suggesting an increased risk of cognitive difficulties in early school age.
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