Related Experiment Videos
School-age outcomes in children with birth weights under 750 g
1Department of Pediatrics, School of Medicine, Case Western Reserve University, Cleveland, OH.
Insights
Children born weighing less than 750 grams show significant developmental challenges, including lower cognitive and motor skills. These very-low-birth-weight survivors require targeted support for neurobehavioral dysfunction and academic success.
Area of Science:
- Neonatalogy
- Developmental Pediatrics
- Neuroscience
Background:
- Increasing survival rates of extremely low birth weight (ELBW) infants (birth weight < 750g) since the 1980s.
- ELBW survivors face potential long-term health and developmental issues.
- Need for comprehensive assessment of ELBW children's outcomes at school age.
Purpose of the Study:
- To compare neurodevelopmental outcomes in school-aged children born with birth weights under 750g to those born with higher birth weights.
- To identify risk factors associated with poor developmental outcomes in ELBW survivors.
- To inform clinical practice and support strategies for ELBW populations.
Main Methods:
- Matched cohort study comparing 68 ELBW survivors (born 1982-1986, mean birth weight 670g, gestational age 25.7 weeks) with two control groups: 65 children (750-1499g birth weight) and 61 term-born children.
- Assessment of growth, neurosensory status, and school-age functioning.
- Logistic-regression analyses to examine associations between biologic/social risk factors and developmental outcomes.
Main Results:
- ELBW children demonstrated significantly poorer cognitive ability, psychomotor skills, and academic achievement compared to both control groups.
- Higher rates of mental retardation (21% vs 8% vs 2%), cerebral palsy (9% vs 6% vs 0%), and severe visual disability (25% vs 5% vs 2%) were observed in the ELBW group.
- Major cerebral ultrasonographic abnormalities and oxygen dependence at 36 weeks were associated with increased risk for mental retardation, cerebral palsy, and severe visual disability.
Conclusions:
- Surviving children with birth weights under 750g represent a high-risk subgroup requiring specialized care.
- These children are prone to neurobehavioral dysfunction and academic underachievement.
- Early identification and intervention are crucial for optimizing outcomes in extremely premature infants.
Background:
Since the mid-1980s, increasing numbers of children with birth weights under 750 g have survived to school age.
Methods:
We matched a regional cohort of 68 surviving children born from 1982 through 1986 with birth weights under 750 g (mean, 670 g; gestational age, 25.7 weeks) with 65 children weighting 750 to 1499 g at birth and 61 children born at term. Growth, neurosensory status, and functioning at school age in the three groups were compared. Associations of biologic and social risk factors with major developmental outcomes were examined by means of logistic-regression analyses.
Results:
Children with birth weights under 750 g were inferior to both comparison groups in cognitive ability, psychomotor skills, and academic achievement. They had poorer social skills and adaptive behavior and more behavioral and attention problems. The mean (+/- SD) Mental Processing Composite score for the cohort was 87 +/- 15, as compared with 93 +/- 14 for children with birth weights of 750 to 1499 g and 100 +/- 13 for children born at term (P < 0.001). The rates of mental retardation (IQ < 70) in the three groups were 21, 8, and 2 percent, respectively; the rates of cerebral palsy were 9, 6, and 0 percent; and the rates of severe visual disability were 25, 5, and 2 percent. Major cerebral ultrasonographic abnormalities were associated with mental retardation (odds ratio, 5.4; 95 percent confidence interval, 1.8 to 15.8) and cerebral palsy (odds ratio, 15.2; 95 percent confidence interval, 3.0 to 77.4). Oxygen dependence at 36 weeks was associated with mental retardation (odds ratio, 4.5; 95 percent confidence interval, 1.2 to 10.7) and severe visual disability (odds ratio, 4.3; 95 percent confidence interval, 1.3 to 14.2). Social disadvantage, though associated with several neuropsychological outcomes, was not associated with major developmental impairment.
Conclusions:
Children with birth weights under 750 g who survive represent a subgroup of very-low-birth-weight children who are at high risk for neurobehavioral dysfunction and poor school performance.