The ELBW survivors in school at age 8 years who were born in the 1990s have considerable long-term health and educational needs.

Objective To describe the prevalence of behavioral problems and symptomatology suggestive of Autism and Asperger’s disorders at age 8 years among extremely low birth weight (ELBW, <1 kg) children, born 1992 through 1995. Method Parent reports of the behavior of 219 ELBW (mean birth weight, 810 g; gestational age 26 weeks) were compared with 176 normal birth weight children of similar maternal sociodemographic status, sex, and age. Behavior was assessed via the Child Symptom Inventory that includes both Symptom Severity Scores and scores meeting DSM-IV criteria for disorders. Results ELBW compared with normal birth weight children had significantly higher mean Symptom Severity Scores for the inattentive, hyperactive, and combined types of attention-deficit hyperactivity disorder (all p < .001) as well as higher scores for Generalized Anxiety (p < .01) and Autistic (p < .001) and Asperger’s (p < .01) disorders. When DSM-IV criteria were considered, ELBW children also had significantly higher rates of attention-deficit hyperactivity disorder of the inattentive (10% vs 3%, p < .01) and combined (5% vs 0.6%, p < .05) types. Conclusions Attention-deficit hyperactivity disorder, mainly the inattentive type is prevalent among ELBW children. Our findings of an increase in symptoms pertaining to Autistic and Asperger’s disorders at school age agree with recent reports of others during early childhood. Early identification and intervention for these problems might improve child functioning and ameliorate parent and child distress.

Extremely low birth weight adolescents born in the 1990s have poorer achievement and higher rates of math LD than NBW peers. The findings suggest a need for more intensive interventions addressing the specific cognitive vulnerabilities in this population.

Context Extremely low birth weight (ELBW, <1kg) children have high rates of chronic conditions during childhood. Information on their trajectory of health during the critical period of adolescence is needed for health care planning. Objective To examine changes in rates of chronic conditions between age 8 and 14 years among ELBW compared to normal birth weight (NBW) controls. Design, Setting and Participants Cohort study conducted from 2004 through2009 of 181 ELBW children (weight <1kg) and 115 NBW controls of similar sociodemographic status born 1992 through 1995 in Cleveland, Ohio. Main Outcome Measures Rates of chronic conditions overall (measured with the revised Questionnaire for Identifying Children with Chronic Conditions) and rates of asthma and obesity. Results The overall rates of chronic conditions did not change significantly between ages 8 and 14 years among ELBW children (75% at age 8 years vs 74% at age 14 years) or NBW controls (37% at 8 years vs 47% at age 14 years). In generalized estimating equations logistic regression, adjusting for sociodemographic status, sex and race, ELBW continued to have higher rates of chronic conditions than NBW controls at age 14 years (74% vs 47%, respectively adjusted odds ratio [AOR],2.8; 95% Confidence Interval {CI},1.7 to 4.6). Rates of asthma requiring medication did not change between 8 and 14 years among ELBW children (23% at both ages), but increased among NBW children from 8% at age 8 years to 17% at age 14 years (p=0.002). Differences in rates of asthma between ELBW and NBW children were no longer significant at the age of 14 years (23% vs 17%, respectively; AOR,1.5; [95%CI,0.8 to 2.8]. Mean z scores for body mass index increased in ELBW children from 0.06 at age 8 yesrs to 0.38 at age 14 years(p<0.001) and rates of obesity increased from 12% at age 8 years to 19% at age 14 years (p=0.02). However, the scores and rates did not change among NBW controls such that at the age of 14 years the differences between ELBW and NBW children in mean z-scores for body mass index (0.38 vs 0.56, respectively; adjusted mean difference −0.2; 95% CI, −0.5 to 0.1) or rates of obesity (19% vs 20%, respectively; AOR,1.1 [95%CI, 0.6to 2.0] were not significant.. Conclusions Among ELBW children rates of overall chronic conditions and asthma did not change between the ages of 8 and 14 years but the rates of obesityincreased. Compared with NBW controls, the rates of chronic conditions were higher but there were no significant differences in the rates of asthma or obesity.

Extremely low birth weight was associated with a negative impact on families. Socioeconomic parental risk, but most especially child-related factors such as neurodevelopmental and the functional impact of chronic conditions, predicted the negative family impact within the extremely low birth weight group. Findings underscore the need to develop and test interventions to provide support for families of extremely low birth weight infants to ameliorate the burden of extremely low birth weight and associated risk factors on families.