Long-Term Developmental Outcomes of Low Birth Weight Infants

Abstract

Advances in neonatal medicine have resulted in the increased survival of infants at lower and lower birth weight. While these medical success stories highlight the power of medical technology to save many of the tiniest infants at birth, serious questions remain about how these infants will develop and whether they will have normal, productive lives. Low birth weight children can be born at term or before term and have varying degrees of social and medical risk. Because low birth weight children are not a homogeneous group, they have a broad spectrum of growth, health, and developmental outcomes. While the vast majority of low birth weight children have normal outcomes, as a group they generally have higher rates of subnormal growth, illnesses, and neurodevelopmental problems. These problems increase as the child's birth weight decreases. With the exception of a small minority of low birth weight children with mental retardation and/or cerebral palsy, the developmental sequelae for most low birth weight infants include mild problems in cognition, attention, and neuromotor functioning. Long-term follow-up studies conducted on children born in the 1960s indicated that the adverse consequences of being born low birth weight were still apparent in adolescence. Adverse sociodemographic factors negatively affect developmental outcomes across the continuum of low birth weight and appear to have far greater effects on long-term cognitive outcomes than most of the biological risk factors. In addition, the cognitive defects associated with social or environmental risks become more pronounced as the child ages. Enrichment programs for low birth weight children seem to be most effective for the moderately low birth weight child who comes from a lower socioeconomic group. Continued research and attempts to decrease the rate of low birth weight and associated perinatal medical sequelae are of primary importance. Ongoing documentation of the long-term outcome of low birth weight children needs to be mandated, as does the implementation of environmental enrichment programs to help ameliorate the long-term consequences for infants who are born low birth weight.

Predictors of Development In Premature Infants From Low-Income Families: African Americans and Hispanics

“…Innumerable studies have demonstrated that the most potent predictive factors for the child development are the circumstances in which the child is raised such as the socioeconomic status of the family, the educational background of the parents, and the quality of the care-giving environment. [2][3][4][5][6][7][8]23 Therefore, it was surprising that in the present study no relationship was found between the home environment and the mental scores for Hispanic families. It is possible that the HOME scores or Bayley scores do not vary sufficiently to show such a relationship.…”

“…1 LBW infants are at increased risk for a variety of biologic, developmental, and behavioral problems in later childhood. [2][3][4][5] Moreover, those LBW infants from disadvantaged backgrounds have the highest incidence of developmental delays and illnesses. Infants who have experienced perinatal complications in addition to being from disadvantaged backgrounds are more likely to manifest developmental delays than infants with similar medical backgrounds but from more advantaged backgrounds.…”

Review of the nutrition situation in the Eastern Mediterranean Region

“…When examining the annual rates of change, only Djibouti (-3.1%), Egypt (-3.5%), Morocco (-4.6%) and the UAE (-4.9%) appeared to be on track towards meeting the global nutrition targets (-2.74% for LBW) (122). This is of concern given that LBW children tend to have higher rates of subnormal growth, illnesses, neurodevelopmental problems and cognitive defects (123,124). In the Region, LBW may be linked, in many instances, to poor maternal health and prenatal conditions, such as poverty, crowded home environments, unfavourable work conditions (125), infections, short interpregnancy intervals, maternal obesity, smoking and poorer nutrition including anaemia (126,127), and rural residence (127).…”

Dopamine Receptor D2 GeneTaq1A(C32806T) Polymorphism Modifies the Relationship Between Birth Weight and Educational Attainment in Adulthood: 21-Year Follow-up of the Cardiovascular Risk in Young Finns Study

“…[1][2][3][4] Children who were born preterm or small for gestational age have been found to be at risk for reduced cognitive test scores and to have higher rates of problems in memory, attention, and neuromotor function. 1,5,6 Very low birth weight (VLBW; Ͻ1500 g), especially, has been shown to be a risk and to predict school difficulties 4,7,8 and low academic achievement that was apparent still in young adulthood. [1][2][3][4] However, previous studies of general populations suggested that birth weight is associated with cognition and educational attainment across the full birth weight range.…”

“…1,5,6 Very low birth weight (VLBW; Ͻ1500 g), especially, has been shown to be a risk and to predict school difficulties 4,7,8 and low academic achievement that was apparent still in young adulthood. [1][2][3][4] However, previous studies of general populations suggested that birth weight is associated with cognition and educational attainment across the full birth weight range. 3 The association between low birth weight or small for gestational age and cognitive achievement has been found to be independent of social background, 3,9,10 although some studies suggest that a contribution of birth weight in cognitive achievement including school and educational achievement is confounded by other factors such as socioeconomic status 11 or childhood home and learning environment.…”