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Low birth weight problem and adulthood

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According to a new and striking finding, problems associated with very low birth weight infants (those weighing less than 1500 g) have now reached young adulthood. A study of young adults born at very low birth weights suggests that certain deficits, such as lower IQ and academic achievement, persist beyond childhood.The researchers followed very low birth weight infants treated at Rainbow Babies and Children's Hospital in Cleveland, Ohio, between 1977 and 1979. They compared 242 survivors among very-low-birth-weight infants with 233 controls from the same population in Cleveland who had normal birth weights. They assessed the level of education, academic achievement, and rates of chronic illness and risk-taking behaviour at 20 years of age.They found that by the age of 20, certain deficits had been relatively more common in this low birth weight group. 74% of the 242 in the group had graduated from high school compared with 83% of a group of normal birth weight individuals. The average IQ and scores on academic tests were also lower in the low birth weight group. Ten percent also had some sort of neurological or sensory impairment, compared with less than 1% of the normal birth weight group.Since the introduction of neonatal intensive care units more and more extremely low birth weight infants have been surviving. But these tiny babies are at an increased risk of impairment such as cerebral palsy. And research has shown that even when they have normal intelligence, these children may have learning problems and poor performance in school. The developmental and academic problems that have been found among very low birth weight children persist into young adulthood.But despite their difficulties, these young adults were less prone to risky behaviour, were less likely than their normal birth weight peers to get in trouble regarding truancy from school, alcohol and drugs. While academic problems are not unexpected among these children, what is unexpected is their relative success despite such difficulties. Many of these adolescents have academic achievement at least equal to that of their normal birth weight peers. More studies are needed to pinpoint the environmental factors that determine the outcomes for children born at a very low weight so that more can be done to prevent these problems.
NEJM Jan 2002, Vol. 346 (3)

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