A child who was born severely underweight does not have more overall chronic health problems between 8 and 14 years of age, researchers from Case Western Reserve University, Cleveland reported in JAMA (Journal of the American Medical Association). However, obesity rates among these children grew as they got older.
Perinatal care improved substantially in the 1990s, and the survival rates among newborns weighing less than 2.2 lbs (1 kilogram) got better – also known as babies or children with extremely low-birth-weight (ELBW).
The authors wrote:
“The school-aged outcomes for these children indicate very high rates of chronic health conditions and developmental problems compared with normal-birth-weight (NBW) controls. There have been few reports of the outcomes of ELBW children during adolescence, which is a time of enormous social, health, and developmental change.”
Maureen Hack, M.B., Ch.B., and team set out to determine what the changes in rates of chronic conditions of ELBW children between 8 and 14 years of age might be. The authors explained that a prior study comparing ELBW children with NBW (normal birth weight) ones at the age of 8 found that the ELBW ones had considerably higher rates of chronic conditions, special health care needs, and functional limitations.
This study included 181 ELBW kids from the prior study as well as 115 NBW controls born from 1992 to 1995. They were all of similar sociodemographic status. This study was conducted from 2004 through 2009.
The authors found that the overall rates of chronic conditions remained the same when the children were aged 8 (75%) to 14 (74%) years. However, there was a considerable drop in the average number of chronic conditions per child.
Functional limitations – rates dropped from 56% to 46%.
Comparing the two groups – 74% of the ELBW children had chronic conditions between the ages of 8 through 14, compared to 47% among the NBW controls.
Asthma – 23% of the ELBW children required asthma medication at 8 and 14 years of age (remained unchanged). Among the NBW kids the percentage was 8% at 8 years, rising to 17% at 14 years. The authors said that the differences between the two groups at age 14 years were no longer significant.
Obesity – rates among ELBW children rose from 12% at age 8 to 19% when they were 14. ELBW kids and the NBW ones had similar obesity rates at the age of 14.
The authors wrote:
“At age 14 years, 46 percent of ELBW children had functional limitations compared with 16 percent of NBW controls, including mental or emotional delay, trouble understanding simple instructions, and speaking and communicating.
Our results may have relevance to current survivors. The ELBW status may be considered a marker for the risk of multiple chronic conditions that warrant closer than average health surveillance during adolescence. In addition to therapy for neurodevelopmental disorders, ELBW children with asthma or obesity should receive interventions such as smoking prevention and exercise encouragement to reduce the consequences of these conditions and to possibly enhance their long-term adult outcomes. “
Maureen Hack, MB, ChB; Mark Schluchter, PhD; Laura Andreias, MD, MS; Seunghee Margevicius, MA; H. Gerry Taylor, PhD; Dennis Drotar, PhD; Leona Cuttler, MD
JAMA. 2011;306(4):394-401. doi: 10.1001/jama.2011.1025
Written by Christian Nordqvist