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Low-Birth-Weight Babies
Become Successful Adults
A Canadian study has good
news for parents of babies born at an extremely low birth weight:
As these children grow up, they seem to catch up with their normal-birth-weight
peers -- graduating from high school, getting jobs, living on
their own and entering into adult relationships.
"What we found, to our pleasant surprise, was that extremely
low-birth-weight babies -- although one-quarter have disabilities
-- at young adulthood seem to have adapted fairly well," said
study author Dr. Saroj Saigal, director of the Neonatal Follow-up
Program at the Michael G. DeGroote School of Medicine at McMaster
University in Ontario.
"They were doing just about as well as children born of normal
birth weight. A similar number were employed and education levels
were similar," Saigal said.
Results of the study appear in the Feb. 8 issue of the Journal
of the American Medical Association .
However, not everyone agrees that the picture is quite so rosy.
In an editorial in the same issue of the journal, Dr. Maureen
Hack, of Rainbow Babies and Children's Hospital in Cleveland,
pointed out that the babies in this study were overwhelmingly
from socially advantaged families and a country that provides
access to universal health care. In other countries, and in less
educated and poorer family settings, studies have indicated that
low-birth-weight infants don't do as well as their normal-weight
peers.
Hack, a professor of pediatrics and director of High Risk Follow-Up
at the hospital and Case Western Reserve University, said, "This
study is promising and shows that in an optimal environment,
these children can do remarkably well. But I think they tend
to have more educational difficulties because they often have
lower IQs."
"In our studies, we tested [low-birth-weight babies] in adulthood
and they did have lower IQs and more difficulty with academic
subjects," she added. "That comes from all the complications
of being premature -- they're sicker, have more respiratory distress
and more infections."
The outcome of this debate may well become even more important
in the coming years. Late last year, the U.S. Centers for Disease
Control and Prevention released a report that found more than
half a million babies were born prematurely in the United States
in 2004. That's the highest number of premature births ever recorded,
up 18 percent from 1990.
Saigal's study followed 149 children who were born weighing
less than 2.2 pounds in the late 1970s and early 1980s until
young adulthood -- average age of 23.3 years. The researchers
assessed the children periodically and compared them to a group
of age and sex-matched normal-birth-weight children from the
age of 8 on.
The study looked at a number of factors, such as educational
levels, employment and living status, so the researchers could
assess overall functioning in society.
Twenty-seven percent of the extremely low-birth-weight children
had neurosensory impairments, such as cerebral palsy, autism,
blindness and cognitive impairments. Just 2 percent of the normal-birth-weight
cohort had these impairments.
Educational attainment was similar -- 82 percent of the low-birth-weight
group graduated from high school, while 87 percent of the normal-weight
group did. Thirty-two percent of the low-weight group was pursuing
a higher education, compared to 33 percent in the normal-weight
group.
Forty-eight percent of the low-birth-weight group was permanently
employed vs. 57 percent of the normal-birth-weight group. Forty-two
percent of the low-weight group was living independently compared
to 53 percent of the normal-weight group. For marriage, the numbers
were 23 percent and 25 percent, respectively; for parenthood,
they were 11 percent and 14 percent, respectively.
Saigal said none of the differences was statistically significant.
"When you look at this issue from a lifetime perspective, these
children have either outgrown or adapted. Some recovery does
occur. If children are not doing well at an early age, there's
still hope they'll show later recovery," she said.
"Parents should be hopeful that with intervention, children
can adapt and show improvement and function well in society," Saigal
added.
Hack said that, while not all children will do as well as those
in the Canadian study, most low-birth-weight babies do "all right."
"They can achieve their best potential, though I still think
they will have more difficulties than normal-weight children," she
said.
To learn more about premature babies, visit the March
of Dimes .
SOURCES: Saroj Saigal, M.D., professor, pediatrics, and director,
Neonatal Follow-up Program, Michael G. DeGroote School of Medicine,
McMaster University, Hamilton, Ontario; Maureen Hack, M.D., Ch.B.,
professor, pediatrics, and director, High Risk Follow-up, Rainbow
Babies and Children's Hospital and Case Western Reserve University,
Cleveland; Feb. 8, 2006, Journal of the American Medical
Association Reference
Source 62
February 7,
2006
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