Better on Time than Extremely Early

Preterm or extremely low birth weight babies face long term health challenges

(RxWiki News) Advances in prenatal medicine have meant doctors can save babies more often when they are born extremely early, such as halfway through a pregnancy. But medicine can only do so much.

A recent study looked at long-term outcomes of babies born extremely early or with an extremely low birth weight.

These researchers found that more of the children born either very early or very light in 1997 survived to early childhood than those born just seven years earlier.

However, the children born very early or very light still experience much higher rates of cognitive and behavioral problems.

As 8-year-olds, extremely early or low birth weight children performed poorly on academic and IQ assessments.

They also showed more behavioral difficulties than children born on time with a healthy weight.

"Attend all prenatal appointments."

The study was led by Esther A. Hutchinson, DpsychClinNeuro, of the Royal Women's Hospital, the Royal Children's Hospital and the University of Melbourne.

Dr. Hutchinson and colleagues assessed the cognitive, academic and behavioral characteristics of 8-year-olds who had been born extremely early or with an extremely low birth weight.

Among 317 babies who were born either before 28 weeks of pregnancy or under 1000 g in Victoria, Australia in 1997, 63 percent of them survived to age 2.

These 201 surviving children were compared to 199 children who had been born at term (at 37 weeks of pregnancy or later) and at 2500 g or heavier. All the children were 8 years of age at the time of the assessments.

The children who had been born extremely early or with an extremely low birth weight did more poorly on tests measuring IQ, educational achievement and certain areas of behavior than the healthy weight children born at term did.

These differences remained even when the researchers made adjustments to their calculations to account for socioeconomic differences among the children and children who had certain handicaps such as limited sight or hearing.

For example, 71 percent of the extremely early/low birth weight children showed at least one mild to severe neurobehavioral difficulty. Only 42 percent of the healthy weight/full-term children had at least one neurobehavioral impairment.

Half of all the babies born very early or of a very low weight showed multiple problems in neurobehavioral issues. Only 16 percent of the babies born at term with a healthy weight showed multiple problems.

"Despite ongoing improvements in the management of extremely preterm/extremely low birth weight infants, the rate of neurobehavioral impairment at school-age remains too high" compared to children born at a healthy weight at term, the authors wrote.

The good news in the study is that more babies born extremely early are surviving now than in previous years. Among these children born in 1997, 63 percent survived, but only 53 percent of extremely preterm or extremely low birth babies born in 1991 to 1992 survived.

The study was published March 18 in the journal Pediatrics. The research was funded by Australia's National Health and Medical Research Council Senior Research Fellowship and the Victorian Government's Operational Infrastructure Support Program. The authors declared no conflicts of interest.

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Review Date: 
March 17, 2013