Babies With Low-Birth-Weight Do Not Undergo an Increase in Chronic Health Issues in Adolescence

Researchers analyzing the potential long-term effects of babies born with extremely low-birth-weight have found that the rates of chronic health conditions overall, particularly asthma, did not alter between the ages of eight and fourteen years old, although the rate of obesity did increase.

Modifications made in prenatal care during the 1990s were a result of an increase seen in survival rates within a population of extremely low-birth-weight (ELBW) infants, characterized as such by a birth weight less than 2.2 lbs.

The authors of the study reported, "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.”

According to prior research, children with extremely low-birth-weight at eight years of age had significantly higher rates of chronic conditions, functional limitations, and special health care needs than the normal-birth-rate control children.

Maureen Hack, M.B., Ch.B., of Case Western Reserve University in Cleveland, and her fellow researchers performed this study in order to analyze alterations in the rates of chronic conditions of ELBW children between the ages of eight and fourteen years old.

Hack’s study was conducted from the year 2004 until 2009. The researchers focused on it 181 ELBW child participants from the previous study and 115 NBW controls of similar sociodemographic status, born between the years 1992 and 1995.

The researchers found that the overall rates of chronic conditions for the ELBW group did not change between the ages of eight and fourteen years of age (75% and 74% respectively) but they did observe a drastic reduction in the average number of chronic conditions per child. On measures of functional limitation, the rates decreased significantly from 56% to 46%.

Considerably increased rates and instances of chronic conditions among the ELBW children at age eight years continued throughout until the age of fourteen (74% for ELBW children vs. 47% for NBW controls).

"At age fourteen years, 46% of ELBW children had functional limitations compared with sixteen percent of NBW controls, including mental or emotional delay, trouble understanding simple instructions, and speaking and communicating," the authors wrote.

The rate of children with extremely low-birth-weight with asthma who needed medication did not deviate from 23% between the ages of eight and fourteen years, whereas the rate of asthma for the NBW controls increased from 8% at the age of eight to 17% at fourteen years.

By the age of fourteen, asthma rates between ELBW and NBW children were no longer significant (23% vs. 17%).

A major difference found between the ELBW children and the NBW controls was the rate of obesity. In the ELBW children, this rate increased from 12% at age eight to 19% at age fourteen. This rate did not alter in the NBW controls; at age fourteen years, the rate of obesity did not differ considerably between the ELBW children and NBW controls.

"Our results may have relevance to current survivors,” stated the authors. “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,” the authors conclude.

This study was publishing in the July 27 issue of JAMA.