RESULTS AT AGE 8 YEARS OF EARLY INTERVENTION FOR LOW-BIRTH-WEIGHT PREMATURE-INFANTS - THE INFANT HEALTH AND DEVELOPMENT PROGRAM

Objective.-To reevaluate at age 8 years children who had participated during the first 3 years of life in a randomized clinical trial of spe cial services for low-birthweight (LBW) premature infants. Design.-Fol low-up of a randomized controlled trial of premature infants (less tha n or equal to 37 weeks' gestation), stratified by 2 LBW groups (lighte r [less than or equal to 2000 g] and heavier [2001-2500 g]) and divide d into intervention (n=377) and follow-up only (n=608) groups. Setting .-Eight sites serving diverse populations. Participants.-At age 8 year s, 874 children were assessed: 336 in the intervention group and 538 i n the follow-up only group. Intervention.-The 3-year intervention cons isted of home visits (birth to 3 years), child development center serv ices (ages 1 to 3 years), and parent group meetings (ages 1 to 3 years ). Primary Outcome Measures.-Cognitive functioning (Weschler Intellige nce Scale for Children-III; Peabody Picture Vocabulary Test-Revised); academic achievement (Woodcock-Johnson Tests of Achievement-Revised); and parental reports of school performance, behavior (Child Behavior C hecklist), and health (Child General Health Survey). Results.-At age 8 years, in the entire cohort and in the lighter LBW stratum, the inter vention and follow-up only groups were similar on all primary outcome measures, Differences favoring the intervention group were found withi n the heavier LBW group: full-scale IQ score (4.4 points higher, P=.00 7), verbal IQ score (4.2 points higher, P=.01), performance IQ score ( 3.9 points higher, P=.02), mathematics achievement score (4.8 points h igher, P=.04), and receptive vocabulary score (6.7 points higher, P=.0 01). On a physical functioning subscale, the whole intervention group received less favorable ratings, while the lighter LBW in intervention group had lower maternal ratings assessing social limitations caused by behavior. Conclusion.-Although at age 8 years there were modest int ervention-related differences in the cognitive and academic skills of heavier LBW premature children, attenuation of the large favorable eff ects seen at 3 years was observed in both the heavier and lighter LBW groups, This indicates a need-to develop additional intervention strat egies for LBW premature children that can provide sustained benefits.