LONG-TERM DEVELOPMENTAL OUTCOMES OF LOW-BIRTH-WEIGHT INFANTS

Advances in neonatal medicine have resulted in the increased survival of infants at lower and lower birth weight. While these medical succes s stories highlight the power of medical technology to save many of th e tiniest infants at birth, serious questions remain about how these i nfants will develop and whether they will have normal, productive live s. Low birth weight children can be born at term or before term and ha ve varying degrees of social and medical risk. Because low birth weigh t children are not a homogeneous group, they have a broad spectrum of growth, health, and developmental outcomes. While the vast majority of low birth weight children have normal outcomes, as a group they gener ally have higher rates of subnormal growth, illnesses, and neurodevelo pmental problems. These problems increase as the child's birth weight decreases. With the exception of a small minority of low birth weight children with mental retardation and/or cerebral palsy, the developmen tal sequelae for most low birth weight infants include mild problems i n cognition, attention, and neuromotor functioning. Long-term follow-u p studies conducted on children born in the 1960s indicated that the a dverse consequences of being born low birth weight were still apparent in adolescence. Adverse sociodemographic factors negatively affect de velopmental outcomes across the continuum of low birth weight and appe ar to have far greater effects on long-term cognitive outcomes than mo st of the biological risk factors. In addition, the cognitive defects associated with social or environmental risks become more pronounced a s the child ages. Enrichment programs for low birth weight children se em to be most effective for the moderately low birth weight child who comes from a lower socioeconomic group. Continued research and attempt s to decrease the rate of low birth weight and associated perinatal me dical sequelae are of primary importance. Ongoing documentation of the long-term outcome of low birth weight children needs to be mandated, as does the implementation of environmental enrichment programs to hel p ameliorate the long-term consequences for infants who are born low b irth weight.