PREDICTORS OF EARLY SCHOOL-AGE OUTCOMES IN VERY-LOW-BIRTH-WEIGHT CHILDREN

The purpose of this study was to examine predictors of outcome in very low birth weight (<1500 g) children. The very low birth weight sample consisted of 68 children weighing less than 750 g at birth and 65 chi ldren weighing 750 to 1499 g at birth who had been matched to the less than 750 g birth weight children in terms of hospital of birth, age, sex, and race. Mean ages for these two groups were 6.7 and 6.9 years, respectively. Outcomes were measured in terms of tests of cognitive fu nction, neuropsychological abilities, and academic achievement and par ent and teacher ratings of child behaviour and school performance. A w eighted sum of the number of major neonatal medical complications (Neo natal Risk Index) provided a composite measure of biological risk. Soc ial risks were also assessed. Results indicated that the Neonatal Risk Index was the most consistent predictor of outcomes. Even after takin g social risks into account, neonatal risk predicted overall cognitive ability and other achievement, neuropsychological, and behaviour outc omes. Individual neonatal complications that predicted outcomes includ ed severe cerebral ultrasonographic abnormality, chronic lung disease, necrotizing enterocolitis, and apnea of prematurity. Research and the rapy to prevent or reduce neonatal complications and amelioration of s ocial risks are of critical importance in improving outcomes of very l ow birth weight.