Functional limitations and special health care needs of 10-to 14-year-old children weighing less than 750 grams at birth

Objective. To examine the health status, functioning, and special health ca re needs of children 10 to 14 years old weighing <750 g at birth. Methods. We compared outcomes of a regional cohort of 59 children born from 1982 through 1986 weighing <750 g at birth (mean: 665 g; gestational age: 26 weeks) to matched groups of 54 children weighing 750 to 1499 g at birth and 49 children born at term. Assessments of limitations in functioning, co mpensatory dependence and needs for services above routine, at a mean age o f 11 years, were based on responses to maternal questionnaires. Rates of th ese outcomes were compared between groups using logistic regression analyse s that controlled for gender and social risk. Results. Children weighing <750 g at birth had significantly higher rates o f functional limitations, greater compensatory dependence, and need for ser vices above routine than the other 2 groups. Compared with children born at term, the odds ratio for mental or emotional delay was 4.7 (95% confidence interval [CI]: 2.0-11.0), for restrictions in activity, 5.1 (CI: 1.6-16.3) and for blindness or difficulty seeing 3.9 (CI: 1.3-11.4). With the except ion of 3% of children who were severely impaired, the only compensatory aid that differentiated the children weighing <750 g at birth from the childre n born at term was the greater need for glasses (odds ratio [OR]: 2.8 [CI: 1.3-6.3]). Increased services above routine included special education (OR: 5.0 [CI: 2.1-11.7]), counseling (OR: 4.8 [CI: 1.0-23.1]) and special arran gements in school (OR: 9.5 [C.I. 2.1-43.6]). Conclusion. Parents and educators need to be informed of the potential for disability and special health care needs of children weighing <750 g at bir th.