School-age consequences of birth weight less than 750 g: A review and update

Recent advances in perinatal care have led to the survival of increasing nu mbers of children born at the lower limits of viability. Children with very low birth weight (LBW; less than 1,500 g, 3 Ib 5 oz) have been studied ext ensively. Findings document poorer outcomes relative to normal birth weight term-born controls in neurologic and health status, cognitive-neuropsychol ogical skills, school performance, academic achievement, and behavior. This report reviews current knowledge regarding LBW children, with special emph asis on outcomes for children with birth weight less than 750 g (1 Ib 10 oz ). Results from an ongoing longitudinal study suggest a gradient of sequela e, with poorer outcomes in less than 750 g birth weight children compared t o both 750 g to 1,499 g birth weight children and term-born controls. Child ren with less than 750 g birth weight fail to catch up with their peers ove r time and may even be at risk for age-related increases in sequelae. Outco mes are highly variable but related to neonatal medical complications of pr ematurity and social risk factors. Further research is needed to understand the etiology and neuropathological basis of sequelae, the long-term develo pmental implications of LBW, and treatment needs.