Long-term family outcomes for children with very low birth weights

Objective: To examine long-term outcomes in families of children with very low birth weights (<1500 g) in relation to the extent of low birth weight a nd neonatal medical risk. Design: Concurrent/cohort prospective study. Setting: Regional follow-up program. Participants: Families of 60 children of school age with birth weights less than 750 g, 55 with birth weights between 750 and 1499 g, and 49 normal bi rth weight full-term controls. Main Outcome Measures: Parent ratings of psychological distress, family fun ction, and child-related stress. Results: Families with children with birth weights less than 750 g experien ced greater stress than did families of controls (born at full term), and f amilies who were sociodemographically advantaged experienced greater stress than did those who were disadvantaged. Higher neonatal medical risk also p redicted a more negative impact on the family, but only in advantaged famil ies. Regression analyses suggested that adverse family outcomes were mediat ed by ongoing problems in child functioning. Conclusions: Families of children with birth weights less than 750 g experi ence more long-term adversity than families of full-term children. Family s equelae are also present for children with very low birth weight at high ne onatal medical risk. Ongoing child health and behavior problems may be the major source of these sequelae, and sociodemographic status is an important consideration in identifying family adversity. Although many families appe ar unaffected, results support the need to monitor family outcomes and deve lop interventions for both the child and family.