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 care 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, compensatory dependence and needs for services above routine, at a mean age of 11 years, were based on responses to maternal questionnaires. Rates of these outcomes were compared between groups using logistic regression analyses that controlled for gender and social risk. RESULTS Children weighing <750 g at birth had significantly higher rates of functional limitations, greater compensatory dependence, and need for services 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 exception of 3% of children who were severely impaired, the only compensatory aid that differentiated the children weighing <750 g at birth from the children 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 arrangements 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 birth.

[1]  R. Stein,et al.  Operationalizing a conceptually based noncategorical definition: a first look at US children with chronic conditions. , 1999, Archives of pediatrics & adolescent medicine.

[2]  Christopher Schatschneider,et al.  School-Age Outcomes in Children with Birth Weights under 750 g , 1994 .

[3]  Jeffrey Roth,et al.  Educational Disabilities of Neonatal Intensive Care Graduates , 1998, Pediatrics.

[4]  H. Ireys,et al.  New federal policy for children with special health care needs: implications for pediatricians. , 1992, Pediatrics.

[5]  P. Newacheck,et al.  Childhood chronic illness: prevalence, severity, and impact. , 1992, American journal of public health.

[6]  A. Wilkinson,et al.  Functional abilities at age 4 years of children born before 29 weeks of gestation. , 1993, BMJ.

[7]  L. Kann,et al.  Characteristics of health education among secondary schools--School Health Education Profiles, 1996. , 1998, MMWR. CDC surveillance summaries : Morbidity and mortality weekly report. CDC surveillance summaries.

[8]  L. Horwood,et al.  Cognitive, educational, and behavioural outcomes at 7 to 8 years in a national very low birthweight cohort , 1998, Archives of disease in childhood. Fetal and neonatal edition.

[9]  J. Tyson,et al.  Results at age 8 years of early intervention for low-birth-weight premature infants. The Infant Health and Development Program. , 1997, JAMA.

[10]  J. Tyson,et al.  Very low birth weight outcomes of the National Institute of Child Health and Human Development Neonatal Research Network, January 1993 through December 1994 , 1998 .

[11]  G. Peckham,et al.  The health and developmental status of very low-birth-weight children at school age. , 1992, JAMA.

[12]  M C McCormick,et al.  Declining Severity Adjusted Mortality: Evidence of Improving Neonatal Intensive Care , 1998, Pediatrics.

[13]  Jack P. Shonkoff,et al.  A New Definition of Children With Special Health Care Needs , 1998, Pediatrics.

[14]  N. Paneth,et al.  A quantitative review of mortality and developmental disability in extremely premature newborns. , 1998, Archives of pediatrics & adolescent medicine.

[15]  I B Pless,et al.  Issues involved in the definition and classification of chronic health conditions. , 1993, Pediatrics.

[16]  G. Greisen,et al.  Quality of life among young adults born with very low birth weights , 1995, Acta paediatrica.

[17]  Y. Burns,et al.  SCHOOL PERFORMANCE OF ELBW CHILDREN: A CONTROLLED STUDY , 1996, Developmental medicine and child neurology.

[18]  R. Cooke,et al.  Cost of care for a geographically determined population of low birthweight infants to age 8-9 years. I. Children without disability. , 1996, Archives of disease in childhood. Fetal and neonatal edition.

[19]  A. Fanaroff,et al.  Outcomes of extremely-low-birth-weight infants. , 1996, The New England journal of medicine.

[20]  L. Doyle,et al.  Respiratory health and lung function in 8-year-old children of very low birth weight: a cohort study. , 1992, Pediatrics.

[21]  J. Ware,et al.  Measuring Components of Children's Health Status , 1979, Medical care.

[22]  R. Grunau,et al.  Extremely premature (⩽ 800 g) schoolchildren: multiple areas of hidden disability , 1997, Archives of disease in childhood. Fetal and neonatal edition.

[23]  J. Rogowski,et al.  Measuring the cost of neonatal and perinatal care. , 1999, Pediatrics.

[24]  L. Westbrook,et al.  Framework for identifying children who have chronic conditions: the case for a new definition. , 1993, The Journal of pediatrics.

[25]  I B Pless,et al.  How well they remember. The accuracy of parent reports. , 1995, Archives of pediatrics & adolescent medicine.

[26]  A. Fanaroff,et al.  Outcomes of children of extremely low birthweight and gestational age in the 1990's. , 1999, Early human development.

[27]  L. Doyle,et al.  Outcome to five years of age of children born at 24‐26 weeks' gestational age in Victoria , 1995, The Medical journal of Australia.

[28]  R. Stein,et al.  Consistent but not the same. Effect of method on chronic condition rates. , 1995, Archives of pediatrics & adolescent medicine.

[29]  W. Furlong,et al.  Self-perceived health status and health-related quality of life of extremely low-birth-weight infants at adolescence. , 1996, JAMA.

[30]  W. Kitchen,et al.  Survivors of Extreme Prematurity — Outcome at 8 Years of Age , 1991, The Australian & New Zealand journal of obstetrics & gynaecology.

[31]  C. Schatschneider,et al.  Achievement in children with birth weights less than 750 grams with normal cognitive abilities: evidence for specific learning disabilities. , 1995, Journal of pediatric psychology.

[32]  H. Taylor,et al.  School-age outcomes of children of extremely low birthweight and gestational age , 1996 .

[33]  L. Westbrook,et al.  The Questionnaire for Identifying Children with Chronic Conditions: a measure based on a noncategorical approach. , 1997, Pediatrics.

[34]  C. Schatschneider,et al.  Predictors of Early School Age Outcomes in Very Low Birth Weight Children , 1998, Journal of developmental and behavioral pediatrics : JDBP.

[35]  Jack P. Shonkoff,et al.  An Epidemiologic Profile of Children With Special Health Care Needs , 1998, Pediatrics.

[36]  P. West,et al.  Health at age 11: reports from schoolchildren and their parents , 1998, Archives of disease in childhood.

[37]  L. Mutch,et al.  SCHOOL ATTAINMENT, COGNITIVE ABILITY AND MOTOR FUNCTION IN A TOTAL SCOTTISH VERYLOW‐BIRTHWEIGHT POPULATION AT EIGHT YEARS: A CONTROLLED STUDY , 1995, Developmental medicine and child neurology.