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Tiny babies still have problems as teens

Extremely low birthweight babies’ problems persist but don’t worsen

Louise Prime

Wednesday, 27 July 2011

Extremely low birthweight babies have a high rate of health problems when they reach school age but this does not increase by the time they reach adolescence, research shows.

A study in this week’s JAMA showed that rates of asthma and other chronic health conditions did not increase between the ages of 8 and 14 years but the rate of obesity rose.

Researchers had previously followed 181 extremely low birthweight (ELBW) children to 8 years old, and found that they had higher rates of chronic conditions, functional limitations and special health care needs than normal birthweight (NBW) children. For this study, they continued following these children to 2009, and compared them with 115 NBW control children of similar sociodemographic status.

Between the ages of 8 and 14 years, the overall rates of chronic conditions barely changed in ELBW children (from 75% to 74%) – compared with 47% for NBW children.

But the average number of chronic conditions per child fell significantly, from 56% to 46% on measures of functional limitation.

The authors said: “At age 14 years, 46% of ELBW children had functional limitations compared with 16% of NBW controls, including mental or emotional delay, trouble understanding simple instructions, and speaking and communicating.”

By 14 years old, ELBW children were not significantly more likely than NBW children to need asthma medication. At both 8 and 14 years old, 23% of ELBW children needed medication for asthma; whereas the number of NBW controls needing asthma medication rose from 8% at 8 years old to 17% at 14 years old.

At 8 years old, 12% of ELBW children were obese and this had risen to 19% by the time they were14 years old. For NBW children the rate of obesity did not change over this period and was 20% – not signifanctly different from the ELBW children.

The authors conclude: “Our results may have relevance to current survivors. The ELBW status may be considered a marker for the risk of multiple chronic conditions that warrant closer than average health surveillance during adolescence.

“In addition to therapy for neurodevelopmental disorders, ELBW children with asthma or obesity should receive interventions such as smoking prevention and exercise encouragement to reduce the consequences of these conditions and to possibly enhance their long-term adult outcomes.”

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