In 2002, there were almost 23,000 babies born in the United States weighing 1.1-2.2 pounds at birth. Thanks to the advances of modern medicine, 70% of these babies survived.

In the 1990s, physicians began using sophisticated treatments to help support the lungs of extremely low birth weight (ELBW) babies (those weighing less than 2.2 pounds at birth), dramatically increasing their chances of survival. Researchers hoped these new treatments would reduce the risk of long-term developmental problems but, until now, studies that follow ELBW babies into school age have been limited.

A new study in the July 20, 2005 issue of the Journal of the American Medical Association found that eight-year-old children who weighed less than 2.2 pounds at birth were at significantly increased risk of having chronic health conditions, functional limitations, and educational problems, compared with children of normal birth weight.

About the Study

This study included 219 ELBW eight-year-old children born at a children’s hospital in Cleveland, Ohio. To the extent feasible, these children were matched with normal-birth weight (NBW) children who were recruited from the same schools as the ELBW children, on the basis of age, race, and sex (176 children).

The children’s parents filled out questionnaires that assessed their functional limitations (physical, cognitive, emotional, or social development), dependence on supportive aids (e.g., medications, special diets, assistive devices), or need for special services (e.g., medical, psychological, or educational services; special treatments; accommodations at home or school).

Pediatricians gave the children physical exams, and assessed their hearing, vision, and mental function. The researchers also formally tested the children’s academic achievement and motor skills.

The Findings

For every type of assessment, the ELBW children fared significantly worse than the NBW children. The table below summarizes some of the main findings.

OutcomePercentage of ELBW childrenPercentage of NBW children
Cerebral palsy 14%0%
Vision or hearing problems23%9%
Asthma 21%9%
Low IQ scores (less than 70)15%2%
Limited academic skills18%4%
Poor motor skills27%6%

In addition, compared with the NBW children, the ELBW children were significantly more likely to have delays in growth or development, mental or emotional delays, problems with physical activities, difficulty communicating, and socialization problems.

Furthermore, ELBW children were more likely to take medications, require special equipment for daily activities, see a physician regularly, require nursing care or medical procedures, need occupational or physical therapy, and take advantage of special school arrangements.

Keep in mind that these results do not necessarily apply to children with low birth weights (less than 5.5 pounds) or very low birth weights (less than 5.3 pounds)—only those with extremely low birth weights (1.1-2.2 pounds).

How Does This Affect You?

These findings suggest that many ELBW babies will likely face long-term health and educational difficulties, at least through age eight. Premature infants not only require special care in the days and months after they are born, but a disproportionate number of them continue to require such services into their school-age years.

Although the rates of problems were significant in ELBW children, it is important to note that not all ELBW children exhibited impairments in this study. The challenge now is to predict which ELBW children are particularly vulnerable and determine what steps can be taken to reduce their risk of long-term health and educational problems.

While the causes of preterm delivery or low birth weight are not completely understood, avoiding alcohol and smoking during pregnancy, getting regular prenatal care, eating a balanced diet, and gaining a healthy amount of weight during pregnancy can help reduce the risk of preterm delivery or having a low birth weight baby.