PEDIATRICS Vol. 106 No. 3 September 2000, pp. 554-560
Functional Limitations and Special Health Care Needs of 10- to 14-Year-Old Children Weighing Less Than 750 Grams at Birth
Received Sep 20, 1999; accepted Dec 23, 1999.
, and
From the * Department of Pediatrics, School of Medicine, Case
Western Reserve University, and the Department of Special Education,
Cleveland State University, Cleveland, Ohio.
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. Key words: extremely low birth weight, disability, special health care needs.
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