PEDIATRICS Vol. 97 No. 1 January 1996, pp. 18-25
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The Behavioral and Emotional Well-Being of School-age Children With Different Birth Weights

Marie C. McCormick MD, ScD1, Kathryn Workman-Daniels PhD2, and Jeanne Brooks-Gunn PhD3

1 Department of Maternal and Child Health, Harvard School of Public Health and Joint Program in Neonatology, Department of Pediatrics, Harvard Medical School, Boston, Massachusetts
2 Joint Program in Neonatology, Department of Pediatrics, Harvard Medical School, Boston, Massachusetts
3 Center for the Study of Young Children and Families, Department of Developmental Psychology, Teachers College, and Department of Pediatrics, College of Physicians and Surgeons, Columbia University, New York; Educational Testing Service, Princeton, New Jersey

Objective. To describe the mental and emotional well-being of children born at different birth weights assessed at school age and to identify neonatal, intervening health, and sociodemographic and environmental factors associated with mental and emotional well-being.

Methods. To address this issue, we used a prospective cohort study involving two previously studied cohorts, which were recontacted at 8 to 10 years of age to provide a multisite sample of 247 children weighing 1000 g or less at birth, 364 weighing 1001 to 1500 g, 724 weighing 1501 to 2500 g, and 533 weighing more than 2500 g. Maternal reports were obtained on three standardized measures of mental and emotional well-being (the Rand General Well-being Scale, the Behavior Problem Index, and the Harter Scale of Child Competence) and on intervening health, sociodemographic, and environmental variables. Neonatal variables were derived from records at birth. Statistical techniques included analysis of variance and ordinary least squares multiple regression.

Results. Lower birth weight children did not differ on the General Well-being Scale but were more likely to have behavior problems and to be considered less competent. Other important correlates of mental and emomotional well-being included childhood illness, maternal mental health, home environment score, and exposure to household cigarette smoking.

Conclusion. Although lower birth weight children have poorer mental and emotional well-being, a substantial portion of this adverse outcome reflects modifiable environmental factors.

Submitted on December 5, 1994
Accepted on February 22, 1995




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