Self-Perceived Health, Functioning and Well-Being of Very Low Birth Weight Infants at Age 20 Years

doi:10.1016/j.jpeds.2007.04.063

The Journal of Pediatrics

Volume 151, Issue 6, December 2007, Pages 635-641.e2

https://doi.org/10.1016/j.jpeds.2007.04.063 Get rights and content

Objective

To examine the self-perceived health of very low birth weight (VLBW; <1.5 kg) infants during young adulthood.

Study design

The population included 241 VLBW and 232 normal birth weight (NBW) controls who completed the Child Health and Illness Profile: Adolescent Edition (CHIP-AE) at 20 years of age. The CHIP-AE includes six domains: Satisfaction, Comfort, Resilience, Achievement, Risk Avoidance, and Disorders, and 13 profiles that characterize patterns of health. Results were compared between VLBW and NBW subjects adjusting for sex and sociodemographic status.

Results

VLBW subjects did not differ from NBW controls in the domains of Satisfaction or Comfort but reported less Resilience (effect size [ES] –0.19, P < .05), specifically in physical activity and family involvement. They reported better Achievement, specifically in work performance (ES 0.28, P < .05), more Risk Avoidance (ES 0.43, P < .001), and significantly more long-term medical, surgical, and psychosocial disorders. Similar proportions of VLBW and NBW subjects reported Excellent (15% vs 11%), Average (27% vs 34%), and Poor (12% vs 13%) profiles of health.

Conclusions

VLBW subjects report similar health, well-being, and functioning compared with NBW controls and greater risk avoidance. However, we are concerned that their lesser resilience may prove detrimental to their future adult health.

Section snippets

Very Low Birth Weight Group

A population of 490 VLBW children were admitted to Rainbow Babies and Children’s Hospital (Cleveland, Ohio) between 1977 and 1979 of whom 312 (64%) survived to 20 years of age. The original young adult study population studied at 20 years of age included 242 VLBW participants.¹ One additional subject with cerebral palsy did not participate. Two hundred and forty-one subjects (116 men and 125 women) completed the CHIP-AE. They constitute 77% of the surviving birth cohort. A description of

Sociodemographic Status, 20-Year IQ, and Neurodevelopmental Status of the Very Low Birth Weight and Normal Birth Weight Participants

More mothers of the VLBW participants than mothers of the NBW controls had not completed high school when the children were 8 years of age. However, the VLBW and control groups did not differ in maternal marital status, race, or in the composite sociodemographic risk score.¹ At 8 years of age, the VLBW participants had significantly higher rates of neurosensory impairment and subnormal IQ than NBW subjects¹² (Table I), findings that persisted at 20 years of age.¹ The neurosensory impairments in

Discussion

We sought to examine the health, functioning, and well-being of VLBW infants at 20 years of age to obtain an individual personal assessment of the health-related aspects of their lives. VLBW subjects, as compared with NBW controls, reported similar outcomes in terms of their satisfaction with health and self, and in the levels of physically and emotionally experienced symptoms. On the other hand, the VLBW subjects reported better risk avoidance but poorer psychosocial resilience than their NBW

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Our population-based register-linkage study included all 191 705 children alive at 10 years (8492 preterm [4.4%]) born without malformations in Finland between January 1987 and September 1990 as each mother's first child within the cohort. They were followed until young adulthood. We used Cox regression to assess the hazards of STCTs, teenage pregnancies, payment defaults, criminal offending, and substance abuse by gestational age. Gestational age was considered both as a continuous and categorical (extremely, very, moderately, late preterm, early term, post term, and full term as reference) exposure.
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: Supported by grants RO1 HD34177 and MO1RR00080 (General Clinical Research Center) of The National Institutes of Health.

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Original articleSelf-Perceived Health, Functioning and Well-Being of Very Low Birth Weight Infants at Age 20 Years

Objective

Study design

Results

Conclusions

Section snippets

Very Low Birth Weight Group

Sociodemographic Status, 20-Year IQ, and Neurodevelopmental Status of the Very Low Birth Weight and Normal Birth Weight Participants

Discussion

J Pediatr

Early Hum Dev

J Adoles Health

J Adoles Health

J Pediatr

Soc Sci Med

J Pediatr

Young adult outcomes of very low birth weight children (VLBW, <1.5 kg)

N Engl J Med

Self-perceived health-related quality of life of former extremely low birth weight infants at adulthood

Pediatrics

Health, lifestyle, and quality of life for young adults born very preterm

Arch Dis Child

Quality of life in young adults with very low birth weight

Arch Dis Child Fetal Neonatal Ed

Growth of very low birth weight infants to 20 years

Pediatrics

Blood pressure among very low birth weight (<1.5 kg) young adults

Pediatr Res

Pulmonary outcome in adolescents of extreme preterm birth: a regional cohort study

Acta Pædiatr

Behavioral outcomes and evidence of psychopathology among very low birth weight infants at age 20 years

Pediatrics

Constitution of the World Health Organization

Adolescent health status measurement: development of the child health and illness profile

Pediatrics

The Adolescent Child Health and Illness Profile: a population-based measure of health

Med Care

The effect of very low birth weight and social risk on neurocognitive abilities at school age

J Dev Behav Pediatr

Health status of well vs. ill adolescents

Arch Pediatr Adolesc Med

Original article
Self-Perceived Health, Functioning and Well-Being of Very Low Birth Weight Infants at Age 20 Years