Tiniest babies can become functional young adults

Once they reach their early 20s, people who were born at extremely low birthweight (ELBW) in the late 1970s and 1980s have almost as much chance as normal-weight babies of working or being in school and living independently, according to a Canadian study.

A research team led by Dr. Saroj Saigal, from McMaster University in Hamilton, Ontario, compared achievements among 149 ELBW subjects (born weighing less than 1000 grams) and 133 demographically comparable normal birthweight (NBW) subjects, at ages 22 to 25 years.

The team notes in this week’s Journal of the American Medical Association that 40 of the ELBW subjects had impairments such as cerebral palsy, autism, blindness, and/or significant mental impairment, and eight were incapable of being educated.

Still, there was no significant difference in the proportion that graduated from high school (82 percent among ELBW and 87 percent among NBW), although the total years of education attained was lower among the ELBW subjects (13.9 years versus 14.5 years).

Similar proportions were permanently employed (48 versus 57 percent), living independently (42 versus 53 percent), and were married or cohabiting (23 versus 25 percent).

“Contrary to our hypotheses ... we have shown that a significant majority of our ELBW participants have made a fairly successful transition from adolescence to adulthood...which attests to the remarkable resilience of the study participants,” Saigal’s team writes.

In a related editorial, Dr. Maureen Hack and Dr. Nancy Klein, from Case Western Reserve University in Cleveland, note that in a study they had conducted, outcomes were worse among ELBW young adults.

They suspect that socio-demographics may partially explain the differences. Most of those in the Canadian study were from two-parent families and in upper social classes, and had the benefits of a national health care system; in the Cleveland study, in contrast, most of the subjects were from poor urban areas and many of their mothers were unmarried, and their health care varied depending on type of health insurance.

“There is no place for complacency,” Hack and Klein add. “Long-term outcomes of ELBW children can potentially be improved by research to prevent or treat these complications of prematurity and by uniformly implementing postdischarge health and psychosocial family interventions and monitoring.”

SOURCER: Journal of the American Medical Association, February 8, 2006.

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