Very low birth weight linked to reduced quality of life in pre-school children

Babies with very low birth weights tend to have a much lower quality of life when they are three or four years old, according to a study published in the latest issue of the UK-based Journal of Advanced Nursing.

Researchers assessed 118 children who had birth weights of 1500g or less and compared them with a control group of 170 born at normal weights to compare their quality of life when it came to physical, emotional, cognitive and social functions.

They discovered that the very low birth-weight children scored consistently lower scores on a scale designed to measure quality of life among pre-school children.

Their parents were also much more likely to say that their child had health issues, with 29 per cent reporting a current problem, compared with 18 per cent in the control group.

In general, children with low birth weight had poorer lung function, appetite and motor function than normal birth-weight children, as well as being more anxious, less positive and less lively.

Premature babies delivered before 28 weeks were much more likely to have a lower quality of life when it came to cognitive functions such as communication.

Longer stays in neonatal intensive care units were also linked to reduced social function. The researchers suggest that this could be related to higher stress levels in early life as no specific link was established between longer stays and reduced physical functioning.

The researchers also discovered that children with very low birth weights scored better on emotional and social quality of life scales if their primary caregiver had a higher level of education.

"Previous studies of very low birth-weight babies have mostly focused on issues such as death, illness, neurodevelopment, growth and cognitive ability" says lead researcher Dr Li-Yin Chien, Associate Professor in the Institute of Community Health Nursing at National Yang-Ming University, Taiwan.

"Our research underlines the importance of monitoring quality of life in children with low birth weights to identify those at risk and intervene early.

"Healthcare professionals need to consider a number of biological and environmental factors as part of their assessment. These include current health problems, age at delivery, length of stay in the neonatal intensive care unit and the educational level of the primary caregiver."

Children ranging from 36 to 53 months were included in the study, supported by Taiwan's National Science Council. 57 per cent were boys.

252 mothers, 33 fathers and three other caregivers took part in the questionnaire-based study, which was carried out using a Mandarin language version of a quality of life instrument developed in the Netherlands.

The 118 very low birth weight children were less than 1500g (three pounds and five ounces) and were cared for in the neonatal intensive care units of four hospitals in northern Taiwan. The survival rate for babies in this weight range is just over 76 per cent in Taiwan.

Meanwhile, the control group were children who attended preschools and weighed at least 2500g (five pounds and eight ounces) or more at birth.

The mothers of very low birth-weight babies tended to be younger than the mothers in the control group, and were half as likely to be educated to college degree or higher. 45 per cent didn't work, compared with 17 per cent in the control group.

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Last reviewed: By John M. Grohol, Psy.D. on 21 Feb 2009
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