Most ‘Extreme Preemies’ Grow Into Happy, Healthy Teens

THURSDAY, June 7 (HealthDay News) — The tiniest, most
underweight babies emerge as teens who feel good about themselves, rating
their health about the same as children born at normal weights, according
to a new study.

The research, which tracked children who weighed less than 2.2 pounds
at birth, found that 69 percent reported their health as good to excellent
when they were teenagers. That was about the same rate reported by both a
control group of teens who weighed at least 7 pounds as newborns, and the
general population of adolescents in the United States.

While severely underweight babies do have more health problems and
learning disabilities than other children, the study’s lead author
stressed that the research revealed how they feel about themselves in
their teen years.

“There is this whole question of whether we should be keeping these
very premature babies alive,” said Dr. Maureen Hack, a professor of
pediatrics at Case Western Reserve University Medical School, in
Cleveland, where the study was done. “It is important to consider how they
feel about themselves, not just how other people feel about them.”

Another key finding of the study was that the smallest children at
birth tended to avoid risk more than their peers in adolescence. But those
risks included dangers such as alcohol, drugs and friends who get into
trouble, according to the research.

The study appeared online June 4 and will be published in the July
issue of Pediatrics.

About 30,000 very low birth weight babies are born in the United States
each year, and about 80 percent survive, Hack said. Risk factors for very
low birth weight include low socioeconomic status, maternal high blood
pressure, maternal infection and multiple births.

Very underweight babies born prematurely often have lung, vision and
hearing problems. But their vision tends to improve as they grow older,
said another expert, Dr. Roya Samuels.

Yet, “these infants do not come out unscathed,” said Samuels, a
pediatrician at Cohen Children’s Medical Center in New Hyde Park, N.Y. She
warned against drawing too many conclusions from the study because
self-reporting by teenagers can be flawed.

She said one finding in the research — that teens in the study group
had significantly higher rates of learning disabilities and other medical
problems — “didn’t make a lot of sense” if the teens also rated their
health as good to excellent.

“There are no objective measures,” she said, adding that parents or
doctors could have given valuable input. The study noted that parents
involved in other research had “reported poorer health” for their preterm
children than the children did.

The study followed 168 extremely underweight babies admitted to Rainbow
Babies and Children’s Hospital from 1992 to 1995. Researchers also
recruited a control group of 115 normal birth-weight children matched for
age, gender and socioeconomic status. Both groups filled out the same
questionnaire at ages 8 and 14. Most participants were black and from
middle- to lower-middle-income households, said Hack, noting that
premature birth is a serious problem among black women.

Participants answered questions about overall health, specific health
problems, self-esteem, sexual activity, drug and alcohol use, peers and
school performance.

At age 14, about 45 percent of the extremely low birth weight children
were in special education programs, compared with about 10 percent of
those with normal birth weights. Significantly, more of the former group
also had long-term medical disorders such as cerebral palsy.

The study noted that the children who were severely underweight at
birth were less likely to engage in physical exercise and risky behaviors,
including riding in fast cars, breaking parental rules, drug and alcohol
use and sexual intercourse.

Hack, who is also a professor of obstetrics and gynecology at Case
Western, said risk aversion in teen years might not be “entirely
beneficial” because some risk-taking during adolescence is normal and it
could mean the children are more socially isolated. She also said parents
might be more protective of preterm children, resulting in fewer
opportunities to take chances.

Yet, the study’s key message is “that the children feel okay about
themselves, despite their problems,” Hack said. “It is important to know
that.”

More information

To learn more about extremely low birth weight, visit Boston Children’s Hospital .

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