Low birthweight and postnatal physical development

Neurological, psychological and educational sequelae of low birth weight

In a prospective study of 501 infants of low birth weight (LBW) who mostly weighed 2,041 g (4 1/2 lb) or less, and of 203 control infants of full birth weight (FBW > 2,500 g), 335 LBW and 139 FBW children were followed beyond the age of 6 years and 6 months. The incidence of neurological defects was negatively correlated with birth weight, and the mean "global" IQ of different birth weight groups retained a direct relationship. While the relationship of birth weight to IQ gradually became less marked, the effect of social class was increasingly evident from the age of 2 years and 6 months. The preterm children whose birth weight was appropriate for gestational age (AGA) attained a slightly higher mean IQ and significantly better grade placement in the third school year than the children who were unduly light for their gestational age. Details of the neurological and ophthalmological defects are given, and the predictive significance of neonatal variables is analyzed.

Relationship between birth weight and perceptual motor performance in children

A perceptual-motor performance test (jumping, skipping, balancing, walking) was administered to 150 5- and 6-yr.-old children categorized according to birth weight. Differences were found among the three birth-weight groups, with the children of low birth weight scoring significantly lower than the groups of medium and high birth weight. A substantial positive correlation of .75 was obtained between birth weight and the perceptual-motor performance (total number of items passed).

[Children's development after placental dysfunction (author's transl)]

Katamnestic neurological and electroencephalographic studies were performed on a group of 6 to 11 year old children who had been born in the years of 1960 to 1966 with the signs of placental dysfunction. Of a total of 288 children (2,8% of the deliveries at the department of obstetrics & gynecology of the Cologne university) 177 were analized katamnestically and 152 uncerwent a clinical examination. For comparison a group of 384 children were studied who had been born in the same years spontaneously from vertex presentation after a maximum duration of labour of 16 hours. At the time of delivery these children were mature and eutrophic. 133 children of this group were studied katamnestically and 114 underwent clinical examination. The katamnestic studies showed that the group with symptoms of placental dysfunction differed in their development from the control group: these children learned later to sit, to walk, to speak, to dress without help, and to control urination. No differences were found in the ability to write and to read or in their results at school. However a larger percentage of the control group was found to attend a higher educational institution. No differences were found in the incidence of disease or behavioral abnormalities. Sleeping problems and lact concentration were more often observed in the group of children with symptoms of placental dysfunction. The general clinical examination showed no differences between the two groups. The applied different tests to examine grow movements were performed less perfect in a higher percentage by the children born with signs of placental dysfunction. Even greater differences were found in testing the voluntery skilled movements. The electroencephalogram of children of both groups showed a normal basic activity, a distinct blocking effect and a significant activation upon hyperventilation. An abnormal and pathological EEG was however significantly more often found in children born with symptoms of placental dysfunction. The results of the examination of the individual children and the combination of these results in the groups of symptoms showed that children with signs of placental dysfunction demonstrated a significantly higher incidence of symptoms. It was furthermore obvious that these symptoms were not singular but part of a complex disturbance which was manifested in the obstetrical characteristics as well as in the katamnesis and in the clinical examination. Thus, these studies have demonstrated a higher rate of morbidity in children with placental dysfunction in addition to the known high perinatal mortality. This points the necessity of an early prepartual diagnosis in particular in pregnancies with predisposition, in order to reduce not only the perinatal mortality but also to avoid the described complications in children born after placental dysfunction.

The relationship of the rate of intrauterine growth of low-birth-weight infants to later growth

The relationship of the rate of intrauterine growth of low-birth-weight infants (1,501 to 2,500 gm) to their postnatal growth up to 10 years of age was investigated. Each child was assigned to one of four gestation quartiles which have identical birth weight distributions but differ widely in their length of gestation. The mean heights and weights of the children in each of the four quartiles were compared with similar data of a control group of children who had birth weights above 2,500 gm. Only infants in the long gestation quartile failed to catch up in height and weight to the control group by the end of the 10-year period. The same results that were obtained for the total cohort were also found separately for white and black children and for boys and girls. The data relate to 488 single white and black low-birth-weight infants and 488 normal-birth-weight infants.