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A correction has been published: N Engl J Med 2002;347(2):141.

Original Article
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Volume 346:149-157 January 17, 2002 Number 3
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Outcomes in Young Adulthood for Very-Low-Birth-Weight Infants
Maureen Hack, M.B., Ch.B., Daniel J. Flannery, Ph.D., Mark Schluchter, Ph.D., Lydia Cartar, M.A., Elaine Borawski, Ph.D., and Nancy Klein, Ph.D.

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ABSTRACT

Background Very-low-birth-weight infants (those weighing less than 1500 g) born during the initial years of neonatal intensive care have now reached young adulthood.

Methods We compared a cohort of 242 survivors among very-low-birth-weight infants born between 1977 and 1979 (mean birth weight, 1179 g; mean gestational age at birth, 29.7 weeks) with 233 controls from the same population in Cleveland who had normal birth weights. We assessed the level of education, cognitive and academic achievement, and rates of chronic illness and risk-taking behavior at 20 years of age. Outcomes were adjusted for sex and sociodemographic status.

Results Fewer very-low-birth-weight young adults than normal-birth-weight young adults had graduated from high school (74 percent vs. 83 percent, P=0.04). Very-low-birth-weight men, but not women, were significantly less likely than normal-birth-weight controls to be enrolled in postsecondary study (30 percent vs. 53 percent, P=0.002). Very-low-birth-weight participants had a lower mean IQ (87 vs. 92) and lower academic achievement scores (P<0.001 for both comparisons). They had higher rates of neurosensory impairments (10 percent vs. <1 percent, P<0.001) and subnormal height (10 percent vs. 5 percent, P=0.04). The very-low-birth-weight group reported less alcohol and drug use and had lower rates of pregnancy than normal-birth-weight controls; these differences persisted when comparisons were restricted to the participants without neurosensory impairment.

Conclusions Educational disadvantage associated with very low birth weight persists into early adulthood.


Source Information

From the Departments of Pediatrics (M.H., D.J.F., M.S., L.C.) and Epidemiology and Biostatistics (E.B.), Case Western Reserve University, and the Department of Special Education, Cleveland State University (N.K.) — both in Cleveland; and the Institute for the Study and Prevention of Violence, Kent State University, Kent, Ohio (D.J.F.).

Address reprint requests to Dr. Hack at the Rainbow Babies and Children's Hospital of the University Hospitals of Cleveland, 11100 Euclid Ave., Cleveland, OH 44106, or at mxh7{at}po.cwru.edu.

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Related Letters:

Outcomes in Young Adulthood for Very-Low-Birth-Weight Infants
Harrison H., Conley D., Bennett N. G., Zach L. J., Tasman W., Hack M., Klein N., Flannery D. J., McCormick M. C., Richardson D. K.
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N Engl J Med 2002; 347:141-143, Jul 11, 2002. Correspondence

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