Study shows low birth weight affects baby’s health for years

Despite the advances in neonatal care, studies indicate significant advances must occur to have better outcomes in long-term prognosis.

A study published in the July 20 issue of the Journal of the American Medical Association compared the development of 219 children born weighing less than 2.2 pounds to 176 kids born at normal weights. All the children were born between 1992 and 1995. At age eight, the children born small had significantly more chronic conditions as well as learning, movement, vision and behavioral problems. In addition, the small babies were much more likely to need special education and services.

While more tiny babies are surviving, they are also more susceptible to suffering complications, so there are greater problems down the road. The study showed that 16% of the extremely low birth weight babies had cerebral palsy, deafness of blindness compared to none of the normal weight newborns. Asthma requiring therapy afflicted 21% of the kids born tiny compared to 9% of the control group, and one in 10 of the former extreme preemies suffered asthma and cerebral palsy.

Even though the percentage of low birth weight babies born in recent years is small overall, there has been a steady increase over the last 20 years. Premature births and low birth weight were the second leading cause of infant deaths after birth defects in 2002. Some experts believe parents have a right to know what could potentially be involved when giving birth to fragile infants, but the matter is complicated since some outcomes can be predicted with precision after birth while others remain unknown to doctors.

Experts do agree that more research and diagnostic tools must be identified in order to prevent births resulting in conditions like cerebral palsy. Still, the idea of setting limits and offering parents the chance for shared decision making is controversial. In a report in the August issue of Pediatrics, a survey of 149 neonatologists in New England showed that 77% said they thought doctors and parents should make the decision to withhold resuscitation jointly, but only 40% said the choice was actually made by both parties.

Medical advances in obstetrics and the care of newborns has greatly improved throughout the years, but ethical debates about how and whether to discuss withholding treatments early on continue.

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