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Long-term Family Outcomes for Children With Very Low Birth Weights
H. Gerry Taylor, PhD;
Nancy Klein, PhD;
Nori M. Minich, BS;
Maureen Hack, MB, ChB
Arch Pediatr Adolesc Med. 2001;155:155-161.
Objective To examine long-term outcomes in families of children with very low
birth weights (<1500 g) in relation to the extent of low birth weight and
neonatal medical risk.
Design Concurrent/cohort prospective study.
Setting Regional follow-up program.
Participants Families of 60 children of school age with birth weights less than 750
g, 55 with birth weights between 750 and 1499 g, and 49 normal birth weight
full-term controls.
Main Outcome Measures Parent ratings of psychological distress, family function, and child-related
stress.
Results Families with children with birth weights less than 750 g experienced
greater stress than did families of controls (born at full term), and families
who were sociodemographically advantaged experienced greater stress than did
those who were disadvantaged. Higher neonatal medical risk also predicted
a more negative impact on the family, but only in advantaged families. Regression
analyses suggested that adverse family outcomes were mediated by ongoing problems
in child functioning.
Conclusions Families of children with birth weights less than 750 g experience more
long-term adversity than families of full-term children. Family sequelae are
also present for children with very low birth weight at high neonatal medical
risk. Ongoing child health and behavior problems may be the major source of
these sequelae, and sociodemographic status is an important consideration
in identifying family adversity. Although many families appear unaffected,
results support the need to monitor family outcomes and develop interventions
for both the child and family.
From the Department of Pediatrics, Case Western Reserve University,
Rainbow Babies and Children's Hospital of University Hospitals of Cleveland
(Drs Taylor and Hack, and Ms Minich); and the Department of Education, Cleveland
State University (Dr Klein), Cleveland, Ohio.
Corresponding author and reprints: H. Gerry Taylor, PhD, Department
of Pediatrics, Rainbow Babies and Children's Hospital, 11100 Euclid Ave, Cleveland,
OH 44106-6038.
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