A Bright Future for Small Babies

    Do underweight babies suffer any long-term deficits as adults? Yes and no. According to new research, babies who are born small for gestational age (SGA) have significant academic difficulties in childhood and adolescence, often resulting in lower earning power as adults. However, their social and emotional lives don't seem to suffer. They are just as likely to be employed, married, and in general, as satisfied with the quality of their adult lives as those of normal birth weight (NBW).

    These are some of the conclusions from a report by Richard M. Strauss, MD, assistant professor of pediatrics at UMDNJ-Robert Wood Johnson Medical School (RWJMS), that was published in the February 2, 2000 issue of The Journal of the American Medical Association. The report is based on a study of 14,189 babies born in Great Britain in 1970. Of the group, 1,064 were SGA, which was defined as a birthweight of approximately 5.5 pounds or less. Normal births averaged about 7.5 pounds. Premature births were not included in the study.

    "Earlier studies of SGA babies focused exclusively on IQ and neurodevelopment," says Strauss. "We took a different approach, assessing quality-of-life factors as well. Solely focusing on testing ignores the social and emotional outcomes, which appear to be excellent."

    The babies were assessed at 5, 10, 16, and 26 years, respectively. At ages 5 and 10, follow-up tests included vocabulary, spelling, and reading. At 16 years, vocabulary tests, spelling tests, and questionnaires about social and emotional attitudes were administered and teacher evaluations obtained. At 26, a written questionnaire gathered data on years of education, occupation, income, marital status and adult height.

    In the school years, those born SGA had lower test scores and teacher evaluations than those born NBW. At age 26, the SGA group did not demonstrate any differences in years of education and employment, hours of work per week, marital status, or overall satisfaction with life. However, they were less than 50 percent as likely to have professional or managerial jobs compared with those who were NBW, and consequently, had lower incomes. They also reported significant height deficits compared with those who were NBW.

    Interestingly, SGA babies with professional parents achieved significantly better professional and economic outcomes as adults than those whose parents were semi-skilled, manual or unskilled workers. The implications are that parents in higher socioeconomic groups provided more stimulating environments, which helped the SGA babies overcome at least part of the deficit.

    "The study is useful in defining a group at risk," says Strauss. "Early intervention may significantly improve cognitive outcome for all SGA babies, and programs such as Head Start may give an added boost to SGA babies born to disadvantaged families."