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Most 'Extreme Preemies' Grow Into Happy, Healthy Teens

By Ellin Holohan
HealthDay Reporter

THURSDAY, June 7 (HealthDay News) -- The tiniest, most underweight babies emerge as teens who feel good about themselves, rating their health about the same as children born at normal weights, according to a new study.

The research, which tracked children who weighed less than 2.2 pounds at birth, found that 69 percent reported their health as good to excellent when they were teenagers. That was about the same rate reported by both a control group of teens who weighed at least 7 pounds as newborns, and the general population of adolescents in the United States.

While severely underweight babies do have more health problems and learning disabilities than other children, the study's lead author stressed that the research revealed how they feel about themselves in their teen years.

"There is this whole question of whether we should be keeping these very premature babies alive," said Dr. Maureen Hack, a professor of pediatrics at Case Western Reserve University Medical School, in Cleveland, where the study was done. "It is important to consider how they feel about themselves, not just how other people feel about them."

Another key finding of the study was that the smallest children at birth tended to avoid risk more than their peers in adolescence. But those risks included dangers such as alcohol, drugs and friends who get into trouble, according to the research.

The study appeared online June 4 and will be published in the July issue of Pediatrics.

About 30,000 very low birth weight babies are born in the United States each year, and about 80 percent survive, Hack said. Risk factors for very low birth weight include low socioeconomic status, maternal high blood pressure, maternal infection and multiple births.

Very underweight babies born prematurely often have lung, vision and hearing problems. But their vision tends to improve as they grow older, said another expert, Dr. Roya Samuels.

Yet, "these infants do not come out unscathed," said Samuels, a pediatrician at Cohen Children's Medical Center in New Hyde Park, N.Y. She warned against drawing too many conclusions from the study because self-reporting by teenagers can be flawed.

She said one finding in the research -- that teens in the study group had significantly higher rates of learning disabilities and other medical problems -- "didn't make a lot of sense" if the teens also rated their health as good to excellent.

"There are no objective measures," she said, adding that parents or doctors could have given valuable input. The study noted that parents involved in other research had "reported poorer health" for their preterm children than the children did.

The study followed 168 extremely underweight babies admitted to Rainbow Babies and Children's Hospital from 1992 to 1995. Researchers also recruited a control group of 115 normal birth-weight children matched for age, gender and socioeconomic status. Both groups filled out the same questionnaire at ages 8 and 14. Most participants were black and from middle- to lower-middle-income households, said Hack, noting that premature birth is a serious problem among black women.

Participants answered questions about overall health, specific health problems, self-esteem, sexual activity, drug and alcohol use, peers and school performance.

At age 14, about 45 percent of the extremely low birth weight children were in special education programs, compared with about 10 percent of those with normal birth weights. Significantly, more of the former group also had long-term medical disorders such as cerebral palsy.

The study noted that the children who were severely underweight at birth were less likely to engage in physical exercise and risky behaviors, including riding in fast cars, breaking parental rules, drug and alcohol use and sexual intercourse.

Hack, who is also a professor of obstetrics and gynecology at Case Western, said risk aversion in teen years might not be "entirely beneficial" because some risk-taking during adolescence is normal and it could mean the children are more socially isolated. She also said parents might be more protective of preterm children, resulting in fewer opportunities to take chances.

Yet, the study's key message is "that the children feel okay about themselves, despite their problems," Hack said. "It is important to know that."

More information

To learn more about extremely low birth weight, visit Boston Children's Hospital .

SOURCES: Maureen Hack, M.D., professor of pediatrics and of obstetrics and gynecology, Case Western University Medical School, Cleveland; Roya Samuels, M.D., pediatrician, Cohen Children's Medical Center, New Hyde Park, N.Y.; July 2012, Pediatrics

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