From Our 2010 Archives

Tiniest Babies Don't Hurt Family Health in Long Run

By Kathleen Doheny
HealthDay Reporter

THURSDAY, June 10 (HealthDay News) -- Families caring for extremely low birth weight babies generally face a higher chance of having to cope with developmental difficulties, but researchers who have tracked the tiniest babies have come upon some good news.

By the time these tiniest preemies reach young adulthood, any negative effect they've had on family health has all but faded away, the Canadian scientists noted.

"The big finding here is, over time, the impact on the family diminishes," said Dr. Saroj Saigal, professor emeritus of pediatrics/neonatology at McMaster University in Hamilton, Ontario.

But she noted that her findings may not apply to all populations, especially those in the United States. "Universal health care [in Canada] may play a role," she says. And 80 percent of her families were composed of two parents, which also could have had a positive impact on the outcome.

In the United States, about one of 12 babies is born with low birth weight, defined as less than 5 pounds, 8 ounces, according to the March of Dimes. Saigal tracked extremely low birth weight (ELBW) babies, who weigh less than 1.6 pounds. Low birth weight babies are at increased risk for serious health conditions as newborns, as well as long-term disabilities.

Saigal and her colleagues evaluated 130 of the original 161 extremely low birth weight group she has been tracking since birth, and 126 of the original 141 normal birth weight group. The babies were born between 1977 and 1982 in central-west Ontario. For the latest reports, mothers of both groups answered detailed questionnaires about how they and their children, now aged 22 to 25, were doing.

Saigal found no significant differences in the scores between the two groups in terms of marital problems, family dysfunction, the mother's mood, family anxiety and depression, social support and the parents' physical and mental health.

Those families who had children with problems such as blindness or cerebral palsy -- two conditions that sometimes, but rarely, occur in low birth weight infants -- had healthier family functioning scores than others, for reasons Saigal can't explain.

The one downside: more parents of the extremely low birth weight children reported negative job effects, such as fewer job and educational opportunities, presumably due to the time commitment needed to tend to their children's needs.

But the families of the extremely low birth weight group also said the experience brought their family closer, and that relatives and friends were more helpful to them than the help reported by mothers with normal birth weight children.

A U.S.-based expert is said he is surprised by the finding. "The outcomes were a lot better than I would have anticipated," said Dr. Avroy Fanaroff, chair of the department of pediatrics at the Rainbow Babies and Children's Hospital and Case Western Reserve University, and the Eliza Henry Barnes chair in neonatology at Case Western in Cleveland.

The new findings are more positive, Fanaroff said, than previous ones from a team from Rainbow Babies and Children's Hospital, which found that families with extremely low birth weight babies experienced more long-term adversity than those of full-term children, and that differences persisted even at early adolescence.

He agreed with Saigal that the new conclusions may not apply universally. "When you do a study you hope it is generalizable, but I think her sounding a word of caution is appropriate."

What should not be overlooked, he said, is the need for extra support and services to the families of the tiniest infants.

The study appears in the July issue of Pediatrics.

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SOURCES: Saroj Saigal, M.D., FRCP., professor emeritus, pediatrics/neonatology, McMaster University, Hamilton, Ontario, Canada; Avroy Fanaroff, M.D., FRCP., professor and chair, department of pediatrics, Rainbow Babies and Children's Hospital and Case Western Reserve University, and the Eliza Henry Barnes chair in neonatology, Case Western in Cleveland; July 2010 Pediatrics