A Follow-up Study On Growth And Development Status Of 0-to 6-year-old Children With Low Birth Weight

Objective To assess physical, social adaptive capacity, neural and behavior development states of children with low birth weight during 0-6 years of age, and to explore whether low birth weight have negative influence on children's growth of physical, neural and behavior, in order to provide basis for enriching the index system of the growth and development of children and making appropriate intervention methods to children with LBW.Methods In preliminary studies, we established a live birth cohort in a hospital in Tongling from June 2000 to June 2006 and collection the relevant information of all cohort members by nested control-study from August to October by telephone, letters and door appointments, 124 children of town accounts whose birth weight were from 1500 to 2500 g of single fetus from the cohort were established a LBW group including 53 boys and 71 girls in which there were 63 children with AGA-LBW preterm infants , 15 children with SGA preterm infants and 46 children with full-term SGA infants. Meanwhile, normal birth weight and term children were matched 1:1 with same sex preterm children, with an age gap less than 1 month and living in the same administrative district, and were served as the control group. We collected children's demographic characteristics and family background by questionnaires and measured height/length, weight, chest and head circumference, and evaluated their growth and nutritional status. Infants-Junior School Students'Social Life Abilities Scale was adopted to evaluate the social adaptive capacity and Gesell Development Diagnosis Scale (GDDS) was adopted to valuate the development quotient of the neural, and we use Parents Symptom Questionnaire (PSQ) to assess the emotional and behavior disorders of 3-6 year olds. Numerical data was analyzed by paired-samples t test or 2 related-samples rank sum test, and categorical data was analyzed by chi-square test or 2 independent-samples rank sum test. The relation between physical development of children and their age was researched with Pearson's correlation analysis and linear regression analysis. And we preliminarily study the effect of LBW on the nutrition, psychology and behavior with homogeneity analysis.Results The study shows that the level of physical development of LBW groups lagged than normal children. The height and weight of the LBW children and the controls are certain gap. And the difference of chest circumference and head circumference are not obvious. The relation of the growth of height, weight and age were positively correlated. The manifestation of the deflection of the development quotient of LBW children is obvious, and the detection rate of low weight is statistic difference from NBW. The scores of five subtest of DQ including the adaptive behavior, language, gross motor, fine motor and personal-social behavior are lower than the controls. After the 3-year-old, there are no obvious differences between the LBW and NBW in personal-social behavior and gross motor. The adaptive ability scale indicates that the LBW children are markedly lagged behind the controls in physical social adaptive capacity and the prevalence of SAC's defect are also higher than that of the controls. The results of PSQ show that the scores of behavior problems, impulsivity- hyperactivity and hyperactivity index of PSQ in children with 3-6 years old were higher than those of NBW children. And the prevalence of behavior problem is also higher than that of the controls. Whatever AGA-LBW preterm groups or full-term SGA groups, the growth of height and weight is lag than that of the concrols. The prevalence of low weight, neural development's defects, SAC's defects and behavior problems have no statistic difference among different LBW group.A homogeneity analysis was adapted to the further research. The results show that: the relation of different development outcomes and birth weight is some closely linked. NBW children are more easily emerge better adaptive ability and the normal weight. And LBW children emerge behavior abnormalities and low weight outcome in preschool.Conclusions Whatever AGA-LBW preterm groups or full-term SGA groups, because of low weight in birth, the level of physical development lagged behind normal children. And the development of nerve and social adaptive capacity are also lagged than that of controls. They have more behavior problems. Homogeneity analysis suggests that LBW children more easily have behavioural problems in preschool and low weight outcome. LBW children's low weight and behavior problems should arouse concerns of scholars, social workers and clinican.