Clinical Question: Do extremely low–birth-weight infants achieve functional adulthood?

Setting: Population-based

Study Design: Cohort (prospective)

Synopsis: Extremely low–birth-weight children and adolescents often exhibit lower measures of cognition, academic achievement, behavior, and social adaptation than normal–birth-weight peers. Extremely low birth weight is defined as a birth weight of less than 2 lb, 3 oz (1,000 g). To determine successful transition to adulthood, the investigators analyzed the results of a prospective, population-based cohort of 166 extremely low–birth-weight participants and 145 sociodemographically comparable normal–birth-weight participants assessed at 22 to 25 years of age.

Interviewers blinded to participant status administered validated questionnaires assessing education, employment, independent living, marital status, and parenthood. Complete follow-up occurred for 90 percent of study participants. Overall, no significant differences were found in attaining an education, getting a job, living independently, getting married, or having children. The age of attainment of these markers was similar for both cohorts.

Bottom Line: Nearly all surviving extremely low–birth-weight children and adolescents overcome early cognitive and social difficulties and reach a functional level comparable with normal–birth-weight peers. (Level of Evidence: 1b)