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Pediatrics in the News

Long-term Outcome of Prematurity -- Behavior and Intelligence

There has been a lot in the news about an important large study published in the January 17, 2002 New England Journal of Medicine. This is the largest long-term outcome study ever of the tiniest of premature babies. What happens when they grow up? As expected, they were slightly less intelligent than their peers -- with an IQ that averaged about 5 points lower. Almost as many completed high school. Fewer completed college. Surprisingly, though, the tiniest of premies got into less teenage (and young adult) trouble than their peers -- fewer problems with alcohol, drugs, crime, or unwanted pregnancies. Usually these problems are worse with a slightly lower IQ. Perhaps extra attention from their parents made the difference? Another thought -- the children in this study were born between 1977 and 1979 and were followed for twenty years. Today, premies can thrive if they were born more than a month earlier than was the case in the '70s. Medical care has improved greatly, and I expect it to improve even more rapidly in the next twenty years. While the current study contains many valuable lessons, surprises may await us as today's tiniest premies grow up.
Alan Greene MD FAAP
January 21, 2002




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