Information and Resources

This article is from the WebMD News Archive

Font Size

Despite Disadvantages, Small Babies Make Happy Adults

By Norra MacReady
WebMD Health News

Feb. 1, 2000 (Los Angeles) -- Low-birth- weight babies attain lower professional and economic levels as adults than their normal-weight counterparts, but social class and family environment play a greater role in determining future achievements, a new study shows.

The study, appearing in this week's Journal of the American Medical Association, also showed that despite their lower socioeconomic status, these babies, known as small for gestational age (SGA), were as likely to go on to get married and express satisfaction with life as those born of normal weight. "Therefore," writes author Richard S. Strauss, MD, "previous studies that have focused on developmental and neurological outcomes of children who were SGA do not present a complete picture of the long-term consequences. Solely focusing on [developmental] testing ignores the social and emotional outcome of adolescents and adults who were SGA, which appears to be excellent."

Strauss arrived at these conclusions using data from the 1970 British Birth Cohort study. Initially developed to provide insight into obstetrical and neonatal care in the United Kingdom, the study has since become a vehicle for observing the physical, social, and emotional development of those children into adulthood. The children were followed up at age 5, 10, 16, and 26 years, by evaluators unaware of each child's birth weight. All of the over 14,000 subjects were full-term, and nearly 1,000 were SGA, defined as weighing approximately 5 pounds or less at birth. The average weight of the normal birth weight (NBW) infants was approximately 7 pounds.

From age 5 to 16, the children born SGA exhibited small deficits in a wide range of standardized tests, but in others, such as the 10-year reading score and the 16-year spelling and word recognition test, there was no significant difference between the two groups. Children born SGA were more likely to receive lower ratings from their teachers in terms of academic ability and class rank. By age 26, those who were SGA were less likely to have professional or managerial occupations and were more likely to have jobs as unskilled, semiskilled, or manual laborers. They also reported a significantly lower income than their NBW counterparts. However, there was no significant difference between the groups in marital status, satisfaction with life, and perception of standard of living.

While being born SGA is a significant predictor of professional and economic achievement in adulthood, Strauss writes, the deficits attributable to being SGA "were relatively small compared with the impact of parental social class. In addition, social class was associated with long-term differences in satisfaction with life, while SGA was not. ... This study supports the use of early intervention programs such as Head Start for children who were born to disadvantaged families."

"A consistent, loving home environment is much more important than where you start out, in relation to where you finish," says Craig Shoemaker, MD, chairman of pediatrics at MeritCare Children's Hospital in Fargo, N.D. Shoemaker, who was not involved in the study, says, "I'm very much a nurture vs. nature kind of person," and tells WebMD that he has two adopted children who were born SGA, both of whom are 'A' and 'B' students.

Craig questions the efficacy of programs like Head Start, whose effects fade once a child leaves. For maximum benefit, he recommends that the interventions continue through organizations such as Big Brothers and Big Sisters and various mentoring programs. "The important point is that SGA children tend to perform adequately in society and to be satisfied with their lot in life. This is something we try to tell parents all the time: that your child is going to be normal."

1 | 2

Next Page >

SHARE What is this?