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Babies Born Very Small Are Likely to Have Problems Later

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These findings suggest that "higher maternal education is protective," Vohr says, and that "families with more socioeconomic problems are at higher risk of having a premature child with developmental problems." Vohr is director of neonatal follow-up at Women's and Infants Hospital and professor of pediatrics at Brown University, in Providence, R.I.

"This study is a useful addition to the literature," says Stephen Bates, MD, who reviewed the report for WebMD. The fact that so many premature children are surviving "is a reflection of excellent perinatal care and incredibly expensive neonatal care. ... But it raises ethical issues. ? These children are going to have a huge number of problems."

Bates, a pediatric neurologist at Arkansas Children's Hospital in Little Rock, also warns that the children examined in this study may encounter even more problems once they enter school.

"That is absolutely correct," Vohr says. "If you look at studies of school performance of children who weighed less than [2 pounds] at birth, half of them require special help. However, with the proper intervention, many of those problems can be addressed."

Vohr prefers to take a brighter outlook on these findings. "Overall, 49% of the children had poor outcomes at 18 months of age, but that means 50% of them had good outcomes," she says. "Eighty-three percent of them were walking, and 80% of them were able to feed themselves independently. I'm optimistic that these children will be doing even better by age 4 to 5 years."

Bates and Vohr urge women to everything they can to ensure a healthy pregnancy and decrease the risk of delivering prematurely. "For every week you can gain of intrauterine life and every [few ounces of birth weight] you can gain, it seems to make a significant difference in outcome," Bates says.

Vohr adds: "Seek prenatal care early. Get good nutrition, don't smoke or drink, engage in moderate exercise -- maintain a healthy lifestyle."

If you already have a baby who was premature, she advises, "ask about early interventions. Talk to the neonatologist and other experts available. Most of all, just provide a lot of love and nurturing for your baby."

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