Follow-up of very low birthweight babies to adolescence.

Reports on the school-age outcomes and behavioural difficulties at adolescence of infants who were very low birthweight (VLBW) are only just emerging. Studies which compare VLBW with same age controls consistently show significantly poorer performance, with average scores between 8 and 13 points lower. Even children with no neurological impairments have scores which are significantly lower on cognitive and achievement measures. The extremely low birthweight (ELBW) adolescents fare worse on all measures and perform particularly poorly in mathematics. A high proportion of VLBW adolescents (15%-20%), and an even higher proportion of ELBW adolescents (30%-50%), are receiving remedial assistance and/or have failed a grade. There are conflicting reports on whether the behavioural problems increase or improve with age, but most studies show that at adolescence the problems are still significantly greater in the VLBW cohort than in their peers. Methodologically rigorous studies of the current survivors to school-age should be conducted to determine whether the technological innovations in the 1990s have contributed to a reduction in psychoeducational and behavioural difficulties. Future research should also be directed towards early identification of school difficulties and development of intervention strategies targeted to the most vulnerable infants.