Outcome of low birthweight in China: A 16-year longitudinal study

Aim: To compare the growth and neurodevelopment of low-birthweight (LBW) and normal-birthweight (control) infants born and raised in China. Design: Prospective cohort study. Subjects and setting: 203 LBW (1200-2499 g) and 71 control (>= 2500 g) infants born at two Shanghai hospitals in 1983 did not differ for date of birth, gender, parental occupation, parental weight and age. LBW <10th centile at >= 37 wk gestation was defined as small for gestational age (SGA, n = 102). LBW at 537 wk gestation was defined as preterm (n = 101). Main outcome measures: Weight, height, head circumference, Gesell developmental quotient (DQ), Wechsler intelligence quotient (IQ), and scholastic achievement score. Results: Of the 274 enrolled subjects, 234 (85%) returned at 6 mo, 135 (49%) at 6 y, and 104 (38%) at 16 y. SGA, preterm, and control subjects did not differ in rates of follow-up or baseline characteristics. However, SGA and preterm were lower than control subjects in weight and head circumference through 16 y, height through 4 y, DQ through 3 y, IQ at 5 and 16 y, and scholastic achievement at 16 y. Catch-up to growth in the control group, defined as >3rd centile, and normal IQ, defined as >= 85, were both more common among preterm than SGA subjects. Conclusions: Adolescents in China with birthweights of 1200-2499 g, and particularly those who were SGA, lag behind peers with birthweights >2500 g in physical growth, cognitive capacity, and school achievement. The findings suggest that LBW adolescents in China today represent a population in need of evaluation and support.