Pune low birth weight study--a six year follow up.

OBJECTIVE: To evaluate the intelligence, visuo-motor perception, emotional problems and preschool skills in low birth weight (LBW) infants and the impact of social and environmental factors on their development. DESIGN: A prospective cohort study. SETTING: Infants discharged from a Neonatal Special Care Unit of a referral hospital with birth weight less than 2000 g followed up in the High Risk Clinic. METHODS: Low birth weight infants were assessed by Stanford Binet Scales of intelligence, Bender Gestalt Test for visuo-motor perception, Human Figure Drawing for emotional indicators and occupational therapy assessment. A detailed evaluation of their environment and socio-economic status was done. Hearing and ophthalmic assessment was also done and the school progress report was scrutinized. RESULTS: Two hundred and one LBW and seventy one control children were assessed. The mean IQ of LBW children was within normal limits (94.3), though significantly lower than controls (101.3). Preterm SGA children had the lowest mean IQ. Visuo-motor perception and preschool skills and language development was poorer in LBW children. There was no difference in the emotional indicators. Thirteen per cent of LBW children had borderline IQ, as compared to 5.6% in controls (p<0.05). Mother's education and spaciousness of the house had a positive impact and chronic medical problems had a negative impact on the IQ. CONCLUSIONS: The mean IQ of LBW children was within normal limits. The incidence of children with borderline intelligence (IQ 70-85) was significantly higher than controls. Mother's education had a positive impact on the intelligence of the children. A longer follow up is necessary to identify "slow learners".

Growth and development of twins compared with singletons at ages one and four years.

OBJECTIVE: To compare the growth and development of twins with normal control singletons and also with matched 'high risk' singletons, at one and four years of age. DESIGN: A four year prospective follow up study. SETTING: High risk clinic (HRC) of a referral hospital. SUBJECTS: Twin pairs enrolled in the HRC; normal full term singleton controls; and high risk "matched" singletons enrolled in the HRC. METHODS: The height, weight and head circumference was measured at one and four years. Development was assessed at 1 year using the Bayley Scales of Infant Development. At 4 years, the intelligence quotient was determined by the Stanford Binet Intelligence Scale. RESULTS: Forty two twins and an equal number of controls were assessed at one year. All the twins weighed less than 2 kg at birth. They lagged behind in all three parameters of growth, namely, height, weight and head circumference. AT 4 years, 24 twins came for follow up. Although, they had caught up for head circumference, they lagged behind in height and weight, particularly the group of fourteen SGA twins. The growth parameters of LBW twins and LBW matched singletons did not show any significant difference. At one year, the development of twins was within normal limits although the motor quotients were significantly lower than that of controls. At 4 years, the intelligence quotients of twins were well within normal limits. CONCLUSIONS: Twins were lighter and shorter than controls at four years, particularly the SGA twins. The growth parameters of LBW twins and LBW matched singletons showed no significant difference. The intelligence of twins was normal at four years.