All ETDs from UAB

School

School of Public Health

Document Type

Dissertation

Department (new version)

Public Health

Date of Award

2000

Degree Name by School

Doctor of Public Health (DrPH) School of Public Health

Abstract

We evaluated the long-term effects of small for gestational age (SGA) and preterm birth on psychomotor and physical development of children. We followed 857 singleton newborns to assess their physical growth at 5 y of age using z Scores of weight-for-age, weight-for-height, and height-for-age. Of the 857 infants, 740 children were assessed at age 5 y for intelligence quotient (IQ) using Wechsler Preschool and Primary Scales of Intelligence-Revised. A subset of 740 (68%) children was also evaluated at 1 y of age for mental development index (MDI) and psychomotor development index (PDI) measured by Bayley Scales for Infant Development. After we adjusted for mothers' psychosocial status and home environment, preterm infants had a risk of developing low MDI or PDI that was fourfold the risk of appropriate for gestational age (AGA) infants. However, preterm birth was not a predictor of low IQ measured at 5 y of age. The adjusted odds ratio (95% confidence interval) for development of low IQ were 5.0 (1.6–15.2) for African Americans compared with Caucasians, 3.5 (1.4–8.8) for children whose mothers had less than 12th grade education compared with those whose mothers had higher education, and 2.7 (1.2–6.1) for children whose mothers' had no personal income compared with those whose mothers had income. At birth, weight-for-age, weight-for-height, and height-for-age in African American babies were lower than in Caucasian babies. However, at 5 y of age these indices were higher among African American than Caucasian children. In regression analysis, African American children were 60% less likely to have low height-for-age (<−1 SD of z Score) than Caucasian children. Similarly, SGA children had twice the risk for developing low weight-for-age (<−1 SD of z Score) than AGA children. Mothers' pre-pregnancy body mass index (BMI) <22 was associated with twice the risk of having low weight-for-height (<−1 SD of z Score) in their 5-y-old children than mothers who had BMI ≥22. African American children from low-income families and children whose mothers had fewer years of formal education or no personal income were at higher risk of developing mild mental retardation. Children who were SGA or whose mothers had low pre-pregnancy BMI were more likely to exhibit undernutrition at preschool age.

ProQuest Publication Number

Document on ProQuest

ProQuest ID

3001308

ISBN

978-0-493-09906-4

Comments

DrPH

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