McMaster study highlights challenges faced by preemies in adulthood

Babies who are born with an extremely low birth weight are more likely to be disadvantaged when it comes to  employment, income, self-esteem, marriage and more, according to a new study from McMaster University in Hamilton.

Researchers have spent the past three decades following a cohort of extremely low birth weight (ELBW) survivors who were born between 1977 and 1982. The latest installment of their study was published Monday in the scientific journal JAMA Pediatrics. 

Dr. Saroj Saigal, a professor of pediatrics at McMaster's Michael G. DeGroote School of Medicine and the principal author of this research, said this study has spanned her entire career.

Survey results

The study followed a group of 100 extremely low birth weight survivors — born at less than 2.2 pounds — and compared them to 89 control subjects of normal birth weight (more than 5.5 pounds) of the same age. 

Over the decades, a number of studies have been published on the prematurely born group, highlighting specific segments of their lives. In the latest publication, the participants were surveyed between the ages of 29 and 36, answering a series of questions on a broad range of medical, social and psychiatric outcomes tailored to young adulthood.

The results of the survey showed the preemies had the same levels of education, family and partner relationships as their normal birth weight peers. They were also found to have fewer alcohol and drug abuse issues in comparison.

However, when looking at employment, income and social interactions, differences appeared between the preemies and the normal birth weight (NBW) group.

• The preemies were less likely to be employed (80 per cent versus 92 per cent of NBW).
• They were less likely to have a full-time job (62 per cent versus 77 per cent for NBW).
• They made an average of $20,000 less in personal income compared to the control subjects.
• More of them were single (51 per cent versus 35 per cent of NBW).
• More of them had never had sexual intercourse (21 per cent versus 2 per cent of NBW).
• Fewer of them had children (20 per cent versus 33 per cent)

Seeing the glass as half full

"You have to look at the positive aspects, as well," Saigal said. "Sure, they're doing less well compared to the normal birth rate group, but on the whole, considering their disabilities and their earlier difficulties they had, the majority are still employed, living independently and contributing to society."

Approximately 20 per cent of this group suffers from some sort of neurosensory impairment, such as blindness and cerebral palsy. When these individuals are removed from the findings, the differences in employment, marital status and children are no longer significant. 

"Our premature group are less outgoing, less assertive than the normal birth weight group," Saigal said, adding this may have contributed to their lower employment rate.

Research to benefit preemies of the future

John Guise is one of the low birth weight participants involved in the study. The 36-year-old man from Hamilton said he gladly takes part in the study whenever he's called upon because he sees value in this research for future generations. 

His premature birth left him with minor cerebral palsy and blindness in his right eye. He says his participation in this study has helped give doctors an idea of what issues premature babies might have to deal with as they age.

As a result of this study and knowing what to look for, "they've been able to reduce the chance of blindness to less than one per cent," he said. Previously, the chance of blindness in people born prematurely was closer to 10 per cent, he said.

I think it's made me a bit more understanding of people.- John Guise, a participant in the study

Educated at Carleton University in Ottawa and employed by Metroland Media in Hamilton, Guise said the fact that he was a premature baby with a low birth weight doesn't often come up in his day-to-day life. He said, if anything, his status as a preemie has made him into a more well-rounded person.

"I think it's made me a bit more understanding of people," he said. As a member of this group, "you've dealt with challenges all your life and you have to be adaptable."

Saigal said she hopes to continue her research as the group gets older. When the study began, only half of the premature babies survived. Today, their survival rate has nearly doubled, she said.

One of the aims of this ongoing research is to guide the development of programs to help support these individuals with the health and social issues they may face.

"We could be proactive instead of waiting for problems to occur," she said.