A longitudinal study of the growth and development of prematurely and maturely born children

Abstract

The health history has been studied of a group of nearly 600 prematurely and maturely born children in Edinburgh in the first two years of life. The following conclusions were reached: More than 85% of all illness requiring medical attention was infective in origin, nearly one-half of this being due to respiratory infections. Prematurely born children suffer from more medical illness in the first year of life, especially from respiratory infections. The incidence and severity of respiratory infection is highly correlated with the standard of maternal care. Prematurely born children are affected to a greater extent by an adverse environment than maturely born children from similar homes. No great difference was found in the incidence of respiratory infections in different types of housing, for children receiving similar care. Prematurely born boys appeared to be more susceptible to respiratory infections than girls. The incidence and severity of gastro-intestinal infections is highly correlated with the standard of maternal care. The incidence and severity of measles and whooping cough is also highly correlated with standard of care both for firstborn and later born children. No statistically significant difference in case incidence was found between children who had or had not received protective immunization against whooping cough. Infective skin conditions were associated with unsatisfactory care. Infantile eczema was found predominantly amongst intelligent children of good type mothers. No social gradient was demonstrated in the incidence of accidents, most of which occurred in the second year of life. The incidence was highest amongst maturely born boys. The incidence of congenital defects, both major and minor, increased with decreasing birth weight. No social gradient could be demonstrated. Hospital admissions for medical illness were considerably higher in the prematurely born, especially for lower respiratory infections. Details are given of deaths. The health experience of the Edinburgh group is compared with that of similar surveys, and some reasons put forward for certain discrepancies observed.