Birth weight effects on children's mental, motor, and physical development : Evidence from twins data
Objective—To determine the effect of very low birth weight (VLBW; <1500g) and moderately low birth weight (MLBW; 1500–2499g) on children’s mental and motor development and physical growth during the first two years of life and whether VLBW and MLBW babies catch up to normal birth weight (NBW; >=2500g) children by age 2. Methods—We use data on dizygotic (DZ) and monozygotic (MZ) twins and singleton births from the first two waves of the Early Childhood Longitudinal Study – Birth Cohort (ECLS-B), a nationally representative dataset of children born in the U.S. in 2001. We estimate the effects of VLBW and MLBW on children’s mental and motor development scores, weight-for-age, weight-forlength, weight-for-height, and length-for-age z-scores at 9 months and 2 years. We examine whether differences in outcomes within twin pairs are related to differences in their birth weights. The within-twins analysis is conducted on samples of DZ and MZ twins. For comparison, we also estimate birth weight effects on child outcomes from multivariate linear regression models using the full singleton and twins sample. We also estimate the effect of being small-forgestational age (SGA; birth weight<10th percentile for gestation) using the same set of models in order to separate out the effects of fetal growth restriction from prematurity. Results—Evaluation of all births showed that VLBW and MLBW have large negative effects on mental development, motor development, and growth at 9 months and 2 years of age. However, results from within-twin models with DZ twins that control for shared maternal and environmental factors showed much less effect of birth weight on mental or motor development, but continued large effects on growth for the VLBW group. Within-twin models with MZ twins that control for shared maternal, environmental, and genetic factors showed statistically insignificant effects of birth weight on mental and motor development, but continued effects on growth. Similar patterns were found when examining the effects of SGA. Conclusions—After controlling for the influence of maternal, environmental, and genetic factors, low birth weight has at most a small negative effect on children’s mental and motor development in their first two years of life. However, low birth weight is a major risk factor for children’s physical growth in the early years and there is no evidence of catch-up by age 2.