The Influence of Multiple Risk Factors on Very Low Birth Weight Infants

Abstract

"Vulnerable" and "at risk" are words used to describe very low birth weight infants (VLBW <1500 grams). These infants are assigned a high risk status because their intrinsic vulnerability is coupled with factors that are known to influence outcome negatively. The spectrum of risk varies, however, depending on a child's total milieu and on the ability to change or to resist change in response to that milieu ( Alyward & Kenny, 1979). For instance, extreme prematurity, prolonged hospitalization and exposure to iatrogenesis may place a child at great risk for cognitive deficits. Discharge from the hospital into the care of interested, loving parents may minimize that risk. Similarly, a healthy, physiologically intact, premature infant may experience deficits if reared in an indifferent environment. The dynamic relationship between the child and his or her environment determines risk status and outcome is the result of the child and the environment regularly restructuring one another (Sameroff & Chandler, 1975). Change may occur as the child matures, with biological and medical factors becoming less important and environmental and social factors becoming more important. This restructuring of the milieu can amplify or minimize the child's degree of risk. The purpose of this longitudinal study is to describe the developmental progress of children who were of VLBW. A comprehensive holistic model is used to identify medical, biological and environmental factors that influence risk and outcome, and to track their influence over time.