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Birth Weight Effects on Children’s Mental, Motor, and Physical Development: Evidence from Twins Data

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Abstract

Objective To determine the effect of very low birth weight (VLBW; <1500 g) and moderately low birth weight (MLBW; 1500–2499 g) on children’s mental and motor development and physical growth during the first 2 years of life and whether VLBW and MLBW babies catch up to normal birth weight (NBW; ≥2500 g) 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 US in 2001. We estimate the effects of VLBW and MLBW on children’s mental and motor development scores, weight-for-age, weight-for-length, 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-for-gestational 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 2 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.

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Abbreviations

BSF-R:

Bayley short form—research edition

CDC:

Centers for disease control

DZ:

Dizygotic

ECLS-B:

Early childhood longitudinal study—birth cohort

IRT:

Item response theory

IUGR:

Intrauterine growth restriction

LBW:

Low birth weight

MLBW:

Moderately low birth weight

MZ:

Monozygotic

NBW:

Normal birth weight

NCES:

National center for education statistics

NCHS:

National center for health statistics

SGA:

Small-for-gestational age

US:

United States

VLBW:

Very low birth weight

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Acknowledgments

The authors thank Dr. Homero Martinez, Dr. Jennifer Park, three anonymous referees, and participants at the Early Childhood Longitudinal Study—Birth Cohort (ECLS-B) First Release Conference: Development from Birth through Age Two for helpful comments. This research was funded by a National Institute for Child Health and Human Development grant (R03HD051578). All opinions expressed are those of the authors and not of the funding agency.

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Authors and Affiliations

  1. RAND Corporation, 1776 Main Street, Santa Monica, CA, 90407, USA

    Ashlesha Datar

  2. Department of Public Administration and Policy, American University, 4400 Massachusetts Avenue, NW Washington, DC, 20016, USA

    Alison Jacknowitz

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  1. Ashlesha Datar
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  2. Alison Jacknowitz
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Correspondence to Ashlesha Datar.

Appendix

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Table 6 Comparison of length-for-age z-scores at 9-months and height-for-age z-scores at 2-years
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Datar, A., Jacknowitz, A. Birth Weight Effects on Children’s Mental, Motor, and Physical Development: Evidence from Twins Data. Matern Child Health J 13, 780–794 (2009). https://doi.org/10.1007/s10995-009-0461-6

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