Differences in Childhood Health Outcomes Between Term and Preterm Children with and Without Low or Very Low Birth Weight

Background: Despite extensive research evaluating preterm birth (PTB), low birth weight (LBW) and very low birth weight (VLBW), which are leading causes of adverse outcomes, few studies have investigated differences in health outcomes during childhood, including physical, emotional, developmental, and social problems, among term and preterm children with and without LBW or VLBW, especially specific subgroups. Objectives: This study aims to understand the differences during childhood health outcomes, including physical, emotional, developmental, and social problems, among term and preterm children with and without LBW or VLBW in the United States. Methods: A cross-sectional study using data from the National Survey of Children’s Health from 2016 to 2022 was conducted. The sample included 261,307 children aged 0–17 years. Preterm status was derived from a caregiver-reported questionnaire item, and birth weight was classified using NSCH-derived categories. These were combined into six adverse birth outcome categories: normal birth weight (NBW)-Term, LBW-Term, VLBW-Term, NBW-Preterm, LBW-Preterm, and VLBW-Preterm. Health indicators assessed were general physical health, emotional disorders, and developmental and social problems via age-specific questionnaires. Results: Compared to NBW-Term children, LBW-Term children had higher odds of poor physical health, developmental problems, and social problems (adjusted odds ratios [AORs]: from 1.16 to 1.51). NBW-Preterm children showed higher odds for emotional disorders, developmental problems, and social problems (AORs: from 1.39 to 1.53). VLBW-Preterm and LBW-Preterm children faced the highest odds of adverse health outcomes across all indicators (AORs: from 1.52 to 4.29 and from 1.36 to 2.04, respectively). VLBW-Term children did not show significant associations across any health outcome. Conclusions: This study reveals significant health disparities among children born PTB and/or with LBW or VLBW, emphasizing the need for targeted interventions. Particularly, NBW-Preterm and LBW-Term children also demonstrate concerning health issues, underscoring the necessity of enhanced care recommendations and monitoring strategies to support their developmental trajectories.