Premature infants who weigh less than 2 pounds are at a much higher risk for neurodevelopmental, cognitive, behavioral, and emotional difficulties than children born at term. Despite these problems, once these extremely low birthweight (ELBW) babies reach adolescence, their self-esteem is similar to that of other adolescents, according to a study supported in part by the Agency for Healthcare Research and Quality (HS08385). The only difference is that ELBW adolescents rate themselves significantly lower in athletic competence than other adolescents. This is consistent with objective measurements of poorer motor performance among ELBW children, which persist even when children with neurosensory impairments are excluded, notes the study's lead author, Saroj Saigal, M.D., F.R.C.P., of McMaster University.
The researchers compared the self-esteem of a regional group of ELBW adolescents and matched control adolescents born between 1977 and 1982. They administered the adolescents the Harter Adolescents Self-Perception Profile with nine dimensions, as well as achievement tests and sociodemographic questionnaires. Overall, birthweight group, sex, and neurosensory impairments did not contribute significantly to most self-esteem domain scores.
However, boys tended to rate themselves higher in athletic competence and physical appearance than girls, and older teens rated themselves better for job competence. Also, heavier youngsters rated themselves higher on close friendships, girls had higher ratings for close friendships, and controls rated themselves higher on athletic competence than ELBW adolescents. Finally, children with higher math scores rated themselves better on scholastic competence. The authors conclude that self-esteem should nevertheless be monitored closely in ELBW children, since they are considered to be at high risk for problems with adjustment.
See "Self-esteem of adolescents who were born prematurely," by Dr. Saigal, Michael Lambert, Ph.D., Chad Russ, and Lorraine Hoult, in the March 2002 Pediatrics 109(3), pp. 429-433.