A history of low birth weight alters recovery following a future head injury: A case series

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Abstract
Objective: Low birth weight (LBW; below 2500 grams) is a general risk factor for a variety of neurodevelopmental difficulties. However, these children may remain more vulnerable to neurologic and environmental insults occurring years later. This prospective case series reports on children who sustained a mild, moderate, or severe traumatic brain injury (TBI) in middle childhood but who had also been born with birth weights below 2500 grams. Participants: Participants were 14 children with mild, moderate, or severe traumatic brain injury (TBI), 5 of whom had birth weights under 2500 grams (LBW) and 9 children with normal birth weight (NBW). All participants were drawn from a larger study on the long-term cognitive and behavioral impact of pediatric TBI and were matched on age, estimated socioeconomic status (SES), and severity of TBI (with NBW children actually having a slightly worse overall injury severity). Results: At baseline, both groups exhibited similar scores on WJ-R Letter Word Identification and Calculations, Tower of London number solved, and CVLT-C total correct. Baseline group differences were observed on the CELF-III Formulated Sentences (NBW > LBW) and on the VABS Adaptive Behavior Composite and Socialization subdomain (LBW > NBW). Over 2 years, relative to the NBW group, the LBW group evidenced declines on both WJ-R subtests, CVLT-C total correct, CELF-III Formulated Sentences, and VABS Adaptive Behavior Composite and Socialization. Conclusions: Although preliminary in nature due to small sample size, findings suggest a history of LBW influences the recovery trajectory following childhood TBI. Academic and adaptive functioning and verbal memory appeared particularly affected.

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