In this chapter, we will discuss the long-term consequences of being born very early or very small. This issue is relevant to those interested in developmental psychopathology as this area of research emphasizes the understanding of the mechanisms underlying the development of pathology in high-risk individuals, as well as the pathways to competent adaptation despite exposure to conditions of adversity.

Studies in the United States and others have shown that rates of low birth weight increase with decreasing socioeconomic status (e.g., Paneth, 1995). At the individual level, women belonging to lower socioeconomic strata are at significantly higher risk of preterm delivery, even after controlling for other known risk factors such as weight, weight gain, alcohol and tobacco consumption, ethnicity, parity, and source of prenatal care. At the geographic level, for any defined area, the more socioeconomically disadvantaged the population, the higher the incidence of preterm delivery and low birth weight. Socio-demographic factors, such as maternal education and family income, may be related to a less favorable neuropsychological outcome in low birth weight and preterm children, as well as in normal birth weight children (Sameroff, Seifer, Barocas, Zax, & Greenspan, 1987). In addition, a considerable proportion of preterm children are treated by intensive care and sustain some brain injuries and subsequent neurological and neuropsychological impairment. However, even in the absence of major neurological deficits, preterm and low birth weight children seem to be at risk of developing a variety of cognitive and behavioral problems in childhood.