title: Delays in receipt of immunizations in low-birth-weight children: a nationally representative sample.
abstract: BACKGROUND
  Studies of very low-birth-weight (VLBW) children discharged from neonatal intensive care units have shown delays in receipt of routine childhood immunizations. However, a recent study of VLBW children in 3 health maintenance organizations found no significant delays in immunizations.
  
  
  OBJECTIVE
  To assess the risk of immunization delays for moderately low-birth-weight (MLBW; 1500 g-2499 g) and VLBW (<1500 g) children compared with normal-birth-weight children in a nationally representative birth sample.
  
  
  METHODS
  Logistic regression analysis using the 1988 National Maternal and Infant Health Survey and the 1991 Longitudinal Follow-up Survey.
  
  
  METHODS
  Nationally representative sample of children born in 1988 in the United States.
  
  
  METHODS
  A total of 8285 children whose mothers completed both surveys.
  
  
  METHODS
  Age at receipt of each of the first 4 doses of diphtheria and tetanus toxoids and pertussis vaccine, the first 3 doses of polio vaccine, and the first dose of measles-mumps-rubella vaccine for MLBW and VLBW children, and normal-birth-weight children. We also examined whether children were up-to-date for all immunizations at ages 12, 24, and 36 months based on birth-weight groups.
  
  
  RESULTS
  Very low-birth-weight children received their first 3 doses of diphtheria and tetanus toxoids and pertussis vaccine and their first 2 doses of polio vaccine significantly later than normal-birth-weight children (P <.001). Very low-birth-weight children were significantly less likely to be up to date for all immunizations at ages 12 months (odds ratio [OR] =.556; P =.001), 24 months (OR =.439; P <.001), and 36 months (OR =.446; P <.001) compared with normal-birth-weight children.
  
  
  CONCLUSIONS
  Very low-birth-weight children are at risk for immunization delays compared with normal-birth-weight children.
authors.affiliation: Children's Hospital, Room H310, 700 Children's Dr, Columbus, OH 43205, USA. dlangkam@chi.osu.edu
authors.forename: D L
authors.initials: DL
authors.lastname: Langkamp
authors.forename: S
authors.initials: S
authors.lastname: Hoshaw-Woodard
authors.forename: M E
authors.initials: ME
authors.lastname: Boye
authors.forename: S
authors.initials: S
authors.lastname: Lemeshow
mesh_terms: D017677:Age Distribution; D004522:Educational Status; D019538:Health Care Surveys; D006279:Health Maintenance Organizations; D006306:Health Surveys; D006801:Humans; D007114:Immunization / Q000706:statistics & numerical data*; D017589:Immunization Programs / Q000592:standards; D007230:Infant, Low Birth Weight; D007231:Infant, Newborn; D019102:Infant, Very Low Birth Weight; D016015:Logistic Models; D012307:Risk Factors; D013997:Time Factors; D014481:United States