Delays in receipt of immunizations in low-birth-weight children: a nationally representative sample.
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.
Langkamp
D L
DL
Children's Hospital, Room H310, 700 Children's Dr, Columbus, OH 43205, USA. dlangkam@chi.osu.edu
Hoshaw-Woodard
S
S
Boye
M E
ME
Lemeshow
S
S
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