Self-esteem of adolescents who were born prematurely

ABBREVIATIONS. VLBW, very low birth weight; GSW, global self-worth; ELBW, extremely low birth weight; C, control; SPPA, Harter Self-Perception Profile; WRAT-R, Wide Range Achievement Test--Revised; SES, socioeconomic status; MANCOVA, multiple [...]
Objective. To determine whether there are any differences between the self-esteem of a cohort of adolescents who were extremely low birth weight (ELBW) in comparison with term controls (Cs); and to test the associations between self-esteem and several predefined predictor variables. Background. Self-esteem is considered to play a significant role in psychological adjustment and scholastic success. Little information exists on how adolescents who were ELBW regard themselves. Design/Methods. Longitudinal follow-up of a regional cohort of 132/169 (78%) ELBW survivors and 127/ 145 (88%) sociodemographically matched Cs, born between 1977 and 1982. Measures: Harter Adolescent Self-Perception Profile (1988) with 9 dimensions, including Global Self-Worth, socioeconomic status (Hollingshead), height-for-age and weight-for-age z scores, and Wide Range Achievement Test--Revised (WRAT-R; Reading, Spelling, and Arithmetic). Data Analysis: General linear model multiple analyses of covariance were performed to determine whether significant relationships existed between the 9 self-esteem dimensions and the independent variables of birth weight status and gender, and the covariates of age, socioeconomic status, physical development, and academic achievement. Results. Global Self Worth was similar for ELBW and Cs (means: 3.1 and 3.2). Multivariate effects revealed no interactions, but significant main effects emerged for birth weight status, gender, weight-for-age z scores, age in months, and for all 3 WRAT-R subtests, all effect sizes medium to large. Follow-up analysis of covariance revealed medium-size gender effects for athletic competence (means: 3.1 and 2.6), and physical appearance (means: 2.9 and 2.5), where boys rated themselves significantly higher on both domains; and age effects, where older teens rated themselves better for job competence. Significant but small effect sizes emerged for the following: 1) weight-for-age z scores, where heavier youth rated themselves higher on close friendships, 2) gender, where girls had higher ratings for close friendships, 3) birth weight, where Cs rated themselves higher on athletic competence, and 4) WRAT-R math effect, where children with higher math scores rated themselves better on scholastic competence. Conclusions. Overall, ELBW teenagers do not differ significantly from C teenagers on most dimensions of self-esteem. Gender effects emerged on some Harter domains. Pediatrics 2002;109:429-433; self-esteem, adolescence, self-concept, extremely low birth weight, controls.