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T)20(his increased under)-1(-)]TJ 0 -1.48572 TD (standing of the potential consequences of)Tj 0 -1.48571 TD [(LBW provides oppor)-21(tunities for service)]TJ 0 -1.48572 TD (providers and policy makers to develop)Tj T* [(prog)-21(ramming to address both the shor)-21(t )]TJ 0 -1.48571 TD (and long-term needs of LBW children and)Tj 0 -1.48572 TD (their families.)Tj ET /CS1 cs 0.3 scn 234 521.001 247.5 174.416 re f /GS2 gs 0 0 0 0 k 243 551.154 229.5 136.428 re f Q /GS2 gs /GS1 gs q BT /F6 1 Tf 5.6 0 0 5.6 379.6812 555.2098 Tm 0 0 0 1 k (n)Tj 0.64101 -0.00001 TD 0.058 Tc [(=2)19(3)20(3)]TJ -17.81302 0 Td 0 Tc (n)Tj 0.64102 0 Td 0.058 Tc (=496)Tj ET Q /GS2 gs /GS1 gs q BT /F6 1 Tf 5.6 0 0 5.6 331.6585 555.2098 Tm 0 0 0 1 k (n)Tj 0.641 -0.00001 TD 0.058 Tc [(=7)40(49)]TJ ET Q /GS2 gs /GS1 gs q BT /F6 1 Tf 5.854 0 0 5.854 373.766 672.3755 Tm 0 0 0 1 k 0.058 Tc [(2)20(000-2)19(002)]TJ ET Q /GS2 gs /GS1 gs q BT /F6 1 Tf 5.854 0 0 5.854 277.8359 672.3755 Tm 0 0 0 1 k 0.058 Tc [(1)41(982-1)40(989)-2766(1)41(990-1)40(999)]TJ ET Q /GS2 gs /GS1 gs q BT /F6 1 Tf 0 5.854 -5.854 0 252.902 587.1221 Tm 0 0 0 1 k (P)Tj 0.66205 0 TD 0.0582 Tc (E)Tj 0.60023 0 TD (R)Tj 0.66223 0 TD (C)Tj 0.68323 0 TD (E)Tj 0.60023 0 TD (N)Tj 0.76623 0 TD (T)Tj 0.55823 0 TD 0.0292 Tw ( )Tj 0.37944 0 TD (O)Tj 0.80823 0 TD (F)Tj 0.53723 0 TD ( )Tj 0.37944 0 TD (T)Tj 0.49668 0 TD 0 Tc (O)Tj 0.74668 0 TD (T)Tj 0.47667 0 TD 0.0579 Tc (A)Tj 0.66186 0 TD (L)Tj ET Q /GS2 gs /GS1 gs q BT /F6 1 Tf 5.345 0 0 5.345 256.9354 667.0235 Tm 0 0 0 1 k -0.041 Tc [(10)-41(0)]TJ 0.54202 -3.96224 TD -0.0004 Tc (8)Tj 0.58256 0.00001 TD (0)Tj -0.58256 -3.96226 TD 0 Tc (60)Tj T* (40)Tj 0.01976 -3.96224 TD -0.02 Tc (20)Tj 0.563 -3.96224 TD 0 Tc (0)Tj ET 1 w /CS1 CS 1 SCN 269.434 561.642 m 412.273 561.642 l S 0.5 w 0.5 SCN 269.306 582.814 m 412.272 582.814 l S 269.306 604.241 m 412.272 604.241 l S 269.306 625.668 m 412.272 625.668 l S 269.306 647.095 m 412.272 647.095 l S 269.306 668.522 m 412.272 668.522 l S 1 w 1 SCN 269.166 561.067 m 269.166 675.663 l S /CS1 cs 0.2 scn 275.846 561.4 36.655 106.843 re f 323.053 561.4 36.654 106.843 re f 370.259 561.4 36.655 106.843 re f /GS2 gs /CS0 cs 1 scn 275.846 561.401 36.655 74.752 re f 323.053 561.401 36.654 63.862 re f 370.259 561.401 36.655 49.689 re f /CS1 cs 0.8 scn 275.846 561.4 36.655 60.342 re f 323.053 561.401 36.654 39.037 re f 370.259 561.4 36.655 34.026 re f /CS2 cs 1 scn 275.846 561.401 36.655 55.798 re f 323.053 561.401 36.654 33.868 re f 370.259 561.401 36.655 28.855 re f Q /GS2 gs /GS1 gs q BT /F5 1 Tf 5.6 0 0 5.6 243.9038 542.8126 Tm 0 0 0 1 k 0.058 Tc 0.029 Tw (Figure 1 )Tj ET Q /GS2 gs /GS1 gs q BT /F6 1 Tf 5.6 0 0 5.6 272.0409 542.8126 Tm 0 0 0 1 k 0.029 Tw (Comparison of death and survival with and without neuro-developmental)Tj -5.02448 -1.2727 TD [(impairment at 2)20(0 months\325 C)-21(A for 5)19(00-to 999 g bir)-21(th weight infants born during 3 periods:)]TJ 0 -1.27269 TD (1)Tj 0.54202 -0.00001 TD [(982-1)40(989; 1)41(990-1)40(999, and 2)20(000-2)19(002.)]TJ ET Q /GS2 gs /GS1 gs q BT /F6 1 Tf 2.8 0 0 2.8 345.6028 530.7772 Tm 0 0 0 1 k (5)Tj ET Q /GS2 gs q BT /F6 1 Tf 5.091 0 0 5.091 385.5025 575.3531 Tm 0 0 0 0 k 0.058 Tc (68)Tj -19.16798 0 Td 0 Tc (2)Tj 0.62135 0 Td 0.038 Tc (54)Tj ET Q q BT /F6 1 Tf 5.091 0 0 5.091 335.9978 575.3531 Tm 0 0 0 0 k 0.038 Tc [(24)20(1)]TJ ET Q q BT /F6 1 Tf 5.091 0 0 5.091 385.5525 600.6974 Tm 0 0 0 0 k (3)Tj 0.62135 0.00001 TD (6)Tj ET Q q BT /F6 1 Tf 5.091 0 0 5.091 289.4499 626.0739 Tm 0 0 0 0 k 0.0577 Tc (6)Tj 0.64071 0.00001 TD (0)Tj ET Q q BT /F6 1 Tf 5.091 0 0 5.091 336.051 609.4696 Tm 0 0 0 0 k 0.017 Tc [(16)-1(1)]TJ ET Q /GS1 gs q BT /F6 1 Tf 5.091 0 0 5.091 385.6057 590.9074 Tm 0 0 0 1 k (1)Tj 0.60044 0.00001 TD (2)Tj ET Q /GS2 gs /GS1 gs q BT /F6 1 Tf 5.091 0 0 5.091 289.5 617.6934 Tm 0 0 0 1 k (2)Tj 0.62133 0.00001 TD (4)Tj ET Q /GS2 gs /GS1 gs q BT /F6 1 Tf 5.091 0 0 5.091 337.5794 595.9199 Tm 0 0 0 1 k 0.017 Tc (41)Tj ET Q /GS2 gs /GS1 gs q BT /F6 1 Tf 5.091 0 0 5.091 384.0772 652.7816 Tm 0 0 0 1 k 0.017 Tc [(11)-1(7)]TJ -18.87757 0 Td 0 Tc (1)Tj 0.60045 0 Td 0.038 Tc (58)Tj ET Q /GS2 gs /GS1 gs q BT /F6 1 Tf 5.091 0 0 5.091 335.8946 652.7816 Tm 0 0 0 1 k 0.038 Tc [(30)-20(6)]TJ ET /CS0 cs 1 scn 54 54 523 121.5 re f Q /GS2 gs q BT /F5 1 Tf 6.75 0 0 6.75 72.9172 159.0584 Tm 0 0 0 0 k 0.017 Tc 0.029 Tw [(T)19(he information about Dr)62(. Hack\325s research was drawn from the following sources:)]TJ ET Q q BT /F6 1 Tf 6.75 0 0 6.75 73.134 145.0584 Tm 0 0 0 0 k 0.029 Tw [-679(Hack M, Klein N, T)82(aylor H. Long-)61(T)82(erm Developmental Outcomes of Low Bir)-21(th W)20(eight Infants. )]TJ ET Q q BT /F21 1 Tf 6.75 0 0 6.75 360.2888 145.0584 Tm 0 0 0 0 k 0.029 Tw (The Future of Children.)Tj ET Q q BT /F6 1 Tf 6.75 0 0 6.75 431.9319 145.0584 Tm 0 0 0 0 k [(1)41(995;5(1):1)41(7)41(6-1)40(96.)]TJ -53.15524 -1.48148 TD 0.029 Tw [-679(Hack M, T)82(aylor HG, Drotar D, Schluchter M, Car)-22(tar L, Andreias L, W)20(ilson-)-42(Costello D & Klein N. Chronic Conditions, F)19(unctional Limitations, and Special Health Care)]TJ 1.01204 -1.48148 TD (Needs of School-aged Children Born with Extremely Low-Bir)Tj 26.98852 0.00001 TD 0 Tw (th-W)Tj 2.08368 0.00001 TD 0.029 Tw (eight in the 1)Tj 5.98465 0.00001 TD 0 Tw (990s. )Tj ET Q q BT /F21 1 Tf 6.75 0 0 6.75 335.0597 125.0585 Tm 0 0 0 0 k 0.029 Tw (Journal of the American Medical Association.)Tj ET Q q BT /F6 1 Tf 6.75 0 0 6.75 473.2751 125.0585 Tm 0 0 0 0 k (2)Tj 0.56296 0.00001 TD (005;2)Tj 2.58219 0.00001 TD (94(3):3)Tj 3.37417 0.00001 TD [(1)41(8-3)19(2)20(5)1(.)]TJ -65.79948 -1.48151 TD 0.029 Tw [-679(W)20(ightman A, Schluchter M, Drotar D, Andreias, L, T)81(aylor HG, Klein N, W)20(ilson-)-42(Costello D & Hack, M. P)19(arental Protection of Extremely Low Bir)-21(th W)20(eight Children at)]TJ 1.01204 -1.48148 TD [(Age 8 Y)62(ears. )]TJ ET Q q BT /F21 1 Tf 6.75 0 0 6.75 118.8077 105.0584 Tm 0 0 0 0 k 0.029 Tw [(Journal of Behavioral P)20(ediatrics.)]TJ ET Q q BT /F6 1 Tf 6.75 0 0 6.75 218.2608 105.0584 Tm 0 0 0 0 k [(2)20(0)1(0)41(7;2)20(8(4):3)19(1)41(7)41(-)1(3)21(2)20(6)1(.)]TJ -21.50027 -1.48148 TD Tj 1.01204 0.00001 TD 0.029 Tw (Hack M, Flannery D)Tj 8.66816 0.00001 TD (J, Schluchter M, Car)Tj 8.75067 0.00001 TD (tar L, Borawski E, Klein N)Tj 11.24822 0.00001 TD (K. Outcomes in Y)Tj 7.66988 0.00001 TD (oung Adulthood for V)Tj 9.62442 0.00001 TD [(ery-Low-Bir)-21(th-W)19(eight Infants. )]TJ ET Q q BT /F21 1 Tf 6.75 0 0 6.75 479.5935 95.0585 Tm 0 0 0 0 k 0.029 Tw (The New England Journal of)Tj -59.20418 -1.48148 TD 0 Tw (Medicine.)Tj ET Q q BT /F6 1 Tf 6.75 0 0 6.75 111.0886 85.0584 Tm 0 0 0 0 k (2)Tj 0.56296 0.00001 TD (002;3)Tj 2.58219 0.00001 TD (46(3):1)Tj 3.35317 0.00001 TD [(49-1)40(5)41(7)124(.)]TJ -12.12123 -1.48151 TD 0.029 Tw [-679(W)20(ilson-)-42(Costello D, F)19(riedman H, Minich N, Siner B, T)82(aylor G, Schluchter M & Hack M. Improved Neurodevelopmental Outcomes for Extremely Low Bir)-21(th W)19(eight)]TJ 1.01204 -1.48148 TD [(Infants 2)20(000-2)19(002. )]TJ ET Q q BT /F21 1 Tf 6.75 0 0 6.75 139.5372 65.0585 Tm 0 0 0 0 k [(P)20(ediatrics.)]TJ ET Q q BT /F6 1 Tf 6.75 0 0 6.75 172.2045 65.0585 Tm 0 0 0 0 k [(2)20(0)1(0)41(7;1)41(1)41(9(1):3)19(7)41(-45.)]TJ ET Q /GS1 gs q BT /F6 1 Tf 5.091 0 0 5.091 427.0759 663.8821 Tm 0 0 0 1 k 0.029 Tc 0.029 Tw [(NO I)-21(M)-21(P)62(AI)-21(R)-21(M)-21(ENT)]TJ 0 -1.76783 TD 0.05 Tc 0 Tw [(IMP)83(A)21(IRE)21(D)21(*)]TJ 0 Tc (L)' 0.46732 0.00001 TD 0.029 Tc 0.029 Tw [(OS)20(T T)61(O )]TJ -0.46732 -1.17856 TD 0.0289 Tc (F)Tj 0.50786 0.00001 TD 0.029 Tc 0 Tw [(OLL)40(O)20(W-U)-21(P)]TJ -0.50786 -1.76784 TD [(DI)-21(ED)]TJ ET /CS1 cs 0.2 scn 418.697 663.447 5.52 4.925 re f /CS0 cs 1 scn 418.697 654.3589 5.52 4.926 re f /CS1 cs 1 scn 418.697 645.272 5.52 4.926 re f /CS2 cs 1 scn 418.697 630.504 5.52 4.925 re f /CS0 cs 1 scn 53.9996 54.0004 10.5 121.5 re f /GS2 gs q 53.9996 54.0004 10.5 121.5 re W n q 0 122.1364 -11.0666 0 64.8478 53.7272 cm /Im4 Do Q Q Q endstream endobj 20 0 obj << /BitsPerComponent 8 /ColorSpace/DeviceCMYK /Filter/FlateDecode /Subtype/Image /Height 84 /Type/XObject /Length 22075 /Width 526 >> stream Xw|\y&zS0L F 6{H"bꍒ(H{dS|7Ǝz&m7N6}̙9s0`RyOӿ~d&U8 0`L<  0` `   0`U UXVse%B|Z+raV[ ,2kg?^߽)<6^:޽}O#~ğaO$  0`7H>ɰ?%;oo0`:~|1xU}Na |qxjo0` ` H00x 0`z Q 0`*M?y%x1x 0` Pia7#okU.YXzd2-w@uwz{SbGgd-ZzM#OO>t`#{;n^ضƧ}>Z+2WO?~d[={Q_xroM+tia{ݳA_. _ -_cFag6y9) a E(>m`)>g!ҩ.'h>3Vհ-"!3*j˲Գ6"&1J#.V-a 62_^tĈgnޑ^'xlj[_t7TY+ jmݭ=/b~nAzE{]2` #o~yg+I"~_msN-f-/t:'UG,g9,[PgR`A4h~a['ݢP6 Q ՜fiz2nHzkQ)6` o_-Amo|0BҢ-f-მQŀ/p|;,7W7 X1[ھrcpj͠NHpTy@K] ]=.ŊbpHgS >Osҥh% ҹ ;']e. o+*_?> 1 _9"KA~;U /-_ԐWJ %J잨S2>u bs^| ~sYbrހvw}pd2`0@mw.DLdu3lox I7Iw%1 &[K/zD:C*(邎!:4-RȬ /Wij0-ϲ^t x׾ѥ.:4` xCIx{趀b1,5fl L/9lኢ5s-X}8 6%'_Q$ ^:4Jk6s).+K9caezєtĈ. g DS O y9݋JVil[;  ?1;g}O2K7~ɀ0[c6r5]/Ju97١Zb&Re5-ee[H_nm, cv`Es 5OB~Kӓ+p^>X`ڡ^&jy8jd؛lV!߽EN >Oe1qԚA7]wT?mwl)mXLbA\ڏhoe{lʝ7o r}߾?bVv%(Z=7G߲K KFvn|Sfꫬ]+xJW~SX Vme/QG]ض{vx;11~rXqhc^'&3;̯˚m,o>rj_ޱ~pSy5 Fr)"/zcݳc>O\?M+i~sw=큋'giTcK7NLEaW7:] wu;f/5rmKwPu]J_>5=(iCw^_inj{1SGؘϑ]n9zЖlPwZ =NSN伙'kLww|l Nk"b)ePtDn(IiC K薜6ذf&Sܴ^M[|;>Qht5E敋 3|dۅ^9CaYℛo?o; ٔD<aP^B{kDY*y%뗪oXz%b, ԕ\"^ݓ׌_c"C-+5P=}P9}i[u!c^@\kO/!)<'13Gϰ[s)yãur e<=8D>=Hqp0`e-o෮U WU0KTN@ O N]R=ok%{"|tmW o?EIso!K9|]8}0C3: u%Xu~Y[o§!"3:{SyOSxǢ;$}JNMk o<6$!? 6.ͨB?b|D/ Pw`  Oc\R;#v1&y|4t-JݨKrK{y- YTZ;O鐃 B -%ESR ]h/RO3ձ$.xs ig xl54v ;*$;W0[ހ9eyCA{)nI*jA:I8DRjOMbRq iw|Z4 hTW`LjӥZ V% =F ArjZL Djt)#nc1MϩnI+;)~逸ʓƐsnU1k[Fcv MtCO=T&# _FF3_8/k(@S9a4VECL?pH[ta34~p?tkX4d5)z t6=o -2 3-ggMbiUDtK]J .'jStFvJWN E/Yy7t5TYe{Bp:ѕ[ΛSgmO2o{?fJCM9 }H>. 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T)19(hey clear-)]TJ T* 0 Tc [(l)6(y)-315(illustrate the advances in care for low bir)-22(th weight infants over)]TJ T* [(the last 3)20(0 years and show that more and more low bir)-21(th weight)]TJ T* [(babies are surviving. However)41(, more work remains to be done. )]TJ 0 -2.05714 TD -0.0001 Tc (L)Tj 0.45786 0.00001 TD 0 Tc [(ow bir)-21(th weight in the United States is a troublesome and per-)]TJ -0.45786 -1.37144 TD -0.0001 Tc (s)Tj 0.41692 0.00001 TD 0 Tc (istent medical and social problem. Despite the improvement in)Tj -0.41692 -1.37144 TD [(outcomes for LBW infants, the rate of low bir)-21(th weight remains)]TJ 0 -1.37143 TD [(high and has been rising steadily since the mid-1)41(980s and now)]TJ T* -0.012 Tc [(equals the rate repor)-21(ted nearly 40 years ago. 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T)20(hus early and regular prenatal care is critical.)]TJ T* -0.012 Tc (At prenatal visits, the health of both mother and fetus is monitored.)Tj T* 0 Tc [(Specific attention can be g)-21(iven to maternal nutrition and weight)]TJ T* [(gain which affect fetal weight gain and bir)-21(th weight. Prenatal care)]TJ T* [(also provides an oppor)-21(tunity to address maternal behaviors, such)]TJ 29.72374 52.1143 TD (as the use of alcohol, cigarettes, and illicit drugs, which contribute)Tj 0 -1.37143 TD [(to poor fetal g)-21(row)-21(th and other complications. )]TJ 0 -2.05714 TD [(Prog)-21(rams and policies should be put in place to assure that all)]TJ 0 -1.37143 TD [(mothers have access to regular prenatal care. 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Effor)-21(ts)]TJ 0 -1.37143 TD [(to expand elig)-21(ibility for )]TJ ET Q /GS2 gs /GS1 gs q BT /F22 1 Tf 8.75 0 0 8.75 400.2468 566.1271 Tm 0 0 0 1 k (Medicaid)Tj ET Q /GS2 gs /GS1 gs q BT /F4 1 Tf 8.75 0 0 8.75 436.4027 566.1271 Tm 0 0 0 1 k (and )Tj ET Q /GS2 gs /GS1 gs q BT /F22 1 Tf 8.75 0 0 8.75 452.8867 566.1271 Tm 0 0 0 1 k 0.021 Tc [(S)21(CHIP)]TJ ET Q /GS2 gs /GS1 gs q BT /F4 1 Tf 8.75 0 0 8.75 478.6694 566.1271 Tm 0 0 0 1 k 0.029 Tw (\(the State Children\325s)Tj -18.70507 -1.37143 TD [(Health Insurance Prog)-21(ram\) and to ensure that all elig)-21(ible individu-)]TJ T* (als are enrolled are crucial.)Tj 0 -2.05714 TD -0.006 Tc [(In those cases that low bir)-21(th weight is not prevented, as Dr)40(. Hack\325s)]TJ 0 -1.37144 TD 0 Tc (research demonstrates, immediate care and treatment followed)Tj T* [(by early intervention services can g)-21(reatly improve the outcomes)]TJ 0 -1.37143 TD (for these children. 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Long-term developmental outcomes of low bir)-21(th)]TJ 0 -1.48148 TD 0.029 Tw (weight infants. )Tj ET Q /GS2 gs /GS1 gs q BT /F21 1 Tf 6.75 0 0 6.75 365.7371 313.1271 Tm 0 0 0 1 k 0.029 Tw (The Future of Children.)Tj ET Q /GS2 gs /GS1 gs q BT /F6 1 Tf 6.75 0 0 6.75 437.3802 313.1271 Tm 0 0 0 1 k (1)Tj 0.54199 0 TD [(995;5(1):1)41(7)41(6-1)40(96.)]TJ ET Q /GS2 gs /GS1 gs q BT /F6 1 Tf 3.375 0 0 3.375 315 305.8146 Tm 0 0 0 1 k (2)Tj ET Q /GS2 gs /GS1 gs q BT /F6 1 Tf 6.75 0 0 6.75 319.5 303.1271 Tm 0 0 0 1 k -0.005 Tw [(Hack M, T)82(aylor HG, Drotar D, Schluchter M, Car)-22(tar L, Andreias L, W)20(ilson-)-42(Costello)]TJ 0 -1.48148 TD 0.053 Tw (D & Klein N. 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