Reproductive and environmental casualties: a report on the 10-year follow-up of the children of the Kauai Pregnancy Study

The effects of perinatal complications and quality of environment were studied in a cohort of 1955 births and a selected sample of 1956 births in the Kauai Pregnancy Study. The 10-year follow-up of the 866 children utilized records, teachers' ratings, and group tests as screening devices and diagnostic examinations by psychologists, pediatricians, and allied disciplines. Independent environmental ratings of socioeconomic status, educational stimulation, and emotional support were based on home interviews. Differences found between children with and without perinatal stress centered on a small group of survivors of severe complications who had a significantly higher proportion of major physical handicaps, predominantly of the central nervous and sensory systems, a higher proportion of I.Q.'s below 85 and lower mean scores on the factors V, R, N, and P of the Primary Mental Abilities Test. No differences were found between children with and without perinatal complications in the proportion of poor grades and the incidence of language, perceptual, and emotional problems, except for those in institutions. Environmental ratings showed a significant association with intellectual, achievement, and emotional problems at age 10. Many more children were affected by unfavorable environment than by severe perinatal stress.