We followed 11,355 children born in 1966 up to the age of 24 years to investigate the impact of birthweight on long-term outcomes of death and development. As expected, low-birthweight (LBW, 1500-2,499 gm) children showed a higher risk of death than normal-birthweight (NBW, > or =2,500 gm) children before the age of 15 years. Rate ratios for LBW children ranged from 25 for the first week of life to 2.5 for ages 5-14 years. Rate ratios of very-low-birthweight (VLBW, <1,500 gm) children for the first year of life were 10 times higher than those of LBW children. Similarly, for the first 14 years of life, surviving LBW children experienced a higher risk of being hospitalized as well as staying in hospitals for over 2 weeks if they were hospitalized. The LBW children still had a higher risk of receiving sick pensions at the age of 24 years.