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Health and Quality of Life Outcomes
Published in: Health and Quality of Life Outcomes 1/2010

Open Access 01-12-2010 | Research

Health related quality of life after extremely preterm birth: a matched controlled cohort study

Authors: Bente J Vederhus, Trond Markestad, Geir E Eide, Marit Graue, Thomas Halvorsen

Published in: Health and Quality of Life Outcomes | Issue 1/2010

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Abstract

Background

The majority of infants born before the last trimester now grow up. However, knowledge on subsequent health related quality of life (HRQoL) is scarce. We therefore aimed to compare HRQoL in children born extremely preterm with control children born at term. Furthermore, we assessed HRQoL in relation to perinatal and neonatal morbidity and to current clinical and sociodemographic characteristics.

Method

The Child Health Questionnaire (CHQ-PF50) and a general questionnaire were applied in a population based cohort of 10 year old children born at gestational age ≤ 28 weeks or with birth weight ≤ 1000 grams in Western Norway in 1991-92 and in term-born controls, individually matched for gender and time of birth. The McNemar test and paired t-tests were used to explore group differences between preterms and matched controls. Paired regression models and analyses of interaction (SPSS mixed linear model) were used to explore potential effects of sociodemographic and clinical characteristics on HRQoL in the two groups.

Results

All 35 eligible preterm children participated. None had major impairments. Learning and/or attention problems were present in 71% of preterms and 20% of controls (odds ratio (OR): 7.0; 95% confidence interval (CI): 2.2 to 27.6). Insufficient professional support was described by 36% of preterm vs. 3% of control parents (OR: infinite; CI: 2.7 to infinite). Preterms scored lower on eight CHQ-PF50 sub-scales and the two summary scores, boys accounting for most of the deficits in areas of behavior, psychosocial functioning and parental burden. HRQoL was associated with learning and/or attention problems in both preterm and control children, significantly more so in preterms in areas related to health and parental burden. Within the preterm group, HRQoL was mostly unrelated to perinatal and neonatal morbidity.

Conclusions

HRQoL for children born extremely preterm, and particularly for boys, was described by parents to be inferior to that of children born at term, and sufficiently poor to affect the daily life of the children and their families. Learning and/or attention problems were reported for a majority of preterms, strongly influencing their HRQoL.
Appendix
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Literature
1.
Markestad T, Kaaresen PI, Ronnestad A, Reigstad H, Lossius K, Medbo S, et al.: Early death, morbidity, and need of treatment among extremely premature infants. Pediatrics 2005, 115: 1289–1298. 10.1542/peds.2004-1482PubMedCrossRef
2.
Elgen I, Johansson KA, Markestad T, Sommerfelt K: A non-handicapped cohort of low-birthweight children: growth and general health status at 11 years of age. Acta Paediatr 2005, 94: 1203–1207.PubMedCrossRef
3.
Aarnoudse-Moens CS, Weisglas-Kuperus N, van Goudoever JB, Oosterlaan J: Meta-analysis of neurobehavioral outcomes in very preterm and/or very low birth weight children. Pediatrics 2009, 124: 717–728. 10.1542/peds.2008-2816PubMedCrossRef
4.
Bhutta AT, Cleves MA, Casey PH, Cradock MM, Anand KJ: Cognitive and behavioral outcomes of school-aged children who were born preterm: a meta-analysis. JAMA 2002, 288: 728–737. 10.1001/jama.288.6.728PubMedCrossRef
5.
Saigal S, Doyle LW: An overview of mortality and sequelae of preterm birth from infancy to adulthood. Lancet 2008, 371: 261–269. 10.1016/S0140-6736(08)60136-1PubMedCrossRef
6.
Halvorsen T, Skadberg BT, Eide GE, Roksund OD, Markestad T: Better care of immature infants; has it influenced long-term pulmonary outcome. Acta Paediatr 2006, 95: 547–554. 10.1080/08035250500477529PubMedCrossRef
7.
Smith LJ, van Asperen PP, McKay KO, Selvadurai H, Fitzgerald DA: Reduced exercise capacity in children born very preterm. Pediatrics 2008, 122: e287-e293. 10.1542/peds.2007-3657PubMedCrossRef
8.
Vrijlandt EJ, Gerritsen J, Boezen HM, Grevink RG, Duiverman EJ: Lung function and exercise capacity in young adults born prematurely. Am J Respir Crit Care Med 2006, 173: 890–896. 10.1164/rccm.200507-1140OCPubMedCrossRef
9.
Zwicker JG, Harris SR: Quality of life of formerly preterm and very low birth weight infants from preschool age to adulthood: a systematic review. Pediatrics 2008, 121: e366-e376. 10.1542/peds.2007-0169PubMedCrossRef
10.
Indredavik MS, Vik T, Heyerdahl S, Romundstad P, Brubakk AM: Low-birthweight adolescents: quality of life and parent-child relations. Acta Paediatr 2005, 94: 1295–1302.PubMedCrossRef
11.
Johnson A, Bowler U, Yudkin P, Hockley C, Wariyar U, Gardner F, et al.: Health and school performance of teenagers born before 29 weeks gestation. Arch Dis Child Fetal Neonatal Ed 2003, 88: F190-F198. 10.1136/fn.88.3.F190PubMedCentralPubMedCrossRef
12.
Saigal S, Feeny D, Rosenbaum P, Furlong W, Burrows E, Stoskopf B: Self-perceived health status and health-related quality of life of extremely low-birth-weight infants at adolescence. JAMA 1996, 276: 453–459. 10.1001/jama.276.6.453PubMedCrossRef
13.
Donohue PK: Health-related quality of life of preterm children and their caregivers. Ment Retard 2002, 8: 293–297. 10.1002/mrdd.10041CrossRef
14.
15.
Davis E, Waters E, Mackinnon A, Reddihough D, Graham HK, Mehmet-Radji O, et al.: Paediatric quality of life instruments: a review of the impact of the conceptual framework on outcomes. Dev Med Child Neurol 2006, 48: 311–318. 10.1017/S0012162206000673PubMedCrossRef
16.
Drotar D: Validating measures of pediatric health status, functional status, and health-related quality of life: key methodological challenges and strategies. Ambul Pediatr 2004, 4: 358–364. 10.1367/A03-101R.1PubMedCrossRef
17.
Skjaerven R, Gjessing HK, Bakketeig LS: Birthweight by gestational age in Norway. Acta Obstet Gynecol Scand 2000, 79: 440–449. 10.1080/j.1600-0412.2000.079006440.xPubMedCrossRef
18.
Polgar G, Promadhat V: Pulmonary Function Testing in Children: Techniques and Standards. Philadelphia: Saunders; 1971.
19.
Landgraf JM, Abetz L, Ware JE: The CHQ User's Manual. Second printing. Boston, MA: HealthAct; 1999.
20.
21.
Selvaag AM, Flatø B, Landgraf JM, Lien G, Sørskaa D, Vinje O, et al.: VII European Paediatric Rhematology Congress. Annual Scientific Meeting of PRES. Annals of the Rheumatic Diseases 2000, 59: 713–749. 10.1136/ard.59.9.713CrossRef
22.
Selvaag AM, Ruperto N, Asplin L, Rygg M, Landgraf JM, Forre O, et al.: The Norwegian version of the Childhood Health Assessment Questionnaire (CHAQ) and the Child Health Questionnaire (CHQ). Clin Exp Rheumatol 2001, 19: S116-S120.PubMed
23.
Selvaag AM, Flato B, Lien G, Sorskaar D, Vinje O, Forre O: Measuring health status in early juvenile idiopathic arthritis: determinants and responsiveness of the child health questionnaire. J Rheumatol 2003, 30: 1602–1610.PubMed
24.
Fayers PM, Machin D: Quality of life The assessment, analysis and interpretation of patient-reported outcomes. Second edition. West Sussex: John Wiley & Sons Ltd; 2007.
25.
Davis C: Statistical Methods for the Analysis of Repeated Measurements. New York: Springer-Verlag; 2002.
26.
Pocock SJ, Collier TJ, Dandreo KJ, de Stavola BL, Goldman MB, Kalish LA, et al.: Issues in the reporting of epidemiological studies: a survey of recent practice. BMJ 2004, 329: 883. 10.1136/bmj.38250.571088.55PubMedCentralPubMedCrossRef
27.
Slattery MM, Morrison JJ: Preterm delivery. Lancet 2002, 360: 1489–1497. 10.1016/S0140-6736(02)11476-0PubMedCrossRef
28.
Saigal S, Burrows E, Stoskopf BL, Rosenbaum PL, Streiner D: Impact of extreme prematurity on families of adolescent children. J Pediatr 2000, 137: 701–706. 10.1067/mpd.2000.109001PubMedCrossRef
29.
Esbjorn BH, Madsen BM, Munck H, Greisen G: [Extremely prematurely born children's and their parents' need for support] Ekstremt tidligt fodte born og foraeldrenes behov for stotte. Ugeskr Laeger 2008, 170: 3331–3334.PubMed
30.
Hintz SR, Kendrick DE, Vohr BR, Poole WK, Higgins RD: Community supports after surviving extremely low-birth-weight, extremely preterm birth: special outpatient services in early childhood. Arch Pediatr Adolesc Med 2008, 162: 748–755. 10.1001/archpedi.162.8.748PubMedCentralPubMedCrossRef
31.
Elgen I, Sommerfelt K: Low birthweight children: coping in school. Acta Paediatr 2002, 91: 939–945. 10.1080/080352502760148676PubMedCrossRef
32.
Anderson PJ, Doyle LW: Cognitive and educational deficits in children born extremely preterm. Semin Perinatol 2008, 32: 51–58. 10.1053/j.semperi.2007.12.009PubMedCrossRef
33.
Johnson S, Hennessy E, Smith R, Trikic R, Wolke D, Marlow N: Academic attainment and special educational needs in extremely preterm children at 11 years of age, the EPICure study. Arch Dis Child Fetal Neonatal Ed 2009, 94: F283-F289. 10.1136/adc.2008.152793PubMedCrossRef
34.
Litt J, Taylor HG, Klein N, Hack M: Learning disabilities in children with very low birthweight: prevalence, neuropsychological correlates, and educational interventions. J Learn Disabil 2005, 38: 130–141. 10.1177/00222194050380020301PubMedCrossRef
35.
Marlow N, Hennessy EM, Bracewell MA, Wolke D: Motor and executive function at 6 years of age after extremely preterm birth. Pediatrics 2007, 120: 793–804. 10.1542/peds.2007-0440PubMedCrossRef
36.
Rogers M, Fay TB, Whitfield MF, Tomlinson J, Grunau RE: Aerobic capacity, strength, flexibility, and activity level in unimpaired extremely low birth weight (< or = 800 g) survivors at 17 years of age compared with term-born control subjects. Pediatrics 2005, 116: e58-e65. 10.1542/peds.2004-1603PubMedCrossRef
37.
Dahl LB, Kaaresen PI, Tunby J, Handegard BH, Kvernmo S, Ronning JA: Emotional, behavioral, social, and academic outcomes in adolescents born with very low birth weight. Pediatrics 2006, 118: e449-e459. 10.1542/peds.2005-3024PubMedCrossRef
38.
Elgen I, Sommerfelt K, Markestad T: Population based, controlled study of behavioural problems and psychiatric disorders in low birthweight children at 11 years of age. Arch Dis Child Fetal Neonatal Ed 2002, 87: F128-F132. 10.1136/fn.87.2.F128PubMedCentralPubMedCrossRef
39.
Hille ET, den Ouden AL, Saigal S, Wolke D, Lambert M, Whitaker A, et al.: Behavioural problems in children who weigh 1000 g or less at birth in four countries. Lancet 2001, 357: 1641–1643. 10.1016/S0140-6736(00)04818-2PubMedCrossRef
40.
Marlow N, Wolke D, Bracewell MA, Samara M: Neurologic and developmental disability at six years of age after extremely preterm birth. N Engl J Med 2005, 352: 9–19. 10.1056/NEJMoa041367PubMedCrossRef
41.
Michel G, Bisegger C, Fuhr DC, Abel T: Age and gender differences in health-related quality of life of children and adolescents in Europe: a multilevel analysis. Qual Life Res 2009, 18: 1147–1157. 10.1007/s11136-009-9538-3PubMedCrossRef
42.
Costeloe K, Hennessy E, Gibson AT, Marlow N, Wilkinson AR: The EPICure study, outcomes to discharge from hospital for infants born at the threshold of viability. Pediatrics 2000, 106: 659–671. 10.1542/peds.106.4.659PubMedCrossRef
43.
Hintz SR, Kendrick DE, Vohr BR, Kenneth PW, Higgins RD: For The Nichd Neonatal Research Network: Gender differences in neurodevelopmental outcomes among extremely preterm, extremely-low-birthweight infants. Acta Paediatr 2006, 95: 1239–1248. 10.1080/08035250600599727PubMedCrossRef
44.
45.
Halliday HL, Ehrenkranz RA, Doyle LW: Early (< 8 days) postnatal corticosteroids for preventing chronic lung disease in preterm infants. Cochrane Database Syst Rev 2010, CD001146.
46.
Aukland SM, Rosendahl K, Owens CM, Fosse KR, Eide GE, Halvorsen T: Neonatal bronchopulmonary dysplasia predicts abnormal pulmonary HRCT scans in long-term survivors of extreme preterm birth. Thorax 2009, 64: 405–410. 10.1136/thx.2008.103739PubMedCrossRef
47.
Short EJ, Klein NK, Lewis BA, Fulton S, Eisengart S, Kercsmar C, et al.: Cognitive and academic consequences of bronchopulmonary dysplasia and very low birth weight: 8-year-old outcomes. Pediatrics 2003, 112: e359. 10.1542/peds.112.5.e359PubMedCrossRef
Metadata
Title
Health related quality of life after extremely preterm birth: a matched controlled cohort study
Authors
Bente J Vederhus
Trond Markestad
Geir E Eide
Marit Graue
Thomas Halvorsen
Publication date
01-12-2010
Publisher
BioMed Central
Published in
Health and Quality of Life Outcomes / Issue 1/2010
Electronic ISSN: 1477-7525
DOI
https://doi.org/10.1186/1477-7525-8-53

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