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Quality of life in preschool children born preterm
N C Theunissen1, S Veen, M Fekkes
1Department of Health Psychology, Utrecht University, The Netherlands. NTheunissen@fss.uu.nl
Insights
Children born very preterm (<32 weeks) experience significantly lower health-related quality of life (HRQoL) in multiple domains. Parental perceptions also impact a child's HRQoL, highlighting the need for comprehensive care post-neonatal intensive care unit (NICU) stay.
Area of Science:
- Pediatrics
- Neonatology
- Quality of Life Research
Background:
- Preterm birth is a significant global health concern.
- Children born preterm often face long-term health challenges.
- Health-related quality of life (HRQoL) is a crucial outcome measure for pediatric health.
Purpose of the Study:
- To examine the relationship between preterm birth and HRQoL in children aged 1-4 years.
- To compare HRQoL across different gestational age groups with a NICU history and a reference population.
- To investigate the influence of parental perceptions on child HRQoL.
Main Methods:
- A cohort study involving children aged 1-4 years.
- Three preterm groups (<32 weeks, 32-36 weeks, 37+ weeks) with NICU history and one reference group.
- Parent-reported TNO-AZL Preschool Quality Of Life (TAPQOL) questionnaire and other outcome measures.
Main Results:
- Children born <32 weeks showed significantly lower HRQoL in pulmonary, gastrointestinal, feeding, motor, communication, and anxiety domains compared to controls.
- Parental feelings towards the child were correlated with the child's HRQoL.
- Discrepancies between neonatologists' and parents' perceptions of children's health status were observed, potentially impacting clinical decisions.
Conclusions:
- Very preterm birth (<32 weeks) is associated with substantial deficits in HRQoL for young children.
- Neonatal intensive care unit (NICU) admission impacts HRQoL across all preterm infants, especially those born extremely preterm.
- Addressing parental perspectives is vital for optimizing HRQoL outcomes in children with a history of preterm birth and NICU care.
Abstract:
The relationship of preterm birth to health-related quality of life (HRQoL) was examined for children aged 1 to 4 years. Three gestational age groups with a NICU history were selected, <32 weeks (n=65), 32 to 36 weeks (n=41), 237 weeks (n=54), and a reference group from the open population (n=50). The main instrument was the TNO-AZL Preschool Quality Of Life (TAPQOL) questionnaire, which was completed by the parents. In addition, other outcome measures obtained from parents or neonatologists were investigated. Children born <32 weeks had significantly lower HRQoL than the reference group in the scales for lungs, stomach, eating disorders, motor functioning, communication, and anxiety. Parental feelings towards the child were related to the child's HRQoL. We found differences between the neonatologists' and parents' perceptions of the children's situation, which can have clinical consequences (e.g. different opinions about what needed treatment). Neonatal intensive care after birth has HRQoL implications for all children, particularly in children born at <32 weeks of gestation.