Assessing Positive Child Health among Individuals Born Extremely Preterm

Area of Science:

• Pediatric Health
• Child Development
• Quality of Life Research

Background:

• Preterm birth is associated with increased risks of adverse health outcomes.
• Assessing positive child health beyond the absence of disease is crucial for comprehensive well-being.
• The Extremely Low Gestational Age Newborn (ELGAN) cohort provides a unique population for studying long-term child health.

Purpose of the Study:

• To develop and validate a Positive Child Health Index (PCHI) using 11 adverse outcomes.
• To evaluate the association between the PCHI and various domains of Quality of Life (QoL) in a cohort of preterm children.
• To explore potential sex differences in the relationship between PCHI and QoL.

Main Methods:

• Followed 889 children from the ELGAN study at 10 years of age.
• Utilized parent/caregiver questionnaires for QoL, common childhood conditions, and mental health.
• Assessed children for cognitive impairment, autism, and obesity; computed PCHI scores.
• Employed linear regression models to analyze the association between PCHI and QoL categories.

Main Results:

• Higher PCHI scores were significantly associated with higher QoL scores across all measured domains.
• Children with a PCHI of 100% (no adverse outcomes) reported 11 points higher total QoL scores compared to those with any adverse outcomes.
• Boys reported lower QoL scores in total, psychosocial, social, and school domains compared to girls.

Conclusions:

• The Positive Child Health Index (PCHI) effectively quantifies positive child health and demonstrates a strong association with QoL in school-aged preterm children.
• The PCHI, encompassing 11 adverse outcomes, serves as a valuable indicator of health status in the ELGAN cohort.
• Future research should consider expanding the PCHI's scope to include a broader range of child health outcomes for enhanced utility.