Related Experiment Video
Updated: Sep 1, 2025
Transcutaneous Microcirculatory Imaging in Preterm Neonates
Published on: December 31, 2015
Health-related quality of life of children born very preterm: a multinational European cohort study
Sung Wook Kim1, Lazaros Andronis2, Anna-Veera Seppänen3
1Nuffield Department of Primary Care Health Sciences, University of Oxford, Radcliffe Observatory Quarter, Woodstock Road, Oxford, OX2 6GG, UK. sungwook.kim@phc.ox.ac.uk.
Insights
Extremely preterm birth and complications like bronchopulmonary dysplasia (BPD) significantly impair health-related quality of life (HRQoL) in children by age five. These factors, along with severe neonatal morbidity, negatively impact long-term child development outcomes.
Area of Science:
- Pediatric Health
- Neonatal Outcomes
- Quality of Life Research
Background:
- Children born very preterm (28-31 weeks) and extremely preterm (<28 weeks) face significant health challenges.
- Assessing their health-related quality of life (HRQoL) at five years is crucial for understanding long-term impacts.
Purpose of the Study:
- To describe HRQoL outcomes in children born very preterm and extremely preterm at age five.
- To investigate the mediating roles of bronchopulmonary dysplasia (BPD) and severe non-respiratory neonatal morbidity on these HRQoL outcomes.
Main Methods:
- Utilized data from 3687 children born <32 weeks gestation across 11 European countries (EPICE and SHIPS studies).
- Employed multi-level ordinary linear squares (OLS) regression to analyze associations between perinatal factors and PedsQL™ GCS scores.
- Conducted mediation analysis using generalized structural equation modeling to assess the impact of BPD and severe neonatal morbidity.
Main Results:
- Birth at <26 weeks gestation, BPD, and severe non-respiratory morbidity were linked to significant decrements in PedsQL™ GCS scores.
- Mediation analysis showed indirect effects of BPD and severe morbidity reduced HRQoL scores, with greater impact at earlier gestations.
- Specific decrements varied by gestational age, with the most pronounced effects observed for extremely preterm infants (<26 weeks).
Conclusions:
- Extremely preterm birth substantially impairs children's HRQoL.
- Complications such as BPD and severe non-respiratory neonatal morbidity are key mediators affecting long-term HRQoL.
- Early identification and management of these complications are vital for improving outcomes in preterm infants.
Purpose:
This study aims to (1) describe the health-related quality of life (HRQoL) outcomes experienced by children born very preterm (28-31 weeks' gestation) and extremely preterm (< 28 weeks' gestation) at five years of age and (2) explore the mediation effects of bronchopulmonary dysplasia (BPD) and severe non-respiratory neonatal morbidity on those outcomes.
Methods:
This investigation was based on data for 3687 children born at < 32 weeks' gestation that contributed to the EPICE and SHIPS studies conducted in 19 regions across 11 European countries. Descriptive statistics and multi-level ordinary linear squares (OLS) regression were used to explore the association between perinatal and sociodemographic characteristics and PedsQL™ GCS scores. A mediation analysis that applied generalised structural equation modelling explored the association between potential mediators and PedsQL™ GCS scores.
Results:
The multi-level OLS regression (fully adjusted model) revealed that birth at < 26 weeks' gestation, BPD status and experience of severe non-respiratory morbidity were associated with mean decrements in the total PedsQL™ GCS score of 0.35, 3.71 and 5.87, respectively. The mediation analysis revealed that the indirect effects of BPD and severe non-respiratory morbidity on the total PedsQL™ GCS score translated into decrements of 1.73 and 17.56, respectively, at < 26 weeks' gestation; 0.99 and 10.95, respectively, at 26-27 weeks' gestation; and 0.34 and 4.80, respectively, at 28-29 weeks' gestation (referent: birth at 30-31 weeks' gestation).
Conclusion:
The findings suggest that HRQoL is particularly impaired by extremely preterm birth and the concomitant complications of preterm birth such as BPD and severe non-respiratory morbidity.
