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Parent-reported health outcomes at preschool age in preterm survivors: a population-based cohort study
Sydney MacDonald1, Alexandra Stratas2, Anne R Synnes3
1Dalhousie University, Halifax, Nova Scotia, Canada.
Insights
Parental concerns about very preterm infants' health status only moderately align with neurodevelopmental outcomes at preschool age. Many parents of children with significant impairment did not report severe concerns.
Area of Science:
- Pediatrics
- Developmental Pediatrics
- Neonatology
Background:
- Health status (HS) and health-related quality of life in preschool-aged preterm survivors are understudied.
- The relationship between parent-reported HS and standardized neurodevelopmental outcomes in this population is not well understood.
Purpose of the Study:
- To assess parent-reported HS outcomes in very preterm survivors at 36 months of age.
- To examine the correlation between these parent-reported HS outcomes and standardized neurodevelopmental outcomes.
Main Methods:
- A prospective, population-based cohort study was conducted.
- Infants born before 31 weeks of gestational age between 2014-2016 were included.
- Parents completed the Health Status Classification System for Pre-School Children questionnaire at 36 months, alongside neurodevelopmental assessments to determine neurodevelopmental impairment (NDI).
Main Results:
- 87% of parents reported an HS concern for their child.
- Mild and significant neurodevelopmental impairments (NDI) were found in 14.4% and 11.9% of children, respectively.
- A moderate positive correlation (Spearman correlation=0.46, p<0.0001) was observed between parental concern and NDI status.
Conclusions:
- Parental reports of health status concerns show only a moderate correlation with objective neurodevelopmental impairment status.
- Among children with significant NDI, only half of the parents reported severe health status concerns.
Objective:
Literature on health status (HS) and health-related quality of life of preterm survivors at preschool age is sparse. Further, little is known about the relationship between parent-reported HS outcomes and standardised neurodevelopmental outcomes measured in preterm survivors at preschool age. Our objective was to evaluate parent-reported child HS outcomes and their relationship to neurodevelopmental outcomes at 36 months of age in very preterm survivors.
Design:
Prospective population-based cohort study.
Setting:
Perinatal follow-up programme.
Patients:
Infants <31 weeks' gestational age born from 2014 to 2016.
Outcome Measures:
Parents completed the Health Status Classification System for Pre-School Children questionnaire at 36 months. At the same age, neurodevelopmental assessments were completed to determine neurodevelopmental impairment (NDI). NDI was categorised as none, 'mild' or 'significant' (moderate or severe cerebral palsy, Bayley Scales of Infant and Toddler Development - Third Edition <70, blind or required hearing aid).
Results:
Of 118 children, 87 (73.7%) parents reported their child had an HS concern (mild: 61 (51%); moderate: 16 (13.6%); and severe: 10 (8.5%)). Mild and significant NDIs were observed in 17 (14.4%) and 14 (11.9%) children, respectively. For the 14 (12%) children with significant NDI, 7 (50.0%) parents reported severe and 4 (28.6%) reported moderate concerns. Conversely, for 26 (22%) children with parent-reported moderate to severe concerns, 11 (42.3%) met the criteria for significant NDI. There was a moderate positive correlation between parental concern and NDI status (Spearman correlation=0.46, p<0.0001).
Conclusions:
Parental HS concerns only moderately correlated with the NDI status. Of the 12% of children with significant NDI, only half of the parents reported severe HS concerns.
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