Health-related quality of life of children born very preterm: a multinational European cohort study
Sung Wook Kim, Lazaros Andronis, Anna‐Veera Seppänen, Adrien M. Aubert, Henrique Barros, Elizabeth S. Draper, Mariane Sentenac, Jennifer Zeitlin, Stavros Petrou, Jo Lebeer, Patrick Van Reempts, Els Bruneel, Eva Cloet, Ann Oostra, Els Ortibus, Iemke Sarrechia, Klaus Boerch, Pernille Pedersen, Liis Toome, Heili Varendi, Mairi Männamaa, Pierre‐Yves Ancel, A. Burguet, P.-H. Jarreau, Véronique Pierrat, Patrick Truffert, Rolf F. Maier, Michael Zemlin, B. Misselwitz, L. Wohlers, Marina Cuttini, Ileana Croci, Virgilio Carnielli, Gina Ancora, Giacomo Faldella, Fabrizio Ferrari, Arno van Heijst, Corine Koopman-Esseboom, Janusz Gadzinowski, Jan Mazela, A. Montgomery, T. Pikuła, Henrique Barros, Raquel Costa, Carina Rodrigues, U. Aden, Elizabeth S. Draper, Alan Fenton, Samantha Johnson, Silke Mader, Nicole Thiele, Johanna M. Pfeil, Stavros Petrou, S. W. Kim, Lazaros Andronis, Jennifer Zeitlin, Adrien M. Aubert, Camille Bonnet, Rym El Rafei, Anna‐Veera Seppänen
Abstract
Abstract 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.