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. 2023 Jan;32(1):47-58.
doi: 10.1007/s11136-022-03217-9. Epub 2022 Aug 17.

Health-related quality of life of children born very preterm: a multinational European cohort study

Sung Wook Kim  1 , Lazaros Andronis  2 , Anna-Veera Seppänen  3 , Adrien M Aubert  3 , Henrique Barros  4 , Elizabeth S Draper  5 , Mariane Sentenac  3 , Jennifer Zeitlin  3 , Stavros Petrou  6 ; SHIPS Research Group
Collaborators, Affiliations

Health-related quality of life of children born very preterm: a multinational European cohort study

Sung Wook Kim et al. Qual Life Res. 2023 Jan.

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.

Keywords: Children; Mediation analysis; PedsQL; Preterm birth; health-related quality of life.

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Conflict of interest statement

The authors have no relevant financial or non-financial interests to disclose.

Figures

Fig. 1
Fig. 1
Overview of mediation analysis
Fig. 2
Fig. 2
Mediation analysis of the indirect effects and total effects of preterm status on the total PedsQL GCS score*
See this image and copyright information in PMC

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