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Health-Related Quality of Life Outcomes of Very Preterm or Very Low Birth Weight Adults: Evidence from an Individual Participant Data Meta-analysis

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posted on 2022-11-04, 16:51 authored by Corneliu Bolbocean, Sylvia van der Pal, Steff van Buuren, Peter J Anderson, Peter Bartmann, Nicole Baumann, Jeanie Cheong, Brian A Darlow, Lex W Doyle, Kari Anne I Evensen, John Horwood, Marit S Indredavik, Samantha Johnson, Neil Marlow, Marina Mendonca, Yanyan Ni, Dieter Wolke, Lianne Woodward, Erik Verrips, Stavros Petrou

Background and objective: Assessment of health-related quality of life for individuals born very preterm and/or low birthweight (VP/VLBW) offers valuable complementary information alongside biomedical assessments. However, the impact of VP/VLBW status on health-related quality of life in adulthood is inconclusive. The objective of this study was to examine associations between VP/VLBW status and preference-based health-related quality-of-life outcomes in early adulthood.

Methods: Individual participant data were obtained from five prospective cohorts of individuals born VP/VLBW and controls contributing to the 'Research on European Children and Adults Born Preterm' Consortium. The combined dataset included over 2100 adult VP/VLBW survivors with an age range of 18-29 years. The main exposure was defined as birth before 32 weeks' gestation (VP) and/or birth weight below 1500 g (VLBW). Outcome measures included multi-attribute utility scores generated by the Health Utilities Index Mark 3 and the Short Form 6D. Data were analysed using generalised linear mixed models in a one-step approach using fixed-effects and random-effects models.

Results: VP/VLBW status was associated with a significant difference in the Health Utilities Index Mark 3 multi-attribute utility score of - 0.06 (95% confidence interval - 0.08, - 0.04) in comparison to birth at term or at normal birthweight; this was not replicated for the Short Form 6D. Impacted functional domains included vision, ambulation, dexterity and cognition. VP/VLBW status was not associated with poorer emotional or social functioning, or increased pain.

Conclusions: VP/VLBW status is associated with lower overall health-related quality of life in early adulthood, particularly in terms of physical and cognitive functioning. Further studies that estimate the effects of VP/VLBW status on health-related quality-of-life outcomes in mid and late adulthood are needed.


733280/H2020 European Research Council


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Department of Health Sciences, University of Leicester


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Springer Verlag



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