Health-related quality of life in children and adolescents born very preterm and its correlates

Abstract

Objectives: We aimed to assess health-related quality of life (HRQOL) in a cohort of very preterm born children and adolescents (aged 5-16), and to compare it with their fullterm born siblings and the general population. We also explored correlates of HRQOL among the very preterm born. Methods: Cross-sectional survey. Primary outcome was KINDL total score (0 worst - 100 best). Linear mixed models accounted for family unit. Secondary analysis compared very preterm born children to another cohort of healthy children from the same time period. A classification tree analysis explored potential correlates of HRQOL. Results: On average, preterm children had a 2.1 point lower KINDL total score than fullterm sibling controls (95% CI -3.6 to -0.6). Compared to population controls, very preterm born children had a 1.4 point higher KINDL score (0.2 to 2.5). Chronic health conditions, age, and respiratory symptoms affecting daily life were key correlates of HRQOL among very preterm born children. Conclusions: Very preterm birth in children and adolescents was not associated with a relevant reduction in HRQOL compared to their fullterm born peers. However, lower HRQOL was likely explained by other factors, such as older age, the presence of chronic health conditions, but also by current respiratory symptoms that may be modifiable. A comprehensive assessment of the pulmonary sequelae provoking symptoms and interventions targeting medical management, physical activity and exercise capacity of preterm born children and adolescents may help to reduce respiratory symptoms and its potential influence on HRQOL needs to be investigated further.