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Health-related quality of life in adults born extremely preterm or with extremely low birth weight in the postsurfactant era: a longitudinal cohort study


Objectives To compare health-related quality of life (HRQoL) at 25 and 18 years in individuals born extremely preterm (EP, <28 weeks’ gestation) or with extremely low birth weight (ELBW, birth weight <1000 g) with term-born (≥37 weeks) controls. Within the EP/ELBW cohort, to determine whether HRQoL differed between those with lower and higher IQs.

Methods HRQoL was self-reported using the Health Utilities Index Mark 3 (HUI3) at 18 and 25 years by 297 EP/ELBW and 251 controls born in 1991–1992 in Victoria, Australia. Median differences (MDs) between groups were estimated using multiple imputation to handle missing data.

Results Adults born EP/ELBW had lower HRQoL (median utility 0.89) at 25 years than controls (median utility 0.93, MD −0.040), but with substantial uncertainty in the estimate (95% CI −0.088 to 0.008) and a smaller reduction at 18 years (MD −0.016, 95% CI –0.061 to 0.029). On individual HUI3 items, there was suboptimal performance on speech (OR 9.28, 95% CI 3.09 to 27.93) and dexterity (OR 5.44, 95% CI 1.04 to 28.45) in the EP/ELBW cohort. Within the EP/ELBW cohort, individuals with lower IQ had lower HRQoL compared with those with higher IQ at 25 (MD −0.031, 95% CI −0.126 to 0.064) and 18 years (MD −0.034, 95% CI −0.107 to 0.040), but again with substantial uncertainty in the estimates.

Conclusions Compared with term-born controls, young adults born EP/ELBW reported poorer HRQoL, as did those with lower IQ compared with those with higher IQ in the EP/ELBW cohort. Given the uncertainties, our findings need corroboration.

  • Statistics
  • Child Health
  • Neonatology

Data availability statement

Data are available upon reasonable request.

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