Perinatal Institute, Cincinnati Children's Hospital Medical Center, Cincinnati, OH; Department of Pediatrics, University of Cincinnati, College of Medicine, Cincinnati, OH; Division of Neonatology, Children's Hospital of Philadelphia, Philadelphia, PA.
Division of Neonatology, Children's Hospital of Philadelphia, Philadelphia, PA.
J Pediatr. 2019 Apr;207:117-122. doi: 10.1016/j.jpeds.2018.10.001. Epub 2018 Nov 5.
To assess parents' views of their children's health-related quality of life (HRQoL) and the association between neonatal morbidities and HRQoL in children with severe bronchopulmonary dysplasia (BPD) who survived to 18-36 months of corrected age.
Study population included infants born <32 weeks of gestational age with severe BPD. At 18-36 months of corrected age, parents of children with severe BPD completed age appropriate validated Pediatric Quality of Life Inventory assessing parental views of their child's physical (PHY-QoL) and psychosocial HRQoL (PS-QoL). Ten neonatal morbidities provided a composite morbidity score between 0 and 10. Linear regression evaluated associations between PHY-QoL and PS-QoL with composite morbidity score, adjusting for gestational age, sex, corrected age at assessment.
Seventy children (67% male, gestational age 26.1 ± 2.0 weeks, and birth weight 797 ± 318g) were enrolled at 27.1 ± 5.8 months of corrected age. Mean PHY-QoL and PS-QoL were 78.0 ± 21.9 and 75.3 ± 17.9, respectively, both significantly lower than reported means for term and preterm cohorts, with the exception of emotional QoL. Adjusted postnatal composite morbidity score was cumulatively associated with poorer PHY-QoL (P = .002) and poorer PS-QoL (P = .015). Presence of each additional neonatal morbidity was associated with a 4.4-point decrease in PHY-QoL and 2.8-point decrease in PS-QoL.
In this cohort, parental perceived HRQoL for their child with severe BPD was lower than expected for term and preterm populations. Neonatal morbidities had an additive association with poorer parental assessment of PHY-QoL and PS-QoL. These findings may aid in care of children with severe BPD and their families, both in the intensive care nursery and postdischarge.
评估父母对患有严重支气管肺发育不良(BPD)且存活至校正年龄 18-36 个月儿童健康相关生活质量(HRQoL)的看法,以及新生儿合并症与儿童 HRQoL 之间的关系。
研究人群包括胎龄<32 周且患有严重 BPD 的婴儿。在校正年龄 18-36 个月时,患有严重 BPD 儿童的父母完成了适合年龄的儿童生活质量量表(PedsQL)评估,评估父母对其子女身体(PHY-QoL)和心理社会 HRQoL(PS-QoL)的看法。10 种新生儿合并症提供了 0 至 10 分的综合合并症评分。线性回归评估了 PHY-QoL 和 PS-QoL 与综合合并症评分之间的关系,调整了胎龄、性别、评估时的校正年龄。
共有 70 名儿童(67%为男性,胎龄 26.1±2.0 周,出生体重 797±318g)在校正年龄 27.1±5.8 个月时入组。平均 PHY-QoL 和 PS-QoL 分别为 78.0±21.9 和 75.3±17.9,均显著低于足月和早产队列的报告均值,除了情绪 QoL 外。调整后的产后综合合并症评分与较差的 PHY-QoL(P=0.002)和较差的 PS-QoL(P=0.015)呈累积相关。每增加一种新生儿合并症,PHY-QoL 下降 4.4 分,PS-QoL 下降 2.8 分。
在本队列中,患有严重 BPD 的儿童父母感知到的 HRQoL 低于足月和早产人群。新生儿合并症与 PHY-QoL 和 PS-QoL 较差的父母评估呈累加相关。这些发现可能有助于严重 BPD 儿童及其家庭在重症监护病房和出院后的护理。