Berlin Kathryn E K, Scott William, Dawson Sara, Brousseau David, Lagatta Joanne M
Department of Pediatrics, Medical College of Wisconsin, Milwaukee, WI.
Department of Pediatrics, Nemours Children's Health System, Wilmington, DE.
J Pediatr. 2024 Jan;264:113773. doi: 10.1016/j.jpeds.2023.113773. Epub 2023 Oct 13.
To determine how bronchopulmonary dysplasia (BPD) affects health-related quality of life (HRQL) among infants from NICU hospitalization through 1-year postdischarge.
This was a prospective cohort study of infants with BPD and their parents. Parent HRQL was measured with the PedsQL Family Impact Module before NICU discharge and 3- and 12-months post-discharge. At 12 months, parent-reported child health outcomes included questions from the Test of Respiratory and Asthma Control in Kids, Warner Initial Developmental Evaluation of Adaptive and Functional Skills, and National Survey of Children with Special Health Care Needs. HRQL change over time was assessed by multivariable linear regression.
Of 145 dyads, 129 (89%) completed 3-month follow-up, and 113 (78%) completed 12-month follow-up. In the NICU, lower HRQL was associated with earlier gestational age, postnatal corticosteroids, outborn status, and gastrostomy tubes. At 3 months, lower HRQL was associated with readmissions and home oxygen use. At 12 months, lower HRQL was associated with parent-reported difficulty breathing, lower developmental scores, and not playing with other children. At 3 and 12 months, 81% of parents reported similar or improved HRQL compared with the NICU period. Parents reporting infant respiratory symptoms experienced less improvement.
BPD affects parent HRQL over the first year. Most parents report similar or better HRQL after discharge compared with the NICU stay. Less improvement is reported by parents of infants experiencing respiratory symptoms at 12 months. Efforts to improve parent HRQL should target respiratory symptoms and social isolation.
确定支气管肺发育不良(BPD)如何影响从新生儿重症监护病房(NICU)住院到出院后1年的婴儿的健康相关生活质量(HRQL)。
这是一项对患有BPD的婴儿及其父母的前瞻性队列研究。在NICU出院前以及出院后3个月和12个月,使用儿童生活质量量表家庭影响模块测量父母的HRQL。在12个月时,父母报告的儿童健康结局包括来自儿童呼吸与哮喘控制测试、华纳适应性和功能技能初始发育评估以及全国特殊医疗需求儿童调查的问题。通过多变量线性回归评估HRQL随时间的变化。
在145对母婴中,129对(89%)完成了3个月的随访,113对(78%)完成了12个月的随访。在NICU中,较低的HRQL与较早的胎龄、产后使用皮质类固醇、非本地出生状态和胃造瘘管有关。在3个月时,较低的HRQL与再次入院和家庭使用氧气有关。在12个月时,较低的HRQL与父母报告的呼吸困难、较低的发育评分以及不与其他儿童玩耍有关。在3个月和12个月时,81%的父母报告与NICU期间相比,HRQL相似或有所改善。报告婴儿有呼吸道症状的父母改善较少。
BPD在第一年影响父母的HRQL。与NICU住院期间相比,大多数父母报告出院后的HRQL相似或更好。12个月时有呼吸道症状的婴儿的父母报告的改善较少。改善父母HRQL的努力应针对呼吸道症状和社会隔离。