Kim Sung Wook, Tian Xiaoyu, Andronis Lazaros, Maier Rolf F, Varendi Heili, Seppänen Anna-Veera, Siljehav Veronica, Draper Elizabeth S, Zeitlin Jennifer, Petrou Stavros
Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK.
Kleijnen Systematic Reviews Ltd, York, UK.
Pediatr Res. 2024 Sep 7. doi: 10.1038/s41390-024-03521-9.
This study aimed to investigate the health-related quality of life (HRQoL) at 5 years of age of European children born very preterm across multi-dimensional outcomes by presence and severity of congenital anomalies.
The study used data from a European cohort of children born very preterm (<32 weeks of gestation) and followed up to 5 years of age (N = 3493). Multilevel Ordinary Least Squares (OLS) regression were used to explore the associations between the presence and severity of congenital anomalies.
The mean total PedsQL™ GCS score for children with a mild congenital anomaly was lower than the respective value for children without a congenital anomaly by 3.7 points (p < 0.05), controlling for socioeconomic variables only; this effect was attenuated when accumulatively adjusting for perinatal characteristics (3.3 points (p < 0.05)) and neonatal morbidities (3.1 (p < 0.05)). The mean total PedsQL™ GCS scores for children who had a severe congenital anomaly were lower by 7.1 points (p < 0.001), 6.6 points (p < 0.001) and 6.0 points (p < 0.001) when accumulatively adjusting for socioeconomic, perinatal and neonatal variables, respectively.
This study revealed that the presence and severity of congenital anomalies are significant predictors of HRQoL outcomes in children born very preterm.
Children born very preterm with congenital anomalies experience poorer health-related quality of life (HRQoL) than their very preterm counterparts born without congenital anomalies. Increased severity of these anomalies compounds the negative impacts on HRQoL. Our findings can be used by stakeholders for clinical and planning purposes.
本研究旨在通过先天性异常的存在情况和严重程度，调查欧洲极早产出生儿童5岁时与健康相关的生活质量（HRQoL）的多维结果。
该研究使用了欧洲一组极早产（妊娠<32周）儿童的数据，并随访至5岁（N = 3493）。采用多水平普通最小二乘法（OLS）回归来探讨先天性异常的存在情况和严重程度之间的关联。
仅控制社会经济变量时，轻度先天性异常儿童的PedsQL™通用核心量表（GCS）总平均分比无先天性异常儿童的相应值低3.7分（p < 0.05）；在累积调整围产期特征（3.3分（p < 0.05））和新生儿疾病（3.1分（p < 0.05））后，这种影响减弱。在分别累积调整社会经济、围产期和新生儿变量时，患有严重先天性异常儿童的PedsQL™ GCS总平均分分别低7.1分（p < 0.001）、6.6分（p < 0.001）和6.0分（p < 0.001）。
本研究表明，先天性异常的存在情况和严重程度是极早产出生儿童HRQoL结果的重要预测因素。
与无先天性异常的极早产出生儿童相比，有先天性异常的极早产出生儿童的健康相关生活质量（HRQoL）较差。这些异常严重程度的增加加剧了对HRQoL的负面影响。我们的研究结果可供利益相关者用于临床和规划目的。
