Health-Related Quality-of-Life Outcomes of Very Preterm or Very Low Birth Weight Adults: Evidence From an Individual Participant Data Meta-Analysis

Corneliu Bolbocean; Sylvia van der Pal; Stef van Buuren; Peter J Anderson; Peter Bartmann; Nicole Baumann; Jeanie L Y Cheong; Brian A Darlow; Lex W Doyle; Kari Anne I Evensen; John Horwood; Marit S Indredavik; Samantha Johnson; Neil Marlow; Marina Mendonça; Yanyan Ni; Dieter Wolke; Lianne Woodward; Erik Verrips; Stavros Petrou

doi:10.1007/s40273-022-01201-2

Health-Related Quality-of-Life Outcomes of Very Preterm or Very Low Birth Weight Adults: Evidence From an Individual Participant Data Meta-Analysis

Pharmacoeconomics. 2023 Jan;41(1):93-105. doi: 10.1007/s40273-022-01201-2. Epub 2022 Oct 26.

Authors

Corneliu Bolbocean¹, Sylvia van der Pal², Stef van Buuren², Peter J Anderson^{3

4}, Peter Bartmann⁵, Nicole Baumann^{3

6

7}, Jeanie L Y Cheong⁸, Brian A Darlow⁹, Lex W Doyle^{8

10}, Kari Anne I Evensen^{11

12}, John Horwood¹³, Marit S Indredavik¹¹, Samantha Johnson⁶, Neil Marlow¹⁴, Marina Mendonça⁸, Yanyan Ni^{8

14}, Dieter Wolke¹⁵, Lianne Woodward¹⁶, Erik Verrips², Stavros Petrou¹⁷

Affiliations

¹ Nuffield Department of Primary Care Health Sciences, University of Oxford, Radcliffe Observatory Quarter, Woodstock Road, Oxford, OX2 6GG, UK. Corneliu.Bolbocean@phc.ox.ac.uk.
² Netherlands Organisation for Applied Scientific Research, The Hague, the Netherlands.
³ Turner Institute for Brain and Mental Health, School of Psychological Sciences, Monash University, Melbourne, VIC, Australia.
⁴ Clinical Sciences, Murdoch Children's Research Institute, Melbourne, VIC, Australia.
⁵ Department of Neonatology and Paediatric Intensive Care, University Hospital Bonn, Children's Hospital, Bonn, Germany.
⁶ Department of Health Sciences, University of Leicester, Leicester, UK.
⁷ Department of Psychology, University of Warwick, Warwick, UK.
⁸ Department of Obstetrics and Gynaecology, Clinical Sciences, Murdoch Children's Research Institute, Newborn Services, Royal Women's Hospital, University of Melbourne, Melbourne, VIC, Australia.
⁹ Department of Paediatrics, University of Otago Christchurch, Christchurch, New Zealand.
¹⁰ Department of Paediatrics, The University of Melbourne, Melbourne, VIC, Australia.
¹¹ Department of Clinical and Molecular Medicine, Norwegian University of Science and Technology, Trondheim, Norway.
¹² Department of Rehabilitation Science and Health Technology, Oslo Metropolitan University, Oslo, Norway.
¹³ Department of Psychological Medicine, University of Otago Christchurch, Christchurch, New Zealand.
¹⁴ UCL Elizabeth Garrett Anderson Institute for Women's Health, University College London, London, UK.
¹⁵ Department of Psychology, Warwick Medical School, University of Warwick and Division of Health Sciences, Warwick, UK.
¹⁶ Faculty of Health, University of Canterbury, Christchurch, New Zealand.
¹⁷ Nuffield Department of Primary Care Health Sciences, University of Oxford, Radcliffe Observatory Quarter, Woodstock Road, Oxford, OX2 6GG, UK.

Abstract

Background and objective: Assessment of health-related quality of life for individuals born very preterm and/or low birthweight (VP/VLBW) offers valuable complementary information alongside biomedical assessments. However, the impact of VP/VLBW status on health-related quality of life in adulthood is inconclusive. The objective of this study was to examine associations between VP/VLBW status and preference-based health-related quality-of-life outcomes in early adulthood.

Methods: Individual participant data were obtained from five prospective cohorts of individuals born VP/VLBW and controls contributing to the 'Research on European Children and Adults Born Preterm' Consortium. The combined dataset included over 2100 adult VP/VLBW survivors with an age range of 18-29 years. The main exposure was defined as birth before 32 weeks' gestation (VP) and/or birth weight below 1500 g (VLBW). Outcome measures included multi-attribute utility scores generated by the Health Utilities Index Mark 3 and the Short Form 6D. Data were analysed using generalised linear mixed models in a one-step approach using fixed-effects and random-effects models.

Results: VP/VLBW status was associated with a significant difference in the Health Utilities Index Mark 3 multi-attribute utility score of - 0.06 (95% confidence interval - 0.08, - 0.04) in comparison to birth at term or at normal birthweight; this was not replicated for the Short Form 6D. Impacted functional domains included vision, ambulation, dexterity and cognition. VP/VLBW status was not associated with poorer emotional or social functioning, or increased pain.

Conclusions: VP/VLBW status is associated with lower overall health-related quality of life in early adulthood, particularly in terms of physical and cognitive functioning. Further studies that estimate the effects of VP/VLBW status on health-related quality-of-life outcomes in mid and late adulthood are needed.

Publication types

Meta-Analysis
Research Support, Non-U.S. Gov't

MeSH terms

Adolescent
Adult
Birth Weight
Child
Humans
Infant, Extremely Premature*
Infant, Newborn
Infant, Very Low Birth Weight / psychology
Prospective Studies
Quality of Life*
Young Adult

Abstract

Publication types

MeSH terms

Grants and funding