Neonatal Treatment Philosophy in Dutch and German NICUs: Health-related Quality of Life in Adulthood of VP/VLBW Infants
Overview
Rehabilitation Medicine
Authors
Affiliations
Purpose: Although survival after very preterm birth (VP)/very low birth weight (VLBW) has improved, a significant number of VP/VLBW individuals develop physical and cognitive problems during their life course that may affect their health-related quality of life (HRQoL). We compared HRQoL in VP/VLBW cohorts from two countries: The Netherlands (n = 314) versus Germany (n = 260) and examined whether different neonatal treatment and rates of disability affect HRQoL in adulthood.
Method: To analyse whether cohorts differed in adult HRQoL, linear regression analyses were performed for three HRQoL outcomes assessed with the Health Utilities Index 3 (HUI3), the London Handicap Scale (LHS), and the WHO Quality of Life instrument (WHOQOL-BREF). Stepwise hierarchical linear regression was used to test whether neonatal physical health and treatment, social environment, and intelligence (IQ) were related to VP/VLBW adults' HRQoL and cohort differences.
Results: Dutch VP/VLBW adults reported a significantly higher HRQoL on all three general HRQoL measures than German VP/VLBW adults (HUI3: .86 vs .83, p = .036; LHS: .93 vs. .90, p = .018; WHOQOL-BREF: 82.8 vs. 78.3, p < .001). Main predictor of cohort differences in all three HRQoL measures was adult IQ (p < .001).
Conclusions: Lower HRQoL in German versus Dutch adults was related to more cognitive impairment in German adults. Due to different policies, German VP/VLBW infants received more intensive treatment that may have affected their cognitive development. Our findings stress the importance of examining effects of different neonatal treatment policies for VP/VLBW adults' life.
Kwon J, Bolbocean C, Onyimadu O, Roberts N, Petrou S Children (Basel). 2023; 10(11).
PMID: 38002889 PMC: 10670192. DOI: 10.3390/children10111798.
Wollum A, Berdal E, Iversen J, Indredavik M, Evensen K BMC Pediatr. 2022; 22(1):628.
PMID: 36329401 PMC: 9632018. DOI: 10.1186/s12887-022-03676-6.
Linsell L, Johnson S, Wolke D, OReilly H, Morris J, Kurinczuk J Arch Dis Child. 2017; 103(4):363-370.
PMID: 29146572 PMC: 5890637. DOI: 10.1136/archdischild-2017-313414.