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Neonatal treatment philosophy in Dutch and German NICUs : health-related quality of life in adulthood of VP/VLBW infants
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Breeman, Linda D., van der Pal, Sylvia, Verrips, Gijsbert H. W., Baumann, Nicole, Bartmann, Peter and Wolke, Dieter (2016) Neonatal treatment philosophy in Dutch and German NICUs : health-related quality of life in adulthood of VP/VLBW infants. Quality of Life Research . doi:10.1007/s11136-016-1410-7
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Official URL: http://dx.doi.org/10.1007/s11136-016-1410-7
Abstract
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.
| Item Type: | Journal Article | ||||||
|---|---|---|---|---|---|---|---|
| Subjects: | R Medicine > RJ Pediatrics > RJ101 Child Health. Child health services | ||||||
| Divisions: | Faculty of Medicine > Warwick Medical School > Health Sciences > Mental Health and Wellbeing Faculty of Science > Psychology Faculty of Medicine > Warwick Medical School |
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| Library of Congress Subject Headings (LCSH): | Premature infants, Child development, Quality of life | ||||||
| Journal or Publication Title: | Quality of Life Research | ||||||
| Publisher: | Springer Netherlands | ||||||
| ISSN: | 0962-9343 | ||||||
| Official Date: | 22 September 2016 | ||||||
| Dates: |
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| DOI: | 10.1007/s11136-016-1410-7 | ||||||
| Status: | Peer Reviewed | ||||||
| Publication Status: | Published | ||||||
| Access rights to Published version: | Restricted or Subscription Access | ||||||
| Funder: | United States. Agency for Health Care Policy and Research, Germany. Bundesministerium für Bildung und Wissenschaft [Ministry of Education and Science] | ||||||
| Grant number: | HS-08385 (Agency for Health Care Policy and Research), PKE24, JUG14, 01EP9504 and 01ER0801 (Bundesministerium für Bildung und Wissenschaft) |
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