We investigated health-related quality of life in preterm children in association with birth weight, breastfeeding and maternal emotional state. A cross-sectional study was carried out involving 97 mothers of 2year-old children born below 2500 g. Participants completed the Pediatric Quality of Life Inventory and a comprehensive psychological interview. Birth weight and chronic neonatal morbidities were not significant predictors of quality of life at 2 years. However, breastfeeding and positive maternal emotional state were important protective factors to the prospective quality of life of preterm children. Retrospectively, calm mothers reported their children more positively comparing to anxious mothers both during their pregnancy and after birth. As protective factors, the positive maternal emotional state before and after childbirth and breastfeeding are more crucial in the development of quality of life at 2 years than biological factors.

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Intoduction Childhood intelligence is an important predictor of later outcomes in life such as socioeconomic status or health. Hence, a deeper understanding of predictors of child intelligence should suggest points of intervention for children facing adversities. Objectives The purpose of this study is to examine the predictive value of demographic, perinatal and neonatal variables after birth and developmental characteristics at age 2 for 4-year intelligence as outcome among low birth weight children. Methods We designed a panel study with a 2-year follow-up with 114 child-mother pairs. The outcome variable was IQ intelligence quotient at 4 years of age of LBW low birth weight children measured by the Wechsler Primary and Preschool Scales of Intelligence. Potential predictors were maternal education, family wealth, ethnic identity; sex, twin pregnancy, gestational age, birth weight, Apgar scores, maternal smoking during pregnancy; diagnosis of intravetricular haemorrhage, retinopathy of prematurity, bronchopulmonary dysplasia after birth and cognitive, language and motor development at age 2 measured by one composite score of the three Bayley Scales of Infant and Toddler Development aggregated. Results Stepwise backward regression was carried out including significant variables from the bivariate analysis. The best model included 4 predictors which accounted for 57% of the variance of the full IQ intelligence at 4-years of age. Maternal higher education was significant positive, below average family wealth and neonatal diagnosis of bronchopulmonary dysplasia were significant negative predictors in the model after birth. 2-year developmental characteristics such as cognitive, motor and language skills were positive predictors of the IQ intelligence at age 4. Conclusion Sociodemographic assessment at birth and developmental assessment at two years of age are of crucial importance to recognize children at high risk for delayed cognitive development. High-risk children should be directed to supportive interventions and their development should be regulary monitored.

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