Health-related quality of life in young adults born small for gestational age: a prospective cohort study

Abstract

Background Individuals born small for gestational age (SGA) have an increased risk of several adverse health outcomes, but their health-related quality of life (HRQoL) across young adulthood has yet to be studied. The main aim of this study was to investigate if being born SGA at term is associated with poor HRQoL at 32 years of age. A second aim was to explore longitudinal changes in HRQoL from age 20 to 32 years. Methods In the prospective NTNU Low Birth Weight in a Lifetime Perspective study, 56 participants born SGA and 68 non-SGA control participants completed the Short Form 36 Health Survey (SF-36) at age 32 years to assess HRQoL. The SF-36 was also administrated at age 20 and 28 years. Longitudinal changes in the eight SF-36 domains and the two component summaries from 20 to 32 years were analyzed by linear mixed models. In total, 82 adults born SGA and 98 controls participated at least once and were included in the longitudinal analyses. Results At age 32 years the participants born SGA scored 14.8 (95% CI 4.7 to 25.3) points lower in the SF-36 role-physical domain compared with the control group, i.e. more problems with work or other daily activities due to physical health problems. The longitudinal analyses showed significant group differences from 20 to 32 years in the role-emotional domain, and in the physical and mental component summaries. Among participants born SGA, the physical component summary decreased from age 20 to 28 years (-3.2, 95% CI -5.0 to -1.8), while the mental component summary (6.0, 95% CI 2.9 to 8.6) and role-emotional domain score (19.3, 95% CI 9.9 to 30.3) increased, but there were no further changes from 28 to 32 years. There were no longitudinal changes in the control group from 20 to 32 years. Conclusion Overall, individuals born SGA at term reported similar HRQoL at age 32 years compared with non-SGA controls. Self-perceived mental health improved during young adulthood among individuals born SGA, while self-perceived physical health deteriorated. The latter findings warrant further investigation.

Physical activity and associations with health-related quality of life in adults born small for gestational age at term: a prospective cohort study

“…In the SGA group, objectively measured time on the move was positively associated with HRQoL. This may be plausible as the SGA group reported more problems with daily activities due to their physical health at 32 years [ 12 ]. The physical component of SF-36 is a summary of items concerning performance of activities, such as running, lifting, domestic life, walking distances and activities of daily living (physical functioning), limitations due to physical health and bodily pain, which seems highly correlated to time on the move.…”

“…There were no substantial differences between participants and those who did not consent to participate at the 32-year follow-up regarding gestational age, birth weight, birth length, head circumference, ponderal index, maternal age at delivery, parental socioeconomic status (SES) or sex in either group [ 12 ].…”

“…The association was consistent across different measures of PA, although the association with HRQoL was stronger for objective measures [ 10 ]. In the NTNU Low Birth Weight in a Lifetime Perspective (NTNU LBW Life) study, we found that the physical HRQoL of adults born SGA at term on average deteriorated from 20 to 28 years of age, and then remained stable until 32 years, compared with the control group of non-SGA adults [ 12 ].…”

Maternal Plasma Choline during Gestation and Small for Gestational Age Infants

“…Small for gestational age (SGA) infants are at increased risk for neonatal morbidity and mortality, as well as for developmental problems through childhood, which include an increased risk of later mental illness. [1][2][3][4][5] Currently, there is no accepted intervention to decrease the incidence of SGA. Some SGA infants have severe early gestational deficiencies in placenta formation and other developmental abnormalities that are recognized during pregnancy as fetal growth restriction (FGR).…”