Quality of life of extremely preterm school-age children without major handicap: a cross-sectional observational study

Gire, Catherine; Resseguier, Noémie; Brévaut-Malaty, Véronique; Marret, Stéphane; Cambonie, Gilles; Souksi-Medioni, Isabelle; Müller, Jean-Baptiste; Garcia, Patricia; Berbis, Julie; Tosello, Barthélémy; Auquier, Pascal

doi:10.1136/archdischild-2018-315046

Cited by 36 publications

(34 citation statements)

References 39 publications

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“…Our cohort had good overall HRQoL at 7 years, consistent with a 2016 study that reported similar findings in healthy preterm Finnish children born very low birthweight [ 19 ]. However, another study from France reported that extremely preterm children have poorer overall HRQoL than full-term peers [ 20 ]. Our study also found that caring for children with NDI significantly reduced family HRQoL, most noticeably in caregiver emotional states.…”

Section: Discussionmentioning

confidence: 99%

Caregiver-reported health-related quality of life of New Zealand children born very and extremely preterm

Liu

Harding

Team³

2021

PLoS ONE

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Background Children born preterm, particularly at earlier gestations, are at increased risk for mortality and morbidity, but later health-related quality of life (HRQoL) is less well described. Neurodevelopmental impairment and socio-economic status may also influence HRQoL. Our aim was to describe the HRQoL of a cohort of New Zealand children born very and extremely preterm, and how this is related to neurodevelopmental impairment, gestational age, and socio-economic deprivation. Methods Children born <30 weeks’ gestation or <1500 g birthweight were assessed at 7 years’ corrected age. Caregivers completed the Child Health Questionnaire Parent Form (CHQ-PF50), and the Health Utilities Index Mark 2 (HUI-2). Neurodevelopmental impairment was defined as Wechsler full scale intelligence quotient below -1 standard deviation (SD), Movement Assessment Battery for Children total score ≤15 percentile, cerebral palsy, deafness, or blindness. Results Data were collected for 127 children, of whom 60 (47%) had neurodevelopmental impairment. Overall, HRQoL was good: mean (SD) CHQ-PF50 physical summary score = 50.8 (11.1), psychosocial summary score = 49.3 (9.1) [normative mean 50 (10)]; HUI-2 dead-healthy scale = 0.92 (0.09) [maximum 1.0]. Neurodevelopmental impairment, lower gestational age, and higher socio-economic deprivation were all associated with reduced HRQoL. However, on multivariable analysis, only intelligence quotient and motor function were associated with psychosocial HRQoL, while intelligence quotient was associated with physical HRQoL. Conclusions Most seven-year-old children born very and extremely preterm have good HRQoL. Further improvements will require reduced neurodevelopmental impairment.

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Section: Discussionmentioning

confidence: 99%

Caregiver-reported health-related quality of life of New Zealand children born very and extremely preterm

Liu

Harding

Team³

2021

PLoS ONE

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“…Our participating centers care for 20% of EPTs born in France each year. A detailed description of the GPQoL study was published previously [10,11]. All patients included had a longterm evaluation at school age (between 7 and 10 years old) including a clinical examination, along with their cognitive and behavior functions [10,11].…”

Section: Study Design and Populationmentioning

confidence: 99%

The Neurobehavioral Phenotype of School-Aged, Very Prematurely Born Children with No Serious Neurological Sequelae: A Quality of Life Predictor

Tosello

Méziane²,

Resseguier

et al. 2021

Children

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School-aged extremely preterm (EPT) children have multiple specific neurocognitive/behavioral disorders that are often associated with other disorders; this manifests a true neurobehavioral “phenotype” of prematurity. To determine a profile of cognitive/behavioral impairments in a population of school-aged EPT children (7–10 years-old) without major disabilities, a cross-sectional study was conducted in five medical centers. An algorithm distributed the study population according to four WISC-IV subtests, five NEPSY-2 subtests, and two variables of figure of Rey. The behavior (SDQ), anxiety (Spielberg STAI-C), and generic QoL (Kidscreen 10 and VSP-A) were also evaluated. The study included 231 school-aged EPT children. Three neurobehavioral “phenotypes” were defined according to their severity: 1 = moderately, 2 = minor, and 3 = unimpaired. In all the profiles, the working memory, perceptual reasoning, as well as mental flexibility, were close to or below average, and their emotional behavior was always troubled. Self-esteem and school-work were the most impacted QoL areas. The unimpaired neurobehavior exhibited emotional behavioral impairment and executive dysfunction. The profile analysis defined distinct outcome groups and provided an informative means of identifying factors related to developmental outcomes. The QoL deterioration is determined by the severity of the three neurobehavioral “phenotypes”, which is defined as well as by dysexecutive and/or behavioral disorders.

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“…The lifelong burden of neurodevelopmental impairment in survivors of premature birth is a major public health challenge with more than 50% of very preterm infants [born before 32 weeks gestational age (GA)] dependent on complex healthcare, specialized education and social support; and thus limiting quality of life. ( Laptook et al, 2005 ; Hintz et al, 2015 ; Gire et al, 2018 ) In fact, even the relatively mature moderate-to-late (32–36 weeks GA) preterm infants, who are usually free of obvious brain injury on conventional neuroimaging, have a two-fold increased risk for cognitive and behavioral impairments compared with term-born infants. ( Eeles et al, 2017 ; van Baar et al, 2009 ; Cserjesi et al, 2012 ; Spittle et al, 2017 ; Johnson et al, 2015 ) This underscores a critical need to identify the subtle but pervasive microstructural and biochemical derangements in the developing brain prematurely exposed to the extra-uterine environment.…”

Section: Introductionmentioning

confidence: 99%

GABA and glutamate in the preterm neonatal brain: In-vivo measurement by magnetic resonance spectroscopy

et al. 2021

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Cognitive and behavioral disabilities in preterm infants, even without obvious brain injury on conventional neuroimaging, underscores a critical need to identify the subtle underlying microstructural and biochemical derangements. The gamma-aminobutyric acid (GABA) and glutamatergic neurotransmitter systems undergo rapid maturation during the crucial late gestation and early postnatal life, and are at-risk of disruption after preterm birth. Animal and human autopsy studies provide the bulk of current understanding since non-invasive specialized proton magnetic resonance spectroscopy ( 1 H-MRS) to measure GABA and glutamate are not routinely available for this vulnerable population due to logistical and technical challenges. We review the specialized 1 H-MRS techniques including MEscher-GArwood Point Resolved Spectroscopy (MEGA-PRESS), special challenges and considerations needed for interpretation of acquired data from the developing brain of preterm infants. We summarize the limited in-vivo preterm data, highlight the gaps in knowledge, and discuss future directions for optimal integration of available in-vivo approaches to understand the influence of GABA and glutamate on neurodevelopmental outcomes after preterm birth.

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Quality of life of extremely preterm school-age children without major handicap: a cross-sectional observational study

Abstract: NCT01675726, pre-results.

Cited by 36 publications

References 39 publications

Caregiver-reported health-related quality of life of New Zealand children born very and extremely preterm

Caregiver-reported health-related quality of life of New Zealand children born very and extremely preterm

The Neurobehavioral Phenotype of School-Aged, Very Prematurely Born Children with No Serious Neurological Sequelae: A Quality of Life Predictor

GABA and glutamate in the preterm neonatal brain: In-vivo measurement by magnetic resonance spectroscopy

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