Health-Related Quality-of-Life Outcomes of Very Preterm or Very Low Birth Weight Adults: Evidence From an Individual Participant Data Meta-Analysis
Bolbocean, Corneliu; van der Pal, Sylvia; van Buuren, Stef; Anderson, Peter J.; Bartmann, Peter; Baumann, Nicole; Cheong, Jeanie L. Y.; Darlow, Brian A.; Doyle, Lex W.; Evensen, Kari Anne Indredavik; Horwood, John; Indredavik, Marit Sæbø; Johnson, Samantha; Marlow, Neil; Mendonça, Marina; Ni, Yanyan; Wolke, Dieter; Woodward, Lianne; Verrips, Erik; Petrou, Stavros
Peer reviewed, Journal article
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Original versionPharmacoEconomics (Auckland). 2022, 41 93-105. 10.1007/s40273-022-01201-2
Background and Objective Assessment of health-related quality of life for individuals born very preterm and/or low birthweight (VP/VLBW) offers valuable complementary information alongside biomedical assessments. However, the impact of VP/VLBW status on health-related quality of life in adulthood is inconclusive. The objective of this study was to examine associations between VP/VLBW status and preference-based health-related quality-of-life outcomes in early adulthood. Methods Individual participant data were obtained from five prospective cohorts of individuals born VP/VLBW and controls contributing to the ‘Research on European Children and Adults Born Preterm’ Consortium. The combined dataset included over 2100 adult VP/VLBW survivors with an age range of 18–29 years. The main exposure was defined as birth before 32 weeks’ gestation (VP) and/or birth weight below 1500 g (VLBW). Outcome measures included multi-attribute utility scores generated by the Health Utilities Index Mark 3 and the Short Form 6D. Data were analysed using generalised linear mixed models in a one-step approach using fixed-effects and random-effects models. Results VP/VLBW status was associated with a significant difference in the Health Utilities Index Mark 3 multi-attribute utility score of − 0.06 (95% confidence interval − 0.08, − 0.04) in comparison to birth at term or at normal birthweight; this was not replicated for the Short Form 6D. Impacted functional domains included vision, ambulation, dexterity and cognition. VP/VLBW status was not associated with poorer emotional or social functioning, or increased pain. Conclusions VP/VLBW status is associated with lower overall health-related quality of life in early adulthood, particularly in terms of physical and cognitive functioning. Further studies that estimate the effects of VP/VLBW status on health-related quality-of-life outcomes in mid and late adulthood are needed.