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Hegelund ER, Wimmelmann CL, Strizzi JM, Folker AP, Mortensen EL, Flensborg-Madsen T. Birth weight and quality of life in midlife: a 50-year follow-up study of 2079 individuals in Denmark. Qual Life Res 2019; 29:1047-1054. [PMID: 31679110 DOI: 10.1007/s11136-019-02348-w] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/23/2019] [Indexed: 11/28/2022]
Abstract
PURPOSE Low birth weight has been associated with a higher risk of reduced quality of life (QoL) in children, adolescents, and young adults, but the influence seems to diminish over time. However, previous studies have mainly focused on health-related QoL and compared individuals with low birth weight with individuals without low birth weight. The purpose of the present cohort study was to investigate the influence of the entire range of birth weights on three distinct measures of QoL in midlife. METHODS The study population consisted of all live-born singletons from the Copenhagen Perinatal Cohort (CPC, 1959-1961) who participated in a 50-year follow-up examination in 2009-2011 (N = 2079). Birth weight was measured by three pediatricians at birth. QoL was measured at the follow-up by the participants' scores on three QoL self-report measures: The Satisfaction With Life Scale, the Vitality Scale of the Medical Outcomes Study 36-Item Short-Form Health Survey, and a single-item QoL measure based on the question: "How is your quality of life at the moment?". General linear regression and binary logistic regression were used to estimate the association between birth weight and QoL in midlife. RESULTS Small, curvilinear associations of birth weight with life satisfaction, vitality, and the single-item QoL measure were found, suggesting that both low and high birth weights increase the risk of low satisfaction with life, low vitality and low QoL. CONCLUSION The study findings suggest that low and high-range birth weight exert a lasting influence on distinct, but complementary aspects of QoL in midlife.
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Affiliation(s)
- Emilie Rune Hegelund
- Department of Public Health, University of Copenhagen, Øster Farimagsgade 5, P.O. Box 2099, 1014, Copenhagen K, Denmark.
| | - Cathrine Lawaetz Wimmelmann
- Department of Public Health, University of Copenhagen, Øster Farimagsgade 5, P.O. Box 2099, 1014, Copenhagen K, Denmark.,Center for Healthy Aging, University of Copenhagen, Blegdamsvej 3B, 2200, Copenhagen N, Denmark
| | - Jenna Marie Strizzi
- Department of Public Health, University of Copenhagen, Øster Farimagsgade 5, P.O. Box 2099, 1014, Copenhagen K, Denmark
| | - Anna Paldam Folker
- National Institute of Public Health, University of Southern Denmark, Studiestræde 6, 1455, Copenhagen K, Denmark
| | - Erik Lykke Mortensen
- Department of Public Health, University of Copenhagen, Øster Farimagsgade 5, P.O. Box 2099, 1014, Copenhagen K, Denmark.,Center for Healthy Aging, University of Copenhagen, Blegdamsvej 3B, 2200, Copenhagen N, Denmark
| | - Trine Flensborg-Madsen
- Department of Public Health, University of Copenhagen, Øster Farimagsgade 5, P.O. Box 2099, 1014, Copenhagen K, Denmark.,Center for Healthy Aging, University of Copenhagen, Blegdamsvej 3B, 2200, Copenhagen N, Denmark
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Lemyre B, Moore G. Les conseils et la prise en charge en prévision d’une naissance extrêmement prématurée. Paediatr Child Health 2017. [DOI: 10.1093/pch/pxx059] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Lemyre B, Moore G. Counselling and management for anticipated extremely preterm birth. Paediatr Child Health 2017; 22:334-341. [PMID: 29485138 DOI: 10.1093/pch/pxx058] [Citation(s) in RCA: 62] [Impact Index Per Article: 8.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Counselling couples facing the birth of an extremely preterm infant is a complex and delicate task, entailing both challenges and opportunities. This revised position statement proposes using a prognosis-based approach that takes the best estimate of gestational age into account, along with additional factors, including estimated fetal weight, receipt of antenatal corticosteroids, singleton versus multiple pregnancy, fetal status and anomalies on ultrasound and place of birth. This statement updates data on survival in Canada, long-term neurodevelopmental disability at school age and quality of life, with focus on strategies to communicate effectively with parents. It also proposes a framework for determining the prognosis-based management option(s) to present to parents when initiating the decision-making process. This statement replaces the 2012 position statement.
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Affiliation(s)
- Brigitte Lemyre
- Canadian Paediatric Society, Fetus and Newborn Committee, Ottawa, Ontario
| | - Gregory Moore
- Canadian Paediatric Society, Fetus and Newborn Committee, Ottawa, Ontario
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Extremely low birth weight babies grown up: Gene-environment interaction predicts internalizing problems in the third and fourth decades of life. Dev Psychopathol 2016; 29:837-843. [PMID: 27416920 DOI: 10.1017/s0954579416000511] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Extremely low birth weight (ELBW; <1000 g) infants have been exposed to stressful intrauterine and early postnatal environments. Even greater early adversity has been experienced by ELBW survivors who were also born small for gestational age (SGA; <10th percentile for GA) compared to those born appropriate for GA (AGA). ELBW survivors, particularly those born SGA, face increased risk for internalizing problems compared to normal BW (NBW; ≥2500 g) controls. Internalizing problems are related to allelic variations in the promoter region of the serotonin transporter linked polymorphic region gene (5-HTTLPR). We followed the oldest longitudinal cohort of ELBW survivors to adulthood. Participants provided buccal cells and reported on internalizing problems, using the Young Adult Self-Report when they were in their mid-20s (ELBW/SGA, N = 28; ELBW/AGA, N = 60; NBW, N = 81) and mid-30s (ELBW/SGA, N = 27; ELBW/AGA, N = 58; NBW, N = 76). The findings indicate that ELBW/SGAs carrying the 5-HTTLPR short allele reported increased internalizing problems, particularly depression, during the third and fourth decades of life. This is the first known report on gene-environment interactions predicting psychopathology among ELBW survivors. Our findings elucidate putative neurobiological pathways that underlie risk for psychopathology.
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Lemyre B, Daboval T, Dunn S, Kekewich M, Jones G, Wang D, Mason-Ward M, Moore GP. Shared decision making for infants born at the threshold of viability: a prognosis-based guideline. J Perinatol 2016; 36:503-9. [PMID: 27171762 DOI: 10.1038/jp.2016.81] [Citation(s) in RCA: 36] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/26/2016] [Revised: 03/31/2016] [Accepted: 04/11/2016] [Indexed: 11/09/2022]
Abstract
OBJECTIVE Making prenatal decisions regarding resuscitation of extremely premature infants, based on gestational age alone is inadequate. We developed a prognosis-based guideline. STUDY DESIGN We followed a five step approach and used the AGREE II framework: (1) systematic review and critical appraisal of published guidelines; (2) identification of key medical factors for decision making; (3) systematic reviews; (4) creation of a multi-disciplinary working group and (5) external consultation and appraisal. RESULT No published guideline met high-quality appraisal criteria. Survival, neurodevelopmental disability, quality of life of child and parents, and maternal mortality and risk of long-term morbidity were identified as key for quality decision-making. Eighteen stakeholders (including parents) advocated for the incorporation of parents' values and preferences in the process. CONCLUSION A novel framework, based on prognosis, was generated to guide when early intensive and palliative care may both be offered to expectant parents. Pre-implementation assessment is underway to identify barriers and facilitators to putting in practice.
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Affiliation(s)
- B Lemyre
- Division of Neonatology, Department of Obstetrics, Gynecology and Newborn Care, The Ottawa Hospital, Ottawa, Canada
| | - T Daboval
- Division of Neonatology, Department of Obstetrics, Gynecology and Newborn Care, The Ottawa Hospital, Ottawa, Canada
| | - S Dunn
- CHEO Research Institute, Ottawa, Canada.,Better Outcomes Registry & Network (BORN), Ottawa, Canada
| | - M Kekewich
- Department of Clinical and Organizational Ethics, The Ottawa Hospital, Ottawa, Canada
| | - G Jones
- Division of Neonatology, Department of Obstetrics, Gynecology and Newborn Care, The Ottawa Hospital, Ottawa, Canada
| | - D Wang
- Division of Neonatology, Department of Obstetrics, Gynecology and Newborn Care, The Ottawa Hospital, Ottawa, Canada
| | - M Mason-Ward
- Champlain Maternal Newborn Regional Program, Ottawa, Canada
| | - G P Moore
- Division of Neonatology, Department of Obstetrics, Gynecology and Newborn Care, The Ottawa Hospital, Ottawa, Canada
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Båtsvik B, Vederhus BJ, Halvorsen T, Wentzel-Larsen T, Graue M, Markestad T. Health-related quality of life may deteriorate from adolescence to young adulthood after extremely preterm birth. Acta Paediatr 2015; 104:948-55. [PMID: 26059965 DOI: 10.1111/apa.13069] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/11/2015] [Revised: 04/23/2015] [Accepted: 06/03/2015] [Indexed: 11/30/2022]
Abstract
AIM This study examined the development of health-related quality of life (HRQoL) and health from adolescence to adulthood after extremely preterm birth. METHODS We assessed a population-based cohort of extremely preterm-born (EPB) infants (gestational age of ≤28 weeks or birthweight of ≤1000 grams) and term-born (TB) controls at 17 and 24 years of age. They completed the Child Health Questionnaire-Child Form 87 at 17 years of age, the Short Form Health Survey-36 (SF-36) at 24 years of age and the Health Behaviour in School-aged Children-Symptom Checklist at both ages. RESULTS Of the 51 eligible EPB subjects, 46 (90%) were included and nine had severe neurosensory disabilities. On the whole, EPB and TB subjects gave their HRQoL and health similar ratings, but EPB subjects with disabilities reported poorer physical functioning at 17 and EPB subjects without disabilities reported lower scores on three of the eight SF-36 scales for social functioning and mental health and reported more psychological health complaints at 24. Differences remained in adjusted analyses. Changes from 17 to 24 years of age were minor in EPB subjects with disabilities. CONCLUSION Our comparison of EPB and TB subjects at the ages of 17 and 24 indicated that psychosocial HRQoL may deteriorate for EPB subjects when they enter adulthood.
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Affiliation(s)
| | - Bente J. Vederhus
- Department of Pediatrics; Haukeland University Hospital; Bergen Norway
- Department of Clinical Science; University of Bergen; Bergen Norway
- Department of Global Public Health and Primary Care; University of Bergen; Bergen Norway
| | - Thomas Halvorsen
- Department of Pediatrics; Haukeland University Hospital; Bergen Norway
- Department of Clinical Science; University of Bergen; Bergen Norway
| | - Tore Wentzel-Larsen
- Centre for Clinical Research; Haukeland University Hospital; Bergen Norway
- Centre for Child and Adolescent Mental Health; Eastern and Southern Norway; Oslo Norway
- Norwegian Centre for Violence and Traumatic Stress Studies; Oslo Norway
| | - Marit Graue
- Department of Pediatrics; Haukeland University Hospital; Bergen Norway
- Centre for Evidence-Based Practice; Bergen University College; Bergen Norway
| | - Trond Markestad
- Department of Pediatrics; Haukeland University Hospital; Bergen Norway
- Department of Clinical Science; University of Bergen; Bergen Norway
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Vederhus BJ, Eide GE, Natvig GK, Markestad T, Graue M, Halvorsen T. Health-related quality of life and emotional and behavioral difficulties after extreme preterm birth: developmental trajectories. PeerJ 2015; 3:e738. [PMID: 25653912 PMCID: PMC4304859 DOI: 10.7717/peerj.738] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2014] [Accepted: 01/03/2015] [Indexed: 11/20/2022] Open
Abstract
Background. Knowledge of long-term health related outcomes in contemporary populations born extremely preterm (EP) is scarce. We aimed to explore developmental trajectories of health-related quality of life (HRQoL) and behavior from mid-childhood to early adulthood in extremely preterm and term-born individuals. Methods. Subjects born at gestational age ≤28 weeks or with birth weight ≤1,000 g within a region of Norway in 1991-92 and matched term-born control subjects were assessed at 10 and 18 years. HRQoL was measured with the Child Health Questionnaire (CHQ) and behavior with the Child Behavior Checklist (CBCL), using parent assessment at both ages and self-assessment at 18 years. Results. All eligible EP (n = 35) and control children participated at 10 years, and 31 (89%) and 29 (83%) at 18 years. At 10 years, the EP born boys were given significantly poorer scores by their parents than term-born controls on most CHQ and CBCL scales, but the differences were minor at 18 years; i.e., significant improvements had occurred in several CHQ (self-esteem, general health and parental impact-time) and CBCL (total problem, internalizing and anxious/depressed) scales. For the girls, the differences were smaller at 10 years and remained unchanged by 18 years. Emotional/behavioral difficulties at 10 years similarly predicted poorer improvement on CHQ-scales for both EP and term-born subjects at 18 years. Self-assessment of HRQoL and behavior at 18 years was similar in the EP and term-born groups on most scales. Conclusions. HRQoL and behavior improved towards adulthood for EP born boys, while the girls remained relatively similar, and early emotional and behavioral difficulties predicted poorer development in HRQoL through adolescence. These data indicate that gender and a longitudinal perspective should be considered when addressing health and wellbeing after extremely preterm birth.
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Affiliation(s)
- Bente Johanne Vederhus
- Department of Pediatrics, Haukeland University Hospital , Bergen , Norway ; Department of Global Public Health and Primary Care, University of Bergen , Norway ; Department of Clinical Science, University of Bergen , Norway
| | - Geir Egil Eide
- Department of Global Public Health and Primary Care, University of Bergen , Norway ; Centre for Clinical Research, Haukeland University Hospital , Bergen , Norway
| | - Gerd Karin Natvig
- Department of Global Public Health and Primary Care, University of Bergen , Norway
| | - Trond Markestad
- Department of Pediatrics, Haukeland University Hospital , Bergen , Norway ; Department of Clinical Science, University of Bergen , Norway
| | - Marit Graue
- Department of Pediatrics, Haukeland University Hospital , Bergen , Norway ; Centre for Evidence Based Practice, Bergen University College , Bergen , Norway
| | - Thomas Halvorsen
- Department of Pediatrics, Haukeland University Hospital , Bergen , Norway ; Department of Clinical Science, University of Bergen , Norway
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Georgsdottir I, Haraldsson A, Dagbjartsson A. Behavior and well-being of extremely low birth weight teenagers in Iceland. Early Hum Dev 2013; 89:999-1003. [PMID: 24041813 DOI: 10.1016/j.earlhumdev.2013.08.018] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/29/2013] [Revised: 08/14/2013] [Accepted: 08/22/2013] [Indexed: 11/26/2022]
Abstract
BACKGROUND Preterm children are at risk for behavioral and emotional problems. AIMS To evaluate behavior and emotional well-being of extremely low birth weight (ELBW) teenagers born in Iceland in 1991-1995. METHODS Participants, 30 of 35 ELBW survivors (25 girls, 5 boys, mean age 16.8 years), were interviewed, underwent medical examination and answered the Youth Self-Report for ages 11-18 (YSR) of the Achenbach System of Empirically Based Assessment (ASEBA). The ELBW parents answered the ASEBA Child Behavior Checklist for ages 6-18 and the Autism Spectrum Screening Questionnaire (ASSQ). A comparison group of 30 teenagers (23 girls, 7 boys, mean age 16.5 years) answered the YSR questionnaire and their parents answered the CBCL and ASSQ questionnaires. RESULTS ELBW teenagers and parents report more behavior problems than the full term comparison teenagers and parents. They score significantly higher on the YSR and CBCL syndrome scales except for YSR and CBCL rule-breaking behavior and CBCL thought problems. The ELBW teenagers self-report on total competence, activities, social participation and academic performance was not significantly lower than the comparison teenagers. Parents of ELBW teenagers rated total competence, social participation and school performance of their children significantly lower than parents of comparison teenagers. The YSR Positive Qualities Scale was not significantly different between the two teenage groups. Two ELBW teenagers scored above cut-off points on the ASSQ questionnaire and none of the comparison teenagers. Bullying was reported by 20% of ELBW parents compared to none of the comparison group. CONCLUSION ELBW teenagers experience emotional, behavior and social challenges. The teenagers value their positive qualities, activities and academic performance similar to peers.
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Greisen G. The life of people born preterm - what do you want to know? Acta Paediatr 2013; 102:564-6. [PMID: 23551218 DOI: 10.1111/apa.12250] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/21/2013] [Accepted: 03/22/2013] [Indexed: 11/30/2022]
Affiliation(s)
- Gorm Greisen
- Department of Neonatology, National University Hospital-Rigshospitalet, Copenhagen, Denmark.
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