Published online February 1, 2008
PEDIATRICS Vol. 121 No. 2 February 2008, pp. e366-e376 (doi:10.1542/peds.2007-0169)
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REVIEW ARTICLE

Quality of Life of Formerly Preterm and Very Low Birth Weight Infants From Preschool Age to Adulthood: A Systematic Review

Jill Glennis Zwicker, MA, BA, BSc(OT), OT(C)a and Susan Richardson Harris, PhD, PTb

a Rehabilitation Sciences
b Department of Physical Therapy, Faculty of Medicine, University of British Columbia, Vancouver, British Columbia, Canada

OBJECTIVE. The goal of this systematic review was to synthesize studies that examined the health-related quality of life of preschool- and school-aged children, adolescents, and young adults who were born preterm and/or at very low birth weight.

METHODS. We searched 7 databases up to September 2006 (Medline, PubMed, Embase, EBM Reviews, Cumulative Index of Nursing and Allied Health Literature, PsycINFO, and the Educational Resource Information Center) as well as gray literature sources. We independently screened studies and included them only if a quality-of-life outcome measure was used and findings compared preterm, very low birth weight, or extremely low birth weight infants with term or normal birth weight peers. We independently assessed the methodologic quality of each study by using criteria adapted from the Centre for Reviews and Dissemination.

RESULTS. Fifteen cohort or cross-sectional studies met the review criteria. In 6 studies of preschool-aged children, differences were found between study and control groups, suggesting that many preschool children born preterm or at very low birth weight perform more poorly than their peers in physical, emotional, and/or social functioning. Extremely low birth weight school-aged children had lower health utility scores compared with their peers, and similar results were found for adolescents. Parents of preterm and very low birth weight teens noted significantly poorer performance in their child's global health, behavior, and physical functioning, whereas the teenagers themselves did not. In young adulthood, differences in physical functioning remained, but subjective quality of life was similar to normal birth weight peers.

CONCLUSIONS. The effects of preterm birth/very low birth weight on health-related quality of life seem to diminish over time, which possibly reflects issues related to a child's report versus a parent-proxy report, differing definitions of health-related quality of life, and adaptation of individuals over time, versus true change in health-related quality of life.

Key Words: extremely low birth weight • very low birth weight • health-related quality of life • quality of life • systematic review

Abbreviations: VLBW—very low birth weight • ELBW—extremely low birth weight • QoL—quality of life • HRQoL—health-related quality of life • NBW—normal birth weight • ELGA—extremely low gestational age

Accepted Jun 19, 2007.