Published online September 1, 2008
PEDIATRICS Vol. 122 No. 3 September 2008, pp. 556-561 (doi:10.1542/peds.2007-1043)
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ARTICLE

Health-Related Quality of Life for Extremely Low Birth Weight Adolescents in Canada, Germany, and the Netherlands

Erik Verrips, PhDa,b, Ton Vogels, PhDa, Saroj Saigal, MDc, Dieter Wolke, PhDd, Renate Meyer, PhDe, Lorraine Hoult, BAc and S. Pauline Verloove-Vanhorick, MD, PhDa,f

a Applied Scientific Research (TNO) Prevention and Health, Leiden, Netherlands
b Academic Centre Dentistry Amsterdam, Amsterdam, Netherlands
c Department of Pediatrics, McMaster University, Hamilton, Canada
d Department of Developmental Psychology, University of Warwick, Coventry, United Kingdom
e University of Munich Children's Hospital, Munich, Germany
f Department of Pediatrics, Leiden University Medical Center, Leiden, Netherlands

OBJECTIVE. The goal was to compare health-related quality of life of 12- to 16-year-old adolescents born at an extremely low birth weight in regional cohorts from Ontario (Canada), Bavaria (Germany), and the Netherlands.

METHODS. Patients were extremely low birth weight survivors from Canada, Germany, and the Netherlands. Health-related quality of life was assessed with Health Utilities Index 3. Missing data were substituted by proxy reports. Differences in mean Health Utilities Index 3 scores were tested by using analysis of variance. Differences in the numbers of children with affected attributes were tested by using logistic regression analyses.

RESULTS. Survival rates were similar; response rates varied between 71% and 90%. Significant differences in health-related quality of life were found between the cohorts, with Dutch children scoring highest on Health Utilities Index 3 and German children scoring lowest, independent of birth weight, gestational age, and cerebral palsy. Differences in mean utility scores were mainly attributable to differences in the cognition health attribute. Most of the results were corroborated by logistic regression analyses.

CONCLUSIONS. There were significant differences between the 3 cohorts in health-related quality of life, not related to differences in birth weight, gestational age, or cerebral palsy. Survival and response rates alone cannot explain these differences.

Key Words: cross-cultural • extremely low birth weight • health-related quality of life

Abbreviations: CP—cerebral palsy • ELBW—extremely low birth weight • HRQL—health-related quality of life • HUI3—Health Utility Index 3 • MAU—multiple-attribute utility • SAU—single-attribute utility

Accepted Dec 14, 2007.


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