Journal article
Severe neonatal complications and long-term health-related quality of life in very preterm and/or very low birth weight survivors: evidence from the Dutch Project on preterm and small for gestational age cohort
- Abstract:
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Background: Understanding the impact of severe neonatal complications such as Bronchopulmonary Dysplasia (BPD), Intraventricular Hemorrhage (IVH), or Necrotizing Enterocolitis (NEC) on adult health-related quality of life (HRQoL) beyond the effect of prematurity itself is significant for health economic evaluation and policy.
Objective: Analyze the independent associations of BPD, IVH, NEC and multiple birth status with preference-based HRQoL utility scores in adulthood for survivors in the Dutch Project on Preterm and Small-for-gestational-age infants (POPS) a national cohort born in 1983.
Methods: Exposures were documented neonatal BPD, severe IVH (grades 3–4), NEC, and multiple birth status. HRQoL data were available for n = 644 (19 y), n = 314 (28 y), and n = 370 (35 y). Using multivariable linear regression adjusted for confounders, we assessed the association between each exposure and HRQoL utility scores and optimal functioning. Analyses incorporated inverse probability weighting to adjust for potential attrition bias. We conducted comprehensive sensitivity analyses including best-case/worst-case imputation scenarios, comparison of IPW-weighted versus unweighted estimates, and post-hoc power calculations.
Results: After adjustment for confounders, severe IVH (grade 3/4) was the only neonatal complication independently associated with significant and persistent decrements in overall preference-based HRQoL, with utility score reductions at 19 years (HUI3: β = − 0.08, p = 0.05), 28 years (HUI3: β = − 0.13, p = 0.01), and 35 years (SF-6D: β = − 0.07, p = 0.04). These findings were robust to IPW adjustment for attrition (all |∆β| < 0.02) and fell within plausible bounds established by best-case/worst-case sensitivity analyses.
Conclusion: Severe IVH was associated with significant and clinically meaningful utility decrements that persisted into the fourth decade of life.
- Publication status:
- Published
- Peer review status:
- Peer reviewed
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(Preview, Version of record, pdf, 2.9MB, Terms of use)
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- Publisher copy:
- 10.1007/s11136-026-04185-0
Authors
- Publisher:
- Springer
- Journal:
- Quality of Life Research More from this journal
- Volume:
- 35
- Issue:
- 6
- Article number:
- 146
- Publication date:
- 2026-05-03
- Acceptance date:
- 2026-01-26
- DOI:
- EISSN:
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1573-2649
- ISSN:
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0962-9343
- Language:
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English
- Keywords:
- Pubs id:
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2364036
- Local pid:
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pubs:2364036
- Deposit date:
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2026-01-26
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Terms of use
- Copyright holder:
- Bolbocean et al.
- Copyright date:
- 2026
- Rights statement:
- Copyright © 2026, The Author(s). This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article’s Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article’s Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/.
- Licence:
- CC Attribution (CC BY)
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