Health status and health related quality of life of extremely low birth weight babies at eight-ten years of life
Suman, Praveen; Kler, Neelam; Saluja, Satish; Garg, Pankaj; Soni, Arun; Saxena, Usha and Arya, S.C. (2002) Health status and health related quality of life of extremely low birth weight babies at eight-ten years of life. In: The XXII Annual Convention of National Neonatology Forum, 2001, Delhi, India.
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Introduction: The objective of this study is to estimate the health status and health related quality of life of extremely low birth weight babies (ELBW) in comparison with control group at the age of eight to ten years. Material and methods: 43 Extremely low birth weight babies who were discharged from neonatal intensive care unit (NICU) of Sir Ganga Ram hospital over a period of Jan 1993 to Dec 1995 were assessed at the age of 8-10years using multi attribute health status classification system (MAHS). The MAHS system describes both the type and severity of functional limitations according to seven attributes; sensation, mobility, emotion, cognition, self care, pain and fertility (not applicable here) with four or five levels of function within each attributes. 45 children (control) who were matched for age, sex and socioeconomic status were also assessed on the same scale. Utility equation was applied to multi attributes state description of study participants to assess their health related quality of life. The study utilized a utility equation from the random sample of 190 general population parents surveyed. Utilities can be used to estimate a single cardinal value between 0.0 and 1.0(0 = dead, 1 = perfect health) to show the global HRQOL for that individual. Results: According to multi attribute health status classification system health (MAHS) in ELBW group 11.6% subjects had no functional limitation. 58.1% had limitation for one or two functional attribute, bnd 30.3% had at least three affected functional attributes. In the control group 62.2% had no limitation, 33.3% had limitation in less than two attributes only 4.4% had limitation in at least three attributes (p<0.0001) limitation. In ELBW group limitation were more severe and statistically more significant as limitation in cognition (58.1%), sensation (48.8%), mobility (27.9%), self care (18.6%) compared with 24.4%, 11.1%, 2.2% and 0% in control group (all p<0.00 1). Emotion and pain were affected in 18.6% and 11.6% in ELBW group and figures for these attributes in control group were 13.3% and 8.8% respectively (p=0.04). Mean HRQL score were lower for ELBW (0.80 SD 0.24) than for control group (0.93 SD 0.08 : p<0.0001). Only 11.6% ELBW had HRQOL of 1.0 as compared to 62.2% in control group. Conclusion: The fewer ELBW were free of functional limitation. They had significantly higher proportion of multiple attributes affected than the control group. Thus the overall long term burden experienced by ELBW children is greater than control group.
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