Self-Perceived Health, Functioning and Well-Being of Very Low Birth Weight Infants at Age 20 Years

Abstract

Objective-To examine the self-perceived health of very low birth weight (VLBW; <1.5 kg) infants during young adulthood.Study design-The population included 241 VLBW and 232 normal birth weight (NBW) controls who completed the Child Health and Illness Profile: Adolescent Edition (CHIP-AE) at 20 years of age. The CHIP-AE includes six domains: Satisfaction, Comfort, Resilience, Achievement, Risk Avoidance, and Disorders, and 13 profiles that characterize patterns of health. Results were compared between VLBW and NBW subjects adjusting for sex and sociodemographic status.Results-VLBW subjects did not differ from NBW controls in the domains of Satisfaction or Comfort but reported less Resilience (effect size [ES] −0.19, P < .05), specifically in physical activity and family involvement. They reported better Achievement, specifically in work performance (ES 0.28, P < .05), more Risk Avoidance (ES 0.43, P < .001), and significantly more long-term medical, surgical, and psychosocial disorders. Similar proportions of VLBW and NBW subjects reported Excellent (15% vs 11%), Average (27% vs 34%), and Poor (12% vs 13%) profiles of health.Conclusions-VLBW subjects report similar health, well-being, and functioning compared with NBW controls and greater risk avoidance. However, we are concerned that their lesser resilience may prove detrimental to their future adult health.Reports of the young adult outcomes of very low birth weight children (VLBW; <1.5 kg) who were the initial survivors of neonatal intensive care have included educational achievement and various aspects of health and behavior. 1-4 The reports of health outcomes have, with few exceptions, 2,3 pertained to specific biological markers of health such as neurosensory impairments and other chronic conditions. 1,3,5-7 There has been very little prior research on the overall impact of VLBW on young adults' self-perceived health, functioning, and wellbeing. 2,3 This broader concept of self-assessed health has been termed "health-related quality of life," which is widely considered to be an important outcome of medical interventions, because it constitutes the individual's own experiences and evaluations of health.As part of a longitudinal study of the outcomes of a cohort of VLBW young adults born during the years 1977 through 1979, we previously reported on outcomes at 20 years of age, including To more fully describe the health experiences of VLBW children as compared with normal birth weight (NBW) controls at 20 years of age, we used the Child Health and Illness Profile: Adolescent Edition (CHIP-AE) a multidimensional self-report instrument that is based on a framework of health-related quality of life that includes satisfaction with health and self, comfort feelings, psychosocial resiliencies, risk behaviors, and achievement in academic and work settings. The CHIP-AE also includes biological markers of medical health and psychosocial disorders. 10,11 We hypothesized that the self-perceived health-related quality of life of our population would be determined...

Self-Reported Adolescent Health Status of Extremely Low Birth Weight Children Born 1992–1995

“…34,35 In the CHIP-AE, however, "resilience" pertains to states and behaviors that promote health. The decreased physical activity reported by our ELBW adolescents has previously been reported for preterm young adults 36,37 and is considered to be related to poorer motor performance 38 and reduced exercise capacity. 39 Correlates of decreased physical activity in our population included SES, female gender, and neurosensory impairment.…”

Preterm birth: Transition to adulthood

“…Many preterm survivors who have no neurodevelopmental disability or psychiatric illness, however, have subtle cognitive and/or motor impairments that complicate their attempts to complete their education, find and keep meaningful employment, live independently and forge satisfying social and emotional relationships. Despite their many challenges, self-reports of their own quality of life is not statistically significantly different in adults born preterm and adults born fullterm: they report the same degree of satisfaction with their lives, comfort and well-being [Bjerager et al, 1995;Saigal et al, 1996;Dinesen and Greisen, 2001;Saigal et al, 2006a;Hack et al, 2007].…”

“…Many have been successful in their integration in and contributions to society. More important, young adults born preterm acknowledge that they have more health problems than their peers, yet feel the same degree of satisfaction with their quality of life [Bjerager et al, 1995;Dinesen and Greisen, 2001;Hack et al, 2007].…”

Very Low Birth Weight and Behavioral Symptoms of Attention Deficit Hyperactivity Disorder in Young Adulthood: The Helsinki Study of Very-Low-Birth-Weight Adults

“…Because the effects of VLBW on behavioral symptoms of ADHD may vary according to intrauterine growth pattern (4,15), we further examined whether the effects of VLBW differ in VLBW adults whose birth weight was small for gestational age (SGA) as compared with those whose birth weight was appropriate for gestational age (AGA). Moreover, whereas ADHD and its behavioral symptoms are often comorbid with risk-taking behaviors, data demonstrate (4,10,14,16,17), with few exceptions (11), that VLBW adolescents and young adults exhibit fewer delin-VERY LOW BIRTH WEIGHT AND ADHD ajp.psychiatryonline.org quent and other risk-taking behaviors. Thus, our second major objective in this study was to examine whether VLBW is associated with risk-taking behaviors.…”