Health-Related Quality of Life in 5-Year-Old Very Low Birth Weight Infants

Objective To investigate the effect of preterm birth, the time of birth, and birth hospital level and district on health-related quality of life (HRQoL) and quality-adjusted life years (QALYs). Study design This national study included all very low birth weight infants (VLBWIs; birth weight <= 1500 g or gestational age < 32 weeks) born in Finland between 2000 and 2003 (n = 1169; live-born, n = 900) and full-term controls (n = 368). Register data and parental questionnaires were used. The relationships among HRQoL and QALYs at age 5 years and preterm birth, time of birth, and the level and district of the birth hospital were studied. Results HRQoL at age 5 years was lower and 1.3 QALYs were lost in VLBWIs compared with controls. Regional differences in the QALYs of VLBWIs were found among the 5 university hospital districts. Birth hospital level or birth outside office hours had no effect on the QALYs of live-born VLBWIs. The adjusted HRQoL total score was not affected by birth outside office hours or by the birth hospital level or district. Conclusions Differences in QALYs related to hospital district suggest variation in the care of VLBWIs that needs to be addressed. (J Pediatr 2009; 155:338-43).