Quality of life of survivors following treatment in the early neonatal period.

Abstract

Intensive neonatal care has improved the survival rate of critically ill neonates. However there is growing concern about the long-term prospects of these survivors. The objectives of the study was to assess the quality of life of children aged 6 years, who in the early neonatal period required treatment at a special care unit. These children were compared with age matched controls who during the early neonatal period were not exposed to treatment at a special care unit. A retrospective cohort study was carried out with a study population of 413 of which 181 received treatment and 232 were not exposed. The quality of life was assessed subjectively by parents /carers of the study children using a postal questionnaire based on a multiattribute classification system. Eight domains were investigated : hearing, vision, speech, mobility, emotion, learning ability, self care, and pain. 67% of cases compared to 74% of controls had normal function in all eight domains. Chi squared analysis showed no significant difference between cases and controls on a global level of function. For individual attributes, cases had a significantly worse function in speech (P=0.034) and self care (P=0.006). When compared to female cases, males cases had a significantly worse overall function (P=0.004) and poorer function in speech and learning abilities. No significant difference was observed when outcome was assessed according to gestational age at birth and birth weight. This study was able to show that survivors of treatment in the early neonatal period have a favourable quality of life and a good functional outcome indicating an overall beneficial effect.