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Health-related quality of life among 3–4-year-old children born with very low birthweight


  • Li-Yin Chien ScD RN,

  • Yi-Hung Chou MD,

  • Yi-Li Ko EdD RN,

  • Ching-Fang Lee MSN RN

Li-Yin Chien,
Institute of Community Health Nursing,
National Yang-Ming University,
155 Li-Nong Street,
Sec. 2,
Taipei 11221,


Aim.  This paper reports a study comparing health-related quality of life at 3–4 years of age among children born with very low birthweight (≤1500 g) to a group of non-very low birthweight controls, and to examine biological, environmental, demographic and health factors associated with quality of life of children born with very low birthweight.

Background.  Advances in modern medicine have increased the survival of infants with very low birthweight, but its impact on quality of life of children during preschool years has been less studied.

Methods.  The study sample included 118 children born with very low birthweight and 170 non-very low birthweight controls in Taiwan. Primary caregivers of the study children completed structured questionnaires during the period November 2002 to April 2003. Health-related quality of life was measured using the Mandarin version of the TZO-AZL Preschool Children Quality of Life instrument. This tool has four dimensions: physical, emotional, cognitive and social functions. Higher scores indicate better quality of life.

Findings.  Children born with very low birthweight had statistically significantly lower mean quality of life scores in all the four dimensions compared with controls. Among the former, those who had current physical health problems scored lower in all dimensions of quality of life. Primary caregivers with higher educational levels and increased ages of the children were associated with improved scores in the emotional and social functions. Birth gestational age was negatively associated with cognitive function. Length of stay in the neonatal intensive care unit was negatively associated with scores for the social function aspect of quality of life.

Conclusion.  Regular monitoring of the quality of life among very low birthweight children is needed. Nurses need to assess the child's current health state, birth gestational age, and the primary caregiver's educational level in order to identify those who are at risk for low quality of life and intervene early.