Parent-reported quality of life at school age among children born extremely preterm is associated with non-medical determinants of health and developmental outcomes.

Objective The study examined how neonatal medical morbidities and non-medical determinants of health, in children born extremely preterm, affected Pediatric Quality of Life (PedsQL) scores at age 6-7 years, and whether these scores were associated with neurodevelopmental outcomes. Methods This was a secondary analysis of the prospective longitudinal study of neonatal neuroimaging and 6-7 year outcomes among infants born 24-27 + 6/7 weeks estimated gestational age (EGA) in a subgroup of the Surfactant Positive Airway Pressure and Pulse Oximetry Trial (SUPPORT). We fit linear mixed effect regression models of PedsQL, WISC-IV, and WJ-III scale scores by demographic and neonatal factors. Structural equation modeling was used to examine the relationship between quality of life and neurodevelopmental outcomes, accounting for demographic and neonatal factors. Results Higher PedsQL scores were related to better neurodevelopmental outcomes. Children with public or no insurance had lower PedsQL scores for physical health and school functioning. Lowest maternal education was associated with poorer school functioning. Race was associated with positive emotional functioning. Conclusions Parent-reported quality of life scores and non-medical determinants of health were associated with neurodevelopmental outcome at school age. Future studies should consider adding measures of quality of life and how it impacts a child's development.