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The effect of graded and discrete levels of intrauterine growth restriction on later quality of life.
The aim of the study was to compare the quality of life of children born with a normally grown birthweight with that of children born with varying degrees of intrauterine growth restriction (IUGR) and with those who were born SGA. This was a cross-sectional study of 99 children with a birthweight of less than 10th percentile who were born at the Royal Women's Hospital, Melbourne, Australia. Birthweight was measured at birth, and five other parameters describing intrauterine growth were assessed at birth: length-for-age Z score (LAZ), weight-for-age Z score (WAZ), mid upper arm circumference-for-age Z score (MUACZ), head circumference-for-age Z score (HCAZ), and skinfold thickness-for-age Z score (SFATZ). Mothers reported how many hours their child slept a night and if he/she was a 'good' or 'bad' sleeper, using a Likert-type scale of 1 (fair) to 10 (poor). Differences in quality of life were assessed using established instruments for children (Pediatric Quality of Life Inventory, PedsQL 4.0) and parents (Infant Quality of Life Questionnaire, I-QOL), as well as a UCLA/LA Algorithm for growth-related health, which incorporates multiple measures of growth. LAZ was lower in the IUGR group than in the non-IUGR group (P < 0.001), with no differences in WAZ, MUACZ, HCAZ, SFATZ or sleep quality. The IUGR group had lower scores than the non-IUGR group in the domains of physical functioning, emotional functioning and psychological well-being, and the overall health-related quality of life in children. There were also lower scores in the 'growth' and 'feelings' domains of the mothers and fathers' quality of life than those in the non-IUGR group. Following adjustment for age and gender, IUGR was significantly associated with impaired quality of life in five domains of children, 'growth', 'feelings', 'physical functioning', 'emotional functioning' and 'psychological well-being'. In addition, IUGR was significantly associated with impaired quality of life in three of four domains of mother's health 0b46394aab