Neuropediatrics 2015; 46 - FV01-05
DOI: 10.1055/s-0035-1550641

Quality of Life 5 Years after Neonatal Arterial Ischemic Stroke: Is there an Association with Hand Motor Performance?

M. Teuscher 1, S. Grunt 1, M. Studer 1, E. Boltshauser 2, A. Capone Mori 3, A. Datta 4, J. Fluss 5, D. Mercati 6, E. Keller 7, O. Maier 8, C. Poloni 9, G. Ramelli 10, T. Schmitt-Mechelke 11, M. Steinlin 1
  • 1Neuropädiatrie, Bern, Switzerland
  • 2Neuropädiatrie Universitätsspital Zürich, Zürich, Switzerland
  • 3Neuropädiatrie Kantonsspital Aarau, Aarau, Switzerland
  • 4Neuropädiatrie Universitätsspital Basel, Basel, Switzerland
  • 5Neuropädiatrie Genf, Genève, Switzerland
  • 6Champréveyres, Neuchâtel, Switzerland
  • 7Neuropädiatrie Kantonsspital Graubünden, Chur, Switzerland
  • 8Neuropädiatrie Kantonsspital St.Gallen, St.Gallen, Switzerland
  • 9Neuropädiatrie Universitätsspital Lausanne, lausanne, Switzerland
  • 10Neuropädiatrie Bellinzona, Bellinzona, Switzerland
  • 11Neuropädiatrie Luzern, Luzern 16, Switzerland

Aim: Neonatal arterial ischemic stroke (NAIS) is associated with considerable morbidity. It can be assumed, that the long-term burden of NAIS is associated with reduced health-related quality of life (QoL).The objective is to assess health-related QoL in children who were diagnosed with NAIS 5 years after the acute event and to compare the results to age- and sex-adjusted normative data.

Methods: This prospective study evaluated the QoL of children diagnosed with symptomatic NAIS (symptomatic at presentation, diagnosed during the first 28 days of life and confirmed by neuroimaging [CT and/or MRI) by sending questionnaires to the patients 5 years after the initial diagnosis. The Kidscreen-27 parent/proxy version is a standardized questionnaire to evaluate QoL in children and is subdivided in the following five dimensions: physical well being, psychological well being, parent relations and autonomy, social support and peers, and school. The ABILHAND-Kids is a clinical tool for measuring manual ability. The Kidscreen-27 results were compared with normative data using a one sample Students t-test. Calculations of correlation coefficients (Spearman rho = r) between the two questionnaires were also performed.

Results: A total of 43 children diagnosed with NAIS were included (24 boys; 56%). None of the five dimensions of the Kidscreen-27 differed significantly between our patients and normative values. But QoL was significantly associated with manual ability (physical well being: r = 0.43, p = 0.006; psychological well being: r = 0.479, p = 0.002; parent relations and autonomy: r = 0.561, p = 0.002; social support and peers: r = 0.375, p = 0.017; school: r = 0.334, p = 0.38).

Conclusion: Compared with healthy Swiss children neonates diagnosed with AIS do not show reduced QoL at the age of5 years. However, patients with reduced hand motor performance also show reduced QoL. Therefore—after NAIS—especially children with impaired manual ability should be screened and followed thoroughly.