Health-Related Quality of Life and Behavioral Functioning after Intrauterine Transfusion for Alloimmune Anemia

Objective To assess health-related quality of life (HRQOL) and behavioral functioning in children and adolescents treated before birth with intrauterine intravascular blood transfusion for alloimmune anemia. Study design Cross-sectional cohort study conducted at the Dutch referral center for the management of fetal alloimmune anemia. Follow-up data were available for 285 children at a mean age of 10.5 years (range, 3-21.5 years) with a response rate for questionnaires of 97%. Child-, adolescent-, and parent-rated HRQOL was evaluated with The Netherlands Organization for Applied Scientific Research Child/Adult Quality of Life Questionnaire (TACQOL/TAAQOL). Parents reported on behavioral functioning with the Strengths and Difficulties Questionnaire. Scores were compared with Dutch norm data. Results Significantly lower scores were reported by parents of children 6-11 years of age compared with Dutch norms on 3 scales: cognitive functioning, social functioning, and positive emotions ( P P  = .02, and P  = .04). In children aged 8-11 years only the cognitive functioning scale score was significantly lower compared with Dutch norms ( P  = .01). The children aged 12-15 years reported higher scores on the negative emotions scale ( P  = .02). When corrected for multiple testing, only the parent-rated cognitive functioning scale remained significant ( P P Conclusion Parents reported lower scores on cognitive functioning in their children aged 6-11 years compared with norms. Behavioral difficulties were more prevalent than norms, and were associated with maternal educational level. Outcomes of children after intrauterine intravascular blood transfusion were quite good overall.