Background: Preterm infants after posthemorrhagic hydrocephalus that required ventriculoperitoneal shunt insertion (PHH-S) carry a significant risk for major neurodevelopmental impairments.

Aims: To determine the health-related quality of life (HRQoL) of former preterm infants (gestational age <32 weeks) after PHH-S, and to examine the impact of perinatal and neurological morbidity on their QoL.

Methods: Forty preterm infants with PHH-S were matched for gestational age, birthweight, and gender with preterm infants with normal cranial ultrasonography. Pediatric QoL Inventory (PedsQL™) was administered at 5.7 ± 2 years.

Results: PHH-S children exhibited significantly lower HRQoL compared to controls in motor (36±34.9 vs 96.2±6.6), emotional (59.8±26.7 vs 80.6±18.8), social (55.6± 29.7 vs 89.6 ±16.6), and school (40.5 ±22.9 vs 89.7±15.2) domains (P< .001).  Multivariate regression incorporating neonatal risk factors revealed an independent effect of parenchymal brain involvement (β:-0.6, P< .01) and neonatal seizures (β: -0.2, P< .02) on total HRQoL. Low HRQoL of PHH-S children was associated with neurodevelopmental morbidities: cerebral palsy, epilepsy, vision & feeding problems, low cognitive, personal-social, and adaptive scores (P < .05). Multivariate analysis indicated an independent contribution from severe cerebral palsy (β: -0.4, P< .001) and low personal-social score (β: 0.5, P< .001).

Conclusion: Preterm children after PHH-S exhibit significantly lower HRQoL scores compared to preterm peers. HRQoL is associated with neonatal cerebral complications and neurolodevelopmental morbidities. Quantification of HRQoL provides a basis for a broader understanding of the consequences of PHH-S and can contribute to enhanced planning of rehabilitation strategies and clinical trials.