Health-Related Quality of Life in Children and Adolescents With Congenital Adrenal Hyperplasia: A Systematic Review and Meta-Analysis
Authors' conclusion
Based on available data, children/adolescents with CAH had preserved physical QoL but impaired psychosocial QoL, especially in the school domain. Factors associated with lower QoL included poor disease control and disease/treatment-related complications. There is a need for further high-quality research that investigates the relationship between disease control, provision of psychosocial support, and improvement in QoL in children/adolescents with CAH.
Study context
- Population
- Children/adolescents with CAH ≤21 years with self-/parent-reported health-related quality-of-life (QoL); Google Scholar, PubMed, LILACS, Cochrane and Scopus searched up to March 5, 2022
- Participants
- 781 participants12 studies
- Comparison
- Children/adolescents with CAH vs healthy children/adolescents
- CAHn = 227
- Outcome
- MD in health-related QoL between children/adolescents with CAH and healthy children/adolescents
Methodological detailsPROSPERO-registered, NOS quality assessment, I2 heterogeneity, 12 of 1308 publications eligible for systematic review (SR); NOS scores 3 to 7/9
- PROSPERO-registered
- NOS quality assessment
- I2 heterogeneity
- 12 of 1308 publications eligible for SR; NOS scores 3 to 7/9
Pooled result
Parent-reported psychosocial QoL
MD
9.9
CI −12.6,7.3
P ≤ 0.001
As reported in the abstract
Further pooled results
| Outcome | MD (CI) | P value |
|---|---|---|
| Parent-reported school domain QoL | 7.4 (−12.2 to −2.5) | P = 0.003 |
| Parent-reported emotional domain QoL | 5.6 (−10.2 to −0.9) | P = 0.02 |
| Parent-reported social domain QoL | 4.3 (−8.1 to −0.5) | P = 0.03 |
| Self-reported school domain QoL | 8.5 (−15.9 to −1.2) | P = 0.02 |
Parent-reported school domain QoL
- Lower in children/adolescents with CAH
Parent-reported emotional domain QoL
- Lower in children/adolescents with CAH
Parent-reported social domain QoL
- Lower in children/adolescents with CAH
Self-reported school domain QoL
- Lower in children/adolescents with CAH
Parent-reported and self-reported physical QoL
- Similar to controls
Factors associated with lower QoL in CAH
- Poor disease control, poor medication compliance, and complications (hyperpigmentation, virilization, hypertension, hospital admission, urinary incontinence)
Original publication
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