Bias in Reported Neurodevelopmental Outcomes Among Extremely Low Birth Weight Survivors

Castro, Lisa; Yolton, Kimberly; Haberman, Beth; Roberto, Nancy; Hansen, Nellie I.; Ambalavanan, Namasivayam; Vohr, Betty R.; Donovan, Edward F.

doi:10.1542/peds.114.2.404

Cited by 86 publications

(70 citation statements)

References 41 publications

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“…Castro et al 14 and McCormick et al, 4 on the other hand, found that compared with children who were lost to follow-up, those who were compliant with follow-up had more adverse outcomes. It seems that the adolescents with higher completed or current education are overrepresented in the full-response group at the age of 19 years.…”

Section: Discussionmentioning

confidence: 99%

Nonresponse Bias in a Follow-up Study of 19-Year-Old Adolescents Born as Preterm Infants

Hille

Elbertse²,

Gravenhorst³

et al. 2005

Pediatrics

109

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ABSTRACT. Objective. To assess the effect of demographic and neonatal risk factors and outcome at the last available assessment on the probability of full responders, postal responders (those who only responded to the mailed questionnaire), or nonresponders in a follow-up study of 19-year-old adolescents who were born as preterm infants.Design. The 19-year follow-up program was part of a large ongoing collaborative study in the Netherlands on the long-term effect of prematurity and dysmaturity on various medical, psychological, and social parameters. In the original cohort, 1338 infants (94%) with a gestational age of <32 weeks and/or a birth weight of <1500 g were enrolled. Neonatal mortality was 23% (n ‫؍‬ 312), and another 67 children had died between the ages of 28 days and 19 years, leaving 959 survivors (72% of the original cohort) for follow-up at the present assessment. To study the effect of nonresponse, we divided the 959 survivors into 3 groups: full responders (596 [ 62.1%]), postal responders (109 [11.4%]), and nonresponders (254 [26.5%]).In the 3 groups we compared demographic and neonatal data, as well as outcome at the last available assessment.Results. The odds ratios (ORs) for male versus female for the probabilities of nonresponse and postal response were statistically significant: 2.7 (95% CI: 1.9 -3.9) and 1.6 (95% CI: 1.0 -2.5), respectively. The same holds for the ORs for non-Dutch versus Dutch and low versus high maternal education for nonresponse: 2.0 (95% CI: 1.3-3.2) and 3.7 (95% CI: 2.0 -6.7), respectively. Special education and severe handicap showed a statistically significant influence on nonresponse (OR: 1.6; 95% CI: 1.1-2.4 and OR: 2.6; 95% CI: 1.3-5.2) and postal response (OR: 2.0; 95% CI: 1.2-3.3 and OR: 4.4; 95% CI: 2.0 -9.9), respectively. At the age of 19 years, primary school and special education were found significantly more frequent in the postal responders than in the full-response group (20% and 21% vs 6% and 12%). The full responders, on the other hand, were higher educated than were the postal responders.Conclusions. In this follow-up study at the age of 19 years, boys, non-Dutch adolescents, and low maternal education were overrepresented in the nonresponse and postal-response groups. Nonresponse decreased the proportion of infants with adverse outcome in assessed children. To be able to present reliable results for the total group of survivors in long-term follow-up studies, the nonresponse bias needs to be quantified. Therefore, it is evident that more research using statistical methods such as imputation of missing data is needed. L ong-term follow-up studies in preterm and very preterm infants are very important to assess the health status of these children in adolescence and later life in relation to the obstetric and neonatal care provided during the perinatal period. Since the last decade there has been a growing awareness of the long-lasting disabilities associated with preterm birth. A high percentage of social, emotional, cognitive, and learning problems h...

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Section: Discussionmentioning

confidence: 99%

Nonresponse Bias in a Follow-up Study of 19-Year-Old Adolescents Born as Preterm Infants

Hille

Elbertse²,

Gravenhorst³

et al. 2005

Pediatrics

109

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“…This might bias the mortality results, because the event rate was low and the subjects lost to follow-up monitoring might be at either higher or lower risk of death. 18 On the basis of the generalized estimated equation model used to impute missing deaths, the effect of ENC training might be even larger than demonstrated. Further- …”

Section: Discussionmentioning

confidence: 99%

Newborn Care Training of Midwives and Neonatal and Perinatal Mortality Rates in a Developing Country

et al. 2010

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WHAT'S KNOWN ON THIS SUBJECT:The majority of infant deaths occur during the neonatal period. Educational programs available to train neonatal health care workers are effective in improving knowledge and skills, but there are limited data on their effects on neonatal mortality rates. WHAT THIS STUDY ADDS:Training midwives in neonatal care reduces early neonatal mortality rates for infants born in lowrisk, first-level facilities. abstract + OBJECTIVE: This study was designed to test the hypothesis that 2 training programs would reduce incrementally 7-day neonatal mortality rates for low-risk institutional deliveries. METHODS:Using a train-the-trainer model, certified research midwives sequentially trained the midwives who performed deliveries in low-risk, first-level, urban, community health clinics in 2 cities in Zambia in the protocol and data collection, in the World Health Organization Essential Newborn Care (ENC) course (universal precautions and cleanliness, routine neonatal care, resuscitation, thermoregulation, breastfeeding, kangaroo care, care of small infants, and common illnesses), and in the American Academy of Pediatrics Neonatal Resuscitation Program (in-depth basic resuscitation). Data were collected during 3 periods, after implementation of each training course. RESULTS:A total of 71 689 neonates were enrolled in the 3 study periods. All-cause, 7-day neonatal mortality rates decreased from 11.5 deaths per 1000 live births to 6.8 deaths per 1000 live births after ENC training (relative risk: 0.59 [95% confidence interval: 0.48 -0.77]; P Ͻ .001), because of decreases in rates of deaths attributable to birth asphyxia and infection. Perinatal mortality rates but not stillbirth rates decreased. The 7-day neonatal mortality rate was decreased further after Neonatal Resuscitation Program training, after correction for loss to follow-up monitoring.CONCLUSIONS: ENC training for midwives reduced 7-day neonatal mortality rates in low-risk clinics. Additional in-depth basic training in neonatal resuscitation may reduce mortality rates further. Pediatrics

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“…Os dados relativos ao status neuropsicológico dos recém-nascidos prematuros estão disponíveis na literatura, mas a maioria desses estudos foi realizada em países desenvolvidos 4,5,7,[9][10][11][12] . Poucos estudos de acompanhamento foram publicados sobre desempenho escolar ou pré-escolar de lactentes prematuros de baixíssimo peso ao nascimento envolvendo populações sul-americanas 8 , em que recursos de saúde especializados para acompanhar essa população em especial não costumam estar disponíveis.…”

Section: Introductionunclassified

Cognitive and behavioral status of low birth weight preterm children raised in a developing country at preschool age

Santo¹,

Portuguez²,

Nunes³

2009

J Pediatr (Rio J)

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Cognitive and behavioral status of low birth weight preterm children raised in a developing country at preschool age Status cognitivo-comportamental AbstractObjective: To assess cognitive and behavioral development at preschool age of children born preterm and with low birth weight and raised in a developing country. Methods:Prospective cross-sectional study of 80 neonates born in a university hospital in southern Brazil. Neuropsychological assessment at age 4-5 years included the Wechsler Preschool and Primary Scale of Intelligence (WPPSI), Conners' Parent Rating Scale-Revised, Denver test and neurological examination. Perinatal and early neuropsychomotor development information was collected from the database during follow-up. Results were related to birth weight, sex and gestational age.Results: WPPSI scores were: total IQ 88.00±16.96, verbal IQ 89.72±16.72, and executive IQ 88.12±15.71 for the group with less than 1,500 grams; and total IQ 91.11±14.73, verbal IQ 93.36±12.65, and executive IQ 90.20±16.06 for the group between 1,500 and 2,500 grams. The best scores were obtained in tests that evaluated capacity of abstraction and symbolization, picture completion and common perception, in which only 5% and 6.3% of the children had abnormal results, respectively. The lowest scores were obtained in tests that evaluated visual-motor coordination and flexibility-speed of reasoning, in which 27.5% and 16.3% of the children had abnormal results, respectively. A total of 32.5% had abnormal results in the arithmetic tests. Behaviors related to attention deficit/hyperactivity disorder (ADHD) were observed in 48% of the sample. Low score in the Bayley Mental Scale and abnormal result in the Denver test were significantly correlated to ADHD (p = 0.017 and p = 0.004). Abnormal results in the Bayley Mental Scale (p < 0.001), Denver test (p < 0.001) and neurological examination (p = 0.002) were associated with lower IQ. Conclusions:The results revealed an increased incidence of behavioral and cognitive disorders at preschool age. Artigo submetido em 31.03.08, aceito em 27.10.08.

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Bias in Reported Neurodevelopmental Outcomes Among Extremely Low Birth Weight Survivors

Cited by 86 publications

References 41 publications

Nonresponse Bias in a Follow-up Study of 19-Year-Old Adolescents Born as Preterm Infants

Nonresponse Bias in a Follow-up Study of 19-Year-Old Adolescents Born as Preterm Infants

Newborn Care Training of Midwives and Neonatal and Perinatal Mortality Rates in a Developing Country

Cognitive and behavioral status of low birth weight preterm children raised in a developing country at preschool age

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