Document Detail

Relationship between attrition and neurodevelopmental impairment rates in extremely preterm infants at 18 to 24 months: a systematic review.
MedLine Citation:
PMID:  22312176     Owner:  NLM     Status:  In-Data-Review    
OBJECTIVE: To assess the effect of loss to follow-up rates at 18 to 24 months on neurodevelopmental outcome statistics for infants of less than 1000 g birth weight or less than 28 weeks' gestational age.
DATA SOURCES: MEDLINE, EMBASE, PubMed, and Cochrane Library databases (January 1, 2000, to June 30, 2010).
STUDY SELECTION: We searched for studies reporting outcomes of infants of less than 1000 g birth weight or less than 28 weeks' gestational age who were born after 1990. Main Exposure  Eligible articles had to report the primary outcome and follow-up rates at 18 to 24 months. Main Outcome  Our primary composite outcome of neurodevelopmental impairment (NDI) was any of a mental developmental quotient 2 SDs below the mean, using the Bayley Scales of Infant Development II; cerebral palsy; visual impairment; or significant hearing impairment.
RESULTS: Of 43 publications describing outcomes at 18 to 24 months, 20 provided rates of follow-up, describing a total of 34 185 infants. The NDI rates ranged between 12.4% and 57.5%. Follow-up rates ranged between 71.6% and 100%. Higher rates of NDI were significantly correlated with greater loss to follow-up (r(2) = 0.38, P = .007). Higher rates of both NDI and loss to follow-up were seen in the United States compared with Canada, the United Kingdom, Finland, Denmark, Austria, Germany, and Australia (r(2) = 0.70, P = .001).
CONCLUSIONS: Ascertainment bias may overestimate NDI in extremely low-birth-weight or extremely low-gestational-age survivors at 18 to 24 months. Alternatively, the characteristics of different populations and health systems may contribute to higher rates of attrition and higher rates of NDI.
Ursula Guillén; Sara Demauro; Li Ma; John Zupancic; Robin Roberts; Barbara Schmidt; Haresh Kirpalani
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Archives of pediatrics & adolescent medicine     Volume:  166     ISSN:  1538-3628     ISO Abbreviation:  Arch Pediatr Adolesc Med     Publication Date:  2012 Feb 
Date Detail:
Created Date:  2012-02-07     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9422751     Medline TA:  Arch Pediatr Adolesc Med     Country:  United States    
Other Details:
Languages:  eng     Pagination:  178-84     Citation Subset:  AIM; IM    
BM, Division of Neonatology, The Children's Hospital of Philadelphia, 34th St & Civic Center Blvd, Philadelphia, PA 19104..
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