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Is attrition bias a problem in neonatal follow-up?

E T M Hille1, A L den Ouden, M C Stuifbergen

  • 1The Netherlands Organisation for Applied Scientific Research, Quality of Life, PO Box 2215, 2301 CE Leiden, the Netherlands. ET.Hille@pg.tno.nl

Early Human Development
|September 10, 2005
PubMed

Insights

Attrition in follow-up studies of very preterm infants can underestimate adverse outcomes. Non-responders showed more disabilities and lower health utility, highlighting the need for dropout analysis in long-term assessments.

Area of Science:

  • Neonatology
  • Pediatric Follow-up Studies
  • Biostatistics

Background:

  • Long-term outcomes for very preterm infants are crucial for understanding developmental trajectories.
  • Attrition in longitudinal studies can introduce bias and affect the generalizability of findings.
  • Assessing the impact of participant response rates is essential for reliable follow-up research.

Purpose of the Study:

  • To determine if attrition rates influence the assessed outcomes in a national follow-up study of very preterm infants.
  • To compare outcomes between early, late, and non-responders at adolescent follow-up.

Main Methods:

  • A national cohort of very preterm infants born in 1983 in the Netherlands was followed up at age 14 years.
  • Participants were categorized into early responders, late responders, and non-responders based on their response to the follow-up invitation.
  • Univariate and polytomous logistic regression analyses were used to compare neonatal data and outcomes between response groups.

Main Results:

  • Non-responders and late responders had a higher prevalence of non-Dutch origin, disabilities, and school problems at age 10 years compared to early responders.
  • At age 14 years, late responders exhibited a significantly lower health utility index than early responders.
  • No significant differences in school outcomes were observed across response groups at age 14.

Conclusions:

  • Incomplete follow-up due to attrition can lead to an underestimation of adverse outcomes in very preterm infants.
  • Response rate is a significant factor affecting the assessment of late outcomes in this population.
  • Future follow-up studies should incorporate dropout analyses to ensure comprehensive and comparable results.
Abstract

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