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Factors affecting the non-compliance for follow-up in very low birth weight children
Kuo-Inn Tsou1, Chyong-Hsin Hsu, Li-Jung Fang
1College of Medicine, Fu Jen Catholic University, Taipei Hsien 24205, Taiwan. 049687@mail.fju.edu.tw
Insights
Follow-up compliance in very low birth weight (VLBW) children varies by age. Reasons range from inaccessibility at younger ages to parental refusal and paternal education levels later on, impacting long-term VLBW infant care.
Area of Science:
- Pediatrics
- Neonatology
- Developmental Pediatrics
Background:
- Long-term follow-up is crucial for very low birth weight (VLBW) infants.
- Understanding factors influencing follow-up compliance is essential for optimal VLBW child care.
Purpose of the Study:
- To assess factors affecting follow-up non-compliance in VLBW children at different ages.
- To identify age-specific barriers to VLBW infant follow-up.
Main Methods:
- Analysis of demographic, morbidity, and neurodevelopmental data for 321 VLBW infants.
- Comparison of compliant versus non-compliant VLBW children.
- Multivariate logistic regression to identify predictors of non-compliance.
Main Results:
- Inaccessibility and parental refusal were primary reasons for non-compliance.
- Non-compliant children had higher rates of multiple births and lower paternal education.
- Age-specific factors included retinopathy of prematurity (12 months), paternal education (18-36 months), and multiple births (36 months).
Conclusions:
- Reasons for and predictors of non-compliance in VLBW children differ significantly across developmental ages.
- Tailored strategies are needed to improve follow-up adherence in VLBW populations.
Background:
Long-term longitudinal follow up of very low birth weight (VLBW, birth weight < or =1500 g) infants is important. This study assessed the factors affecting non-compliance for follow-up at different ages in VLBW children.
Methods:
The demographic data, morbidity and neurodevelopmental data of 321 VLBW infants were analyzed between those returned and not returned.
Results:
The majority of the children who did not attend the follow-up clinic were caused by inaccessibility, and refusal by the parents. The non-compliant children had higher rate of multiple births, short paternal education years, mother being a housewife, and lower incidence of first child, emergent caesarian section and small for gestational age. They did not differ much from the children returned in the occurrence of neonatal diseases. No significant difference of the growth and neurodevelopmental status at the previous visit could be observed between children of the two groups. When data of different follow-up visits were compared, it was noted that the most common reason for not attending the follow-up visits was inaccessibility for the 6- and 12-month visits and refusal by the parents for other visits. Multivariate logistic regression analysis revealed that variable(s) increasing the non-compliance were none for the 6-month visit, severe retinopathy of prematurity for the 12-month visit, short duration of paternal education for the 18-, 24- and 36-month visits and multiple births for the 36-month visit.
Conclusions:
These results showed that the reasons and the affecting variables for not attending the follow-up assessment were different for different age groups.
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