[Follow-up programme dropouts in very low weight newborns before two years of age]
1Servicio de Neonatología, Hospital Sant Joan de Déu, Universitat de Barcelona, Barcelona, Spain.
Insights
Very low weight newborns (VLWN) lost to follow-up had higher rates of neurodevelopmental impairment and unfavorable social factors. Strategies are needed to prevent follow-up loss in these high-risk infants.
Area of Science:
- Neonatal care
- Developmental pediatrics
- Public health
Context:
- Increased survival of very low weight newborns (VLWN) leads to higher rates of neurodevelopmental morbidity.
- Follow-up programs are crucial for monitoring VLWN outcomes.
- Withdrawal from follow-up compromises care goals and research validity.
Purpose:
- To assess neurodevelopmental status, morbidity, and socioeconomic data in VLWN lost to follow-up.
- To compare outcomes of VLWN lost to follow-up with those who completed monitoring.
- To identify factors associated with follow-up attrition in VLWN.
Summary:
- A study of 318 VLWN (2002-2005) compared 50 who quit follow-up (Group R) with 215 who completed it (Group S).
- 30 VLWN in Group R were interviewed; 26.7% had neurodevelopmental impairment versus 14% in Group S (P<.05).
- Group R had more immigrants, lower parental education, greater distance from hospital, and lower socioeconomic status.
Impact:
- Telephone interviews successfully assessed 60% of lost VLWN.
- Higher sequelae rates, primarily mild, were observed in the lost-to-follow-up group.
- Social, economic, and cultural factors may influence follow-up interruption, necessitating preventative strategies.
Introduction:
The increase in survival rates of very low weight newborns (VLWN) and their neurodevelopmental morbidity has led to the implementation of follow-up programmes. The withdrawal from follow up limits the achievement of care goals and the validity of studies in this field.
Goals:
To assess the neurodevelopmental status, morbidity, social and economical data in the VLWN seen in our Neonatal Care Unit between 2002 and 2005 and lost in the follow up programme before the age of two, and compare these findings with the group who completed follow up.
Patients:
A total of 318 VLWN were included, of 53 had died. At the age of two, 215 had completed the monitoring visits (group S) and 50 had quit (group A).
Methods:
Using the SEN 1500 data base, and telephone interview of those parents who quit the programme.
Results:
A total of 30 cases were interviewed (Group R). Six patients had been admitted to hospital due to respiratory illness; 26.7% had neurodevelopmental impairment (1 case, severe; 1 case, moderate; 6 cases, mild) compared to 14% in group S (P<.05). In group R, compared with group S, included more immigrants (40 vs. 14%), parental education level was lower and distance between home and hospital was greater (P<.05). In group R, 57% of families had a low socioeconomic standard.
Conclusions:
The telephone interview allowed the clinical status of 60% of VLWN lost to follow up to be determined. Sequelae rate, mainly mild, was higher in the lost-to- follow-up group. Some unfavourable social, economical and cultural factors could have influenced the interruption. It is advisable to develop strategies to prevent loss in the follow up.
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