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- Title
Strategies for assessing the impact of loss to follow-up on estimates of neurodevelopmental impairment in a very preterm cohort at 2 years of age.
- Authors
Piedvache, Aurélie; van Buuren, Stef; Barros, Henrique; Ribeiro, Ana Isabel; Draper, Elizabeth; Zeitlin, Jennifer; the EPICE Research group; Martens, E.; Martens, G.; Van Reempts, P.; Boerch, K.; Hasselager, A.; Huusom, L. D.; Pryds, O.; Weber, T.; Toome, L.; Varendi, H.; France, Ile-de; Ancel, P. Y.; Blondel, B.
- Abstract
<bold>Background: </bold>Loss to follow-up is a major challenge for very preterm (VPT) cohorts; attrition is associated with social disadvantage and parents with impaired children may participate less in research. We investigated the impact of loss to follow-up on the estimated prevalence of neurodevelopmental impairment in a VPT cohort using different methodological approaches.<bold>Methods: </bold>This study includes births < 32 weeks of gestational age (GA) from 4 regions in the UK and Portugal participating in a European birth cohort (N = 1737 survivors). Data on maternal characteristics, pregnancy complications, neonatal outcomes and neighborhood deprivation were collected at baseline. Neurodevelopment was assessed at 2 years of corrected age (CA) using standardized parent-report measures. We applied (1) multiple imputation (MI) and (2) inverse probability weighting (IPW) to estimate the impact of non-response on the prevalence of moderate to severe neurodevelopmental impairment and assessed violations of the missing at random (MAR) assumption using the delta method.<bold>Results: </bold>54.2% of children were followed-up. Follow-up was less likely when mothers were younger, multiparous, foreign-born, did not breastfeed and came from deprived areas. The prevalence of neurodevelopmental impairment was 18.4% (95% confidence interval (CI):15.9-21.1) and increased to 20.4% (95%CI: 17.3-23.4) and 20.0% (95%CI:16.9-23.1) for MI and IPW models, respectively. Simulating strong violations of MAR (children with impairments being 50% less likely to be followed-up) raised estimates to 23.6 (95%CI:20.1-27.1) CONCLUSIONS: In a VPT cohort with high loss to follow-up, correcting for attrition yielded modest increased estimates of neurodevelopmental impairment at 2 years CA; estimates were relatively robust to violations of the MAR assumption.
- Subjects
PORTUGAL; UNITED Kingdom; PREGNANCY complications; GESTATIONAL age; NEURAL development; CONFIDENCE intervals; AGE
- Publication
BMC Medical Research Methodology, 2021, Vol 21, Issue 1, p1
- ISSN
1471-2288
- Publication type
journal article
- DOI
10.1186/s12874-021-01264-3