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

BMC Medical Research Methodology

Aurélie Piedvache¹  Jennifer Zeitlin²  Stefvan Buuren³  Henrique Barros⁴  Ana Isabel Ribeiro⁴  Elizabeth Draper⁵ 

[1] CRESS, Obstetrical Perinatal and Pediatric Epidemiology Research Team, EPOPé, INSERM, INRA, Université de Paris, F-75004, Paris, France;CRESS, Obstetrical Perinatal and Pediatric Epidemiology Research Team, EPOPé, INSERM, INRA, Université de Paris, F-75004, Paris, France;Obstetrical, Perinatal and Pediatric Epidemiology Research Team, Center for Epidemiology and Statistics Sorbonne Paris Cité, INSERM UMR 1153, Maternité de Port-Royal, 53 avenue de l’observatoire, 75014, Paris, France;Department of Methodology & Statistics, University of Utrecht, Utrecht, The Netherlands;Netherlands Organisation for Applied Scientific Research TNO, Leiden, The Netherlands;EPI Unit-Instituto de Saúde Pública da Universidade do Porto, Porto, Portugal;University of Leicester, Leicester, UK;

关键词: Loss to follow-up;    Preterm births;    Neurodevelopment;    Multiple imputation;    Inverse probability weighting;    Delta method;   

DOI  :  10.1186/s12874-021-01264-3

来源: Springer

【 摘 要 】

BackgroundLoss 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.MethodsThis 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.Results54.2% 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)ConclusionsIn 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.

【 授权许可】

CC BY