RT Journal
A1 Guillén Ú, DeMauro S, Ma L, et al
T1 Relationship between attrition and neurodevelopmental impairment rates in extremely preterm infants at 18 to 24 months: A systematic review
JF Archives of Pediatrics & Adolescent Medicine
JO Archives of Pediatrics & Adolescent Medicine
YR 2012
FD February 1
VO 166
IS 2
SP 178
OP 184
DO 10.1001/archpediatrics.2011.616
UL http://dx.doi.org/10.1001/archpediatrics.2011.616
AB Objective 
                  To assess the effect of loss to follow-up rates at 18 to 24 months on neurodevelopmental outcome statistics for infants of less than 1000 g birth weight or less than 28 weeks' gestational age.Data Sources 
                  MEDLINE, EMBASE, PubMed, and Cochrane Library databases (January 1, 2000, to June 30, 2010).Study Selection 
                  We searched for studies reporting outcomes of infants of less than 1000 g birth weight or less than 28 weeks' gestational age who were born after 1990.Main Exposure 
                  Eligible articles had to report the primary outcome and follow-up rates at 18 to 24 months.Main Outcome 
                  Our primary composite outcome of neurodevelopmental impairment (NDI) was any of a mental developmental quotient 2 SDs below the mean, using the Bayley Scales of Infant Development II; cerebral palsy; visual impairment; or significant hearing impairment.Results 
                  Of 43 publications describing outcomes at 18 to 24 months, 20 provided rates of follow-up, describing a total of 34 185 infants. The NDI rates ranged between 12.4% and 57.5%. Follow-up rates ranged between 71.6% and 100%. Higher rates of NDI were significantly correlated with greater loss to follow-up (r2 = 0.38, P = .007). Higher rates of both NDI and loss to follow-up were seen in the United States compared with Canada, the United Kingdom, Finland, Denmark, Austria, Germany, and Australia (r2 = 0.70, P = .001).Conclusions 
                  Ascertainment bias may overestimate NDI in extremely low-birth-weight or extremely low-gestational-age survivors at 18 to 24 months. Alternatively, the characteristics of different populations and health systems may contribute to higher rates of attrition and higher rates of NDI.