Hostname: page-component-78c5997874-g7gxr Total loading time: 0 Render date: 2024-11-13T10:13:25.901Z Has data issue: false hasContentIssue false
  • English
  • Français

Analysis of compliance, morbidities and outcome in neurodevelopmental follow-up visits in urban African-American infants at environmental risk

Published online by Cambridge University Press:  09 November 2010

A. Perenyi ,
J. Katz ,
P. Flom ,
S. Regensberg  and
T. Sklar
A. Perenyi
Affiliation:
Pediatrics, SUNY Downstate Medical Center, Brooklyn, NY, USA
J. Katz*
Affiliation:
Physical Therapy, SUNY Downstate Medical Center, Brooklyn, NY, USA
P. Flom
Affiliation:
Scientific Computing Center, SUNY Downstate Medical Center, Brooklyn, NY, USA
S. Regensberg
Affiliation:
Pediatrics, SUNY Downstate Medical Center, Brooklyn, NY, USA
T. Sklar
Affiliation:
Pediatrics, SUNY Downstate Medical Center, Brooklyn, NY, USA
*
*Address for correspondence: Dr J. Katz, SUNY Downstate Medical Center, 450 Clarkson Ave, Box 16, Brooklyn, NY 11203, USA. (Email Joanne.katz@downstate.edu)
Get access Rights & Permissions [Opens in a new window]

Abstract

The objectives of this study were to determine compliance rate in a uniform, urban African-American patient population at environmental risk for adverse neurodevelopmental outcome and to define risk factors for non-compliance with neurodevelopmental follow-up. A retrospective chart review was performed which included 481 infants with birth weight (BW) of 495–4195 g and gestational ages (GAs) between 23 and 42 weeks born at our hospital. Statistical analysis was performed using the Jonckheere–Terpstra test for ordinal variables. For 2 × 2 tables, χ2 test and Fisher’s exact test (P < 0.05) were used. To determine significant predictive variables, data were analyzed by multiple logistic regression with one independent variable at a time. Infants compliant with follow-up had significantly more morbidities in the very low BW category (⩽1500 g) than infants with larger BW. The highest compliance rate (70%) was found among the smallest and most immature (GA ⩽28 weeks) infants. Based on this finding, we postulate that the number of infants with severe disability is not likely to be underestimated. The significantly more frequent developmental anomalies found in the largest BW (⩽2500 g) category raises significant concern, though findings in this subset of infants may not be representative of the whole population. There was no significant difference between the compliant and non-compliant groups regarding socio-economic status. Severe or multiple morbidities and prolonged hospital stay may provide parents with greater opportunity to learn and understand about the infant’s condition which may lead to greater compliance.

Keywords

African-Americancomplianceneurodevelopmental outcome
Type
Original Articles
Information
Journal of Developmental Origins of Health and Disease , Volume 1 , Issue 6 , December 2010 , pp. 396 - 402
Copyright
Copyright © Cambridge University Press and the International Society for Developmental Origins of Health and Disease 2010

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

1. Hintz, SR, Kendrick, DE, Vohr, BR, Poole, WK, Higgins, RD. Changes in neurodevelopmental outcomes at 18 to 22 months’ corrected age among infants less than 25 weeks’ gestational age born in 1993-1999. Pediatrics. 2005; 115, 1645–1651.CrossRefGoogle ScholarPubMed
2. Lemons, JA, Bauer, CR, Oh, W, et al. Very low birth weight outcomes of the National Institute of Child Health and Human Development Neonatal Research Network, January 1995 through December 1996. Pediatrics. 2001; 107, e1.CrossRefGoogle Scholar
3. Vohr, BR, Wright, LL, Dusick, AM, et al. Neurodevelopmental and functional outcomes of extremely low birth weight infants in the National Institute of Child Health and Human Development Neonatal Research Network, 1993-1994. Pediatrics. 2000; 105, 1216–1226.CrossRefGoogle Scholar
4. Mikkola, K, Ritari, N, Tommiska, V, et al. Neurodevelopmental outcome at 5 years of age of a national cohort of extremely low birth weight infants who were born in 1996-1997. Pediatrics. 2005; 116, 1391–1400.CrossRefGoogle ScholarPubMed
5. Adams-Chapman, I. Neurodevelopmental outcome of the late preterm infant. Clin Perinatol. 2006; 33, 947–964.CrossRefGoogle ScholarPubMed
6. Engle, WA, Tomashek, KM, Wallman, C, the Committee on Fetus and Newborn. “Late-preterm” infants: a population at risk. Pediatrics. 2007; 120, 1390–1401.CrossRefGoogle ScholarPubMed
7. McCormick, MC, Baker, J, Brooks-Gunn, J, et al. Cohort reconstruction: which infants can be restudied at school age? Paediatr Perinat Epidemiol. 1991; 5, 410–422.CrossRefGoogle ScholarPubMed
8. Murphy, CC, Yeargin-Allsopp, M, Decoufle, P, Drews, CD. Prevalence of cerebral palsy among ten-year-old children in metropolitan Atlanta, 1985 through 1987. J Pediatr. 1993; 123, S13–S19.CrossRefGoogle ScholarPubMed
9. Ho, S, Saigal, S. Current survival and early outcomes of infants of borderline viability. Neoreviews. 2005; 6, e123–e132.CrossRefGoogle Scholar
10. Goldman, L, Freidin, R, Cook, EF, Eigner, J, Grich, P. A multivariate approach to the prediction of no-show behavior in a primary care center. Arch Intern Med. 1982; 142, 563–567.CrossRefGoogle Scholar
11. Catlett, AT, Thompson, RJ, Johndrow, DA, Boshkoff, MR. Risk status for dropping out of developmental follow-up for very low birth weight infants. Public Health Rep. 1993; 108, 589–594.Google ScholarPubMed
12. Tin, W, Fritz, S, Wariyar, U, Hey, E. Outcomes of very preterm birth: children reviewed with ease at 2 years differ from those followed up with difficulty. Arch Dis Child Fetal Neonatal Ed. 1998; 79, F83–F87.CrossRefGoogle ScholarPubMed
13. Wolke, D, Sohne, B, Ohrt, B, Riegel, K. Follow-up of preterm children: important to document dropouts. Lancet. 1995; 345, 447.CrossRefGoogle ScholarPubMed
14. Castro, L, Yolton, K, Haberman, B, et al. Bias in reported neurodevelopmental outcomes among extremely low birth weight survivors. Pediatrics. 2004; 114, 404–410.CrossRefGoogle ScholarPubMed
15. Vincer, MJ, Allen, AC, Joseph, KS, et al. Increasing prevalence of cerebral palsy among very preterm infants: a population-based study. Pediatrics. 2006; 118, e1621–e1626.CrossRefGoogle ScholarPubMed
16. Frankenburg, WK, Dodds, J, Archer, P, Shapiro, H, Bresnick, B. The Denver II – a major revision and restandardization of the Denver Developmental Screening Test. Pediatrics. 1992; 89, 91–97.CrossRefGoogle Scholar
17. Kennedy, MD, Capute, A. The Capute Scales, CAT/CLAMS Instruction Manual, 2006. Baltimore, MD: Fellows Association.Google Scholar
18. Hollander, M, Wolfe, DA. Nonparametric Statistical Methods, 2nd edn, 1999. New York: John Wiley & Sons.Google Scholar
19. Mutch, L, Alberman, E, Hagberg, B, Kodama, K, Perat, MV. Cerebral palsy epidemiology: where are we now and where are we going? Dev Med Child Neurol. 1992; 34, 547–555.CrossRefGoogle ScholarPubMed
20. Oppenheim, GL, Bergman, JJ, English, EC. Failed appointments: a review. J Fam Pract. 1979; 8, 789–796.Google ScholarPubMed
21. Barron, WM. Failed appointments. Who misses them, why they are missed and what can be done. Prim Care. 1980; 7, 563–574.CrossRefGoogle Scholar
22. Callanan, C, Doyle, LW, Rickards, AL, et al. Children followed with difficulty: how do they differ? J Paediatr Child Health. 2001; 37, 152–156.CrossRefGoogle ScholarPubMed
23. Barth, RP, Scarborough, AA, Lloyd, EC, et al. Developmental Status and Early Intervention Service Needs of Maltreated Children, 2007. Washington DC: Office of the Assistant Secretary for Planning and Evaluation, US Department of Health and Human Services.Google Scholar
24. McClure, RJ, Newell, SJ, Edwards, S. Patient characteristics affecting attendance at general outpatient clinics. Arch Dis Child. 1996; 74, 121–125.CrossRefGoogle ScholarPubMed
25. Aylward, GP, Hatcher, RP, Gustafson, NF, Leavitt, LA. Who goes and who stays: subject loss in a multicenter, longitudinal follow-up study. J Dev Behav Pediatr. 1985; 6, 3–8.CrossRefGoogle Scholar
26. Wariyar, UK, Richmond, S. Morbidity and preterm delivery: importance of 100% follow-up. Lancet. 1989; 333, 387–388.CrossRefGoogle Scholar
27. Fewtrell, MS, Kennedy, K, Singhal, A, et al. How much loss to follow-up is acceptable in long-term randomized trials and prospective studies? Arch Dis Child. 2008; 93, 458–461.CrossRefGoogle ScholarPubMed
28. Petrova, A, Mehta, R, Anwar, M, Hiatt, M, Hegyi, T. Impact of race and ethnicity on the outcome of preterm infants below 32 weeks gestation. J Perinatol. 2003; 23, 404–408.CrossRefGoogle ScholarPubMed
29. Winter, S, Autry, A, Boyle, C, Yeargin-Allsopp, M. Trends in the prevalence of cerebral palsy in a population-based study. Pediatrics. 2002; 110, 1220–1225.CrossRefGoogle ScholarPubMed
30. Als, H. Newborn individualized developmental care and assessment program (NIDCAP): new frontier for neonatal and perinatal medicine. J Neonatal Perinatal Med. 2009; 2, 135–147.CrossRefGoogle Scholar
31. Einspieler, C, Prechtl, HFR. Prechtl’s assessment of general movements: a diagnostic tool for the functional assessment of the young nervous system. Ment Retard Dev Disabil Res Rev. 2005; 11, 61–67.CrossRefGoogle ScholarPubMed