Objective: To determine if very low birthweight children followed with ease
differ in any perinatal or sociodemographic characteristics. or outcomes,
compared with children followed with more difficulty.
Methodology: Consecutive children of birthweight < 1000 g or with gestation
al ages < 28 weeks born in 1991 (n = 51) or of birthweight < 1500 g born in
1992 (n = 166) at the Royal Women's Hospital, Melbourne. surviving to 5 ye
ars of age, were assessed at 5 years of age, corrected for prematurity. Tho
se who attended on the first mutually agreed appointment without substantia
l reluctance were considered to have been followed with ease. The remainder
were considered to have been followed with difficulty. Outcomes included i
mpairments such as cerebral palsy, blindness, deafness, and low IQ. Childre
n had a disability if they had any of cerebral palsy, blindness, deafness r
equiring amplification, or an IQ more than 1 SD below the mean.
Results: Of the 217 survivors, 204 (94%) were assessed fully at 5 years of
age. Of the 204 children assessed, 153 (75%) were followed with ease, and 5
1 (25%) with difficulty. Of data available in the perinatal period, signifi
cantly fewer children followed with more difficulty came from intact famili
es, and more of their mothers had fewer than 12 years of schooling. More ch
ildren followed with difficulty had a disability (41% compared with 19%). a
s they predominantly had lower IQ scores (mean difference in IQ - 12.7, 95%
confidence interval - 18.0. - 7.4). The association between difficulty of
assessment and both higher rates of disability and lower IQ scores remained
after adjustment for significant perinatal and sociodemographic variables.
Conclusions: Children followed with difficulty can partly be recognized on
several sociodemographic characteristics in the perinatal period, and have
substantially worse sensorineural outcomes than those followed with ease. I
n any longitudinal study, the more incomplete the follow up, the lower will
be the rate of adverse sensorineural outcome.