Background
Methods
Study population
Organizational attributes | ||||||||
---|---|---|---|---|---|---|---|---|
Study Center | Total sent questionnaires | Prenatal re-testing interval (months)1
| Duration post-natal treatment (month) | A | B1 | B2. | C | Total |
FRANCE
| ||||||||
Lyon1
| 184 | 1 | 14 | 3 | 0 | 3 | 3 | 9 |
Paris1
| 182 | 1 | 12 | 1 | 1 | 2 | 2 | 6 |
Grenoble1
| 34 | 1 | 12–24 | 1 | 0 | 1 | 1 | 3 |
Marseille1
| 91 | 1 | 12–24 | 3 | 1 | 3 | 3 | 10 |
Nice1
| 44 | 1 | 24 | 4 | 0 | 3 | 3 | 10 |
Toulouse1
| 73 | 1 | 12 | 4 | 0 | 2 | 2 | 8 |
AUSTRIA
| ||||||||
Vienna1
| 187 | 3 | 12 | 4 | 1 | 3 | 2 | 10 |
ITALY
| ||||||||
Naples1
| 53 | 3 | 12 | 4 | 1 | 3 | 3 | 11 |
SWEDEN
| ||||||||
Stockholm1
| 16 | NS4
| 12 | 4 | 1 | 2 | 1 | 8 |
POLAND
| ||||||||
Poznan2
| 180 | NS | 12 | 4 | 1 | 3 | 2 | 10 |
DENMARK
| ||||||||
Copenhagen3
| 14 | NS | 3 | 1 | 1 | 1 | 2 | 5 |
TOTAL
|
Postnatal follow up
Outcomes
Outcome | Question number in questionnaire* | Score range | Source |
---|---|---|---|
Development and behavior
| |||
Motor development | 6 (a–h) | 0–16 | Griffiths Mental Development Scales [23], Denver Developmental screening test [24] |
Speech Development Language development | 10 (a–c) 10 (d–g) | 0–6 0–8 | General Language Screen**, parent completed questionnaire for 3 year olds [25]. Validated against four standardised speech and language tests administered by an assessor. |
Cognitive ability (non-verbal) | 11 (a–g) | 0–7 | PARCA3** (Parent Report of Children's Abilities) [6] validated for 3 year olds against the MacCarthy Scale |
Behavior | 13 (a–y) | 1–16 | 'Strengths and difficulties questionnaire' (SDQ), validated in 3 to 16 year olds against clinician assessment of behavior disorder [10,12]. Entire questionnaire, published translations, and scoring algorithm used. |
Parental concerns, specialist referral, and parental anxiety
| |||
Parental concerns a) Learning, behavior, development b) Speech and language | 5 8 | 1–3 1–3 | Adapted from PEDS** (Parent Evaluation of Developmental Status). Predicts risk for developmental and behavioral problems and the need for clinical assessment.[26,27] |
Impact of behavior on family | 14, 14a–d | 0–2 | SDQ questionnaire [10,12,28] |
Parental anxiety | 25,26,27 | 0–15 | Adaptation of rating scales for measuring anxiety during pregnancy and postpartum [29] in relation to antenatal screening (numbered six point horizontal scale with verbal anchors at extremes). |
Child completed questions
| |||
Cognitive and fine motor skills Copying a line, circle, and cross. Draw a man | 12 (a–c) 30 | 0–3 1–24 | The child's ability to copy a circle, line and cross was assessed using scoring and normative data available from the Beery Buktenica Developmental Test of Visual Motor Integration [30]. The 'draw a man' was scored using a standardised system and normative data from the Goodenough Draw a Man test [31], using raw scores. |
Confounding variables
| |||
Education level achieved | 28 | 0–3 | Educational level achieved based on standard categories defined by the Organisation for Economic Co-operation and Development (OECD) for Europe.[32] |
Questionnaire development and piloting
Analyses
Development of scores
Analysis of response
Characteristic | Number responding (%) | Odds ratio for response4 (95% confidence interval) | Final model: Adjusted odds ratio5 (95% CI) |
---|---|---|---|
All centers | 714 (67.5) | ||
Center Variables
| |||
Lyon (reference) | 134 (72.8) | reference | |
Paris | 91 (50.0) | 0.37 (0.24, 0.57) | |
Grenoble | 8 (23.5) | 0.11 (0.05, 0.27) | |
Marseille | 69 (75.8) | 1.16 (0.65, 2.06) | |
Nice | 33 (75.0) | 1.12 (0.53, 2.38) | |
Toulouse | 44 (60.3) | 0.56 (0.31, 0.99) | |
Copenhagen | 9 (64.3) | 0.67 (0.21, 2.1) | |
Vienna | 134 (71.7) | 0.97 (0.61, 1.54) | |
Stockholm | 8 (50.0) | 0.37 (0.13, 1.05) | |
Naples | 50 (94.3) | 6.22 (1.85, 20.84) | |
Poznan | 134 (74.4) | 1.09 (0.68, 1.73) | |
Total score for organisational attributes
3
| 9 (6,10) | 1.36 (1.27, 1.45) | 1.15 (1.09, 1.23) |
Infection status
1
| |||
CT+ | 178 (80%) | 2.95 (2.01, 4.31) | 4.96 (3.58, 6.88) |
CT- | 527 (64%) | ||
Maternal age
1,2,3
(mean years, 95% CI)
| 582 (67%) 28.4 (27.6, 29.2)
| 1.03 (0.99, 1.07) | 1.02 (0.99, 1.05) |
Parity
1,2,3
(mean, 95% CI)
| 503 (67%) 0.9 (0.8, 1.0)
| 1.05 (0.90, 1.23) | |
Gestational age at birth
1,2,3
(mean weeks, 95% CI)
| 530 (68%) 39.0 (38.8, 39.1)
| 1.00 (0.92, 1.09) | |
Child's gender
1,2
| |||
Male | 379 (68%) | Reference | |
Female | 316 (68%) | 0.94 (0.71, 1.25) | |
Prenatal treatment
1,2
| |||
Any prescribed | 532 (67%) | 1.85 (0.98, 3.49) | |
None | 62 (66%) | ||
Neurological abnormality and/or intracranial lesions
1,2
| |||
Yes | 25 (83.3) | 2.69 (0.56, 13.00) | |
No | 569 (66.3) |
Results
Piloting of questionnaire
Survey of organizational attributes and reasons for non-response
Reasons for non-response (% non-responders) | ||||||
---|---|---|---|---|---|---|
Study Center | Response rate (%) | Total non-responders | Address not known | Refused to participate | No response | Other1
|
FRANCE
| ||||||
Lyon | 73% | 50 | 12 (24) | 1 (2) | 37 (74) | 0 |
Paris | 50% | 91 | 46 (50) | 0 | 45 (49) | 0 |
Grenoble | 24% | 26 | 1 (4) | 0 | 25 (96) | 0 |
Marseille | 76% | 22 | 17 (77) | 0 | 4 (18) | 1 (4) |
Nice | 75% | 11 | 8 (73) | 3 (6) | 0 | 0 |
Toulouse | 60% | 29 | 21 (72) | 0 | 8 (28) | 0 |
AUSTRIA
| ||||||
Vienna | 72% | 53 | 21 (40) | 32 (60) | 0 | 0 |
ITALY
| ||||||
Naples | 94% | 3 | 1(33) | 2 (66) | 0 | 0 |
SWEDEN
| ||||||
Stockholm | 50% | 8 | 3 (37) | 1 (12) | 2 (25) | 2 (25)* |
POLAND
| ||||||
Poznan | 74% | 46 | 20 (43) | 21 (46) | 4 (9) | 1 (2) |
DENMARK
| ||||||
Copenhagen | 64% | 5 | 1 (20) | 0 | 4 (80) | 0 |
TOTAL
| 344 | 151 (44) | 60 (17) | 129 (37) | 4 (1) |