Lost to follow-up in the Norwegian mother, father and child cohort study
Abstract
BACKGROUND
The aim of pregnancy cohorts was to understand causes and development of health and disease throughout the life course. A major challenge in cohort studies is to avoid selection bias from loss to follow-up.
OBJECTIVE
The aim of this study was to describe what characterises drop out from the Norwegian Mother, Father and Child Cohort Study (MoBa), and provide a resource to inform the interpretation of results from analysis of cohort data.
METHODS
We estimated loss to follow-up in subsets of participants that responded to questionnaire waves in MoBa through an eight-year period and described characteristics of participants who responded to follow-ups. Within each wave of questionnaires, we estimated two exposure-outcome associations: the relationship between maternal smoking during pregnancy and offspring birthweight, and between educational level and pre-pregnancy body mass index (BMI). We explored the use of inverse probability weighting to correct the bias due to loss to follow-up.
RESULTS
Participants who continued to respond were older, higher educated, less likely to smoke and had lower BMI. We observed a decline in participation of current smokers from 22.3% to 17.5%, and participants who reported an unplanned pregnancy dropped from 19.2% to 16.4%. There was a gradual decline in the inverse relationship between maternal smoking during pregnancy and offspring birthweight with increasing follow-up information, indicating that selection bias due to drop out…
How strong is the evidence?
Evidence Hub reads this as a cohort study, done in people. Its evidence level is 3 of 5 (Moderate · trial / cohort / secondary analysis). Trials without a large randomized design, cohorts and secondary analyses give moderate evidence.
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