International Journal of Epidemiology, Vol 26, 340-348, Copyright © 1997 by International Epidemiological Association
Enrollment of a population-based cohort of newborns at higher risk of developing a chronic condition: the EDEN study. Etude du Developpement des Nouveau-nes Study
V Addor, B Santos-Eggimann, CL Fawer, F Paccaud and A Calame
Health Services Unit, University of Lausanne, Switzerland.
OBJECTIVE: To describe the methods used at birth to recruit a
population-based cohort of newborns of all birthweights at higher risk of
having a chronic condition, and to present baseline results. METHODS:
Screening of all newborns at hospital discharge for five non- exclusive
criteria: (1) low birthweight (LBW), (2) congenital anomalies or genetic
disease, (3) specified conditions associated with a high probability of
chronicity, (4) referral to a neonatal intensive care unit (NICU), (5) or
defined social problems. Calculation of Hobel risk scores for children
satisfying > or = 1 criterion. SUBJECTS: All 6477 live births delivered
in the 19 maternity hospitals of a geographically defined region (Vaud,
Switzerland) to resident mothers in 1993-1994. RESULTS: Twelve per cent (n
= 760) of newborns met > or = 1 criterion: 6.3% of all newborns had an
LBW (criterion 1), 2.4% had a birth defect, 0.9% met criterion (3), 4.4%
stayed in an NICU and 1.6% had serious social problems. Hobel prenatal
score was high (> or = 10 points) for 41% of children with > or = 1
criterion, the intrapartum score for 87% and the neonatal score for 68%.
CONCLUSIONS: Most newborns identified by the above simple criteria also had
elevated perinatal risks. The validity of the criteria will later be tested
against the results of the examinations of children with > or = 1
criterion at 18 months and 4 years of age, but the assessment at birth
already shows that normal birthweight (NBW) children, in agreement with
previous studies, contribute half the children at high risk perinatally.