Can children's health be predicted by perinatal health?

Abstract

Background: The purpose of this paper was to investigate how well children's health until age 7 years can be predicted by perinatal outcome using routine health registers.

Methods: Follow-up of one year cohort (N = 60192) was performed by record linkages with personal identification number. The data came from the 1987 Finnish Medical Birth Register, from six other national registers and from education registers of one county.

Results: All perinatal health indicators showed a strong correlation with subsequent health, and prediction of good health was satisfactory: 85% of children who were healthy in the perinatal period did not have any reported health problems in early childhood, and 91% of children healthy in early childhood had been healthy in the perinatal period. However, it was not possible to predict poor health outcome: 76% of the children with reported perinatal problems were healthy in early childhood, and 87% of the children with long-term morbidity in childhood did not have any perinatal problems.

Conclusions: Our findings suggest that in assessing risk factors and health care technology, monitoring perinatal health is not enough and long-term follow-ups are needed.

PIP: While perinatal mortality has been widely used as an indicator to measure the standard of health care and to identify risk groups, its value has been questioned because of definition problems and decreasing perinatal mortality rates in industrialized countries. Finnish health register data were used to assess how well children's health until age 7 years can be predicted by perinatal outcome using routine health registers. Specifically, data came from the 1987 Finnish Medical Birth Register, 6 other national registers, and education registers of 1 county. 60,192 children were traced up to age 7 years through record linkages with personal identification numbers. All perinatal health indicators were strongly correlated with subsequent health: 85% of children who were healthy in the perinatal period reported no health problems during early childhood, and 91% of children healthy in early childhood had also been healthy in the perinatal period. However, poor health outcome could not be predicted: 76% of the children with reported perinatal problems were healthy in early childhood, and 87% of the children with long-term morbidity during childhood had no perinatal problems. These findings suggest that when assessing risk factors and health care technology, it is not enough to only monitor perinatal health status. Rather, long-term follow-ups are also needed.