Parent-reported infant health and illness in a whole year birth cohort.

OBJECTIVE: To describe parent-reported infant health and illness experience at 8 weeks.
SETTING: Coventry. STUDY
DESIGN: Prospective whole year birth cohort. OUTCOME MEASURES: Period prevalences (birth to 8 weeks) and incidences, unadjusted and adjusted for differential cohort attrition, of parent-reported infant health outcomes.
METHODS: Of 3891 live births in 1996, 2572 (66%) were recruited into the study. Data were collected by health visitors as part of routine child health surveillance, at 8 weeks using the Warwick Child Health and Morbidity Profile (WCHMP) incorporated into the Parent Held Record. Period prevalences and incidences of parent-reported health outcomes in the first 8 weeks of life were calculated with and without adjustment for the effects of different rates of cohort attrition by sociodemographic group.
RESULTS: Data were collected on 2572 infants at recruitment. Health outcome data were available on 2072 (53% of all 1996 live births) infants at 8 weeks. There was differential attrition by social group between enrollment and 8 weeks. Nineteen (95% confidence intervals (CIs) 14,24)/1000 infants were reported as not very healthy/unhealthy, 12 (95% CIs 8,16)/1000 as having impaired health-related quality of life and 11 (95% CIs 7,15)/1000 impaired functional health. Chronic illness had a period prevalence rate of 19 (95% CIs 14,24)/1000. Sixty-six (95% CIs 55,77)/1000 had acute illnesses requiring medical attention and 43 (95% CIs 34,52)/1000 were admitted to hospital at least once. More minor illness than expected was reported in 87 (95% CIs 75,99)/1000. The incidence rate of accidents requiring medical attention was 16 (95% CIs 9,21)/1000. Behavioural problems had a prevalence rate of 78 (95% CIs 66,90)/1000.
CONCLUSIONS: Infant health status data have traditionally been based on mortality, hospital admissions and specific diagnoses. This is the first report of health and illness experience during infancy in a whole year birth cohort based on a validated measure of parent-reported health status incorporated into the Parent Held Record and administered by the family health visitor as part of routine child health surveillance. These data give a more comprehensive picture of infant health and illness experience than traditional measures and provide the basis for infant health needs assessment.