FETAL AND NEONATAL MEDICINE Comprehensive assessment of the health status of extremely low birth weight children at eight years of age: Comparison with a reference group Saroj Saigal, MD, FRCP(C), Peter Rosenbaum, MD, FRCP(C), Barbara Stoskopf, RN, Lorraine Hoult, BA, William Furlong, BSc, David Feeny, PhD, Elizabeth Burrows, MBA, and George Torrance, PhD From the Departments of Pediatrics and of Clinical Epidemiology and Biostatistics, and the Centre for Health Economics and Policy Analysis, McMaster University, Hamilton, Ontario, Can- ada Objective: To apply a multiattribute health status (MAHS) classification system to data available on two cohorts of school-aged children to describe several dimensions of health simultaneously. The MAHS system describes both the type and severity of functional limitations according to seven attributes: sensation, mobility, emotion, cognition, self-care, pain, and fertility (fertility not applica- ble in this study), with four or five levels of function within each attribute. Design: The MAHS system was applied retrospectively to clinical and psycho- metric data collected prospectively at age 8 years. MAHS application was by selection of items from the database and development of computer-assisted algorithms to assign functional levels within each attribute. Setting: Geographically defined region in central-west Ontario, Canada. Participants: One hundred fifty-six extremely low birth weight (ELBW) survivors born between 1977 and 1982 (follow-up rate 90%) and 145 reference children matched for age, sexl and socioeconomic status. Results: 14% of ELBW subjects had no functional limitations, 58% had reduced function for one or two attributes, and 28% had at least three affected. The cor- responding figures for the reference group were 50%, 48%, and 2% (p <0.0001). The limitations were more severe and complex in the ELBW group, and were no- tably in cognition (58%), sensation (48%), mobility (21%), and self-care (17%), compared with 28%, 11%, 1%, and 0% for reference children (all p <0.0001). Conclusions: These data indicate that fewer ELBW than reference children were free of functional limitations and a significantly highe r proportion had multiple attributes affected. The MAHS classification approach is a useful instrument to compare the health status of different groups and populations, and to monitor changes with time. (J PEDIATR 1994;125:411-7) Supported by grant No. XG 92-043, Hospital Yor Sick Children Foundation, Toronto, Ontario, Canada. Presented at the Society for Pediatric Research, Washington, D.C., May 1993; the Canadian Pediatric Society, Vancouver, British Columbia, Canada, June 1993; the European Society for Pediatric Research, Edinburgh, Scotland, September 1993; and the Amer- ican Academy of Cerebral Palsy and Developmental Medicine, Nashville, Tenn., October 1993. Submitted for publication Feb. 28, 1994; accepted April 18, 1994. Reprint requests: Saroj Saigal, MD, Department of Pediatrics, McMaster University, 1200 Main St. West, Hamilton, Ontario, L8N 3Z5, Canada. Copyright | 1994 by Mosby-Year Book, Inc. 0022-3476/94/$3.00 + 0 9/23/56806 411